Enterohemorrhagic <i>E. coli</i> (EHEC) Shiga Toxin, EIA
| Enterohemorrhagic E. coli (EHEC) Shiga Toxin, EIA | | | |
| Number | | 180935 |
| CPT | | 87427 |
| Synonyms | | E. coli O157 ; EHEC, Stool Culture ; Enterohemorrhagic E. coli ; Shiga Toxin |
| Specimen | | Stool or rectal swab placed in stool culture transport vial |
| Volume | | 1-2 g, 1-2 mL, or one swab |
| Minimum Volume | | Rectal swab with obvious stool |
| Container | | Stool culture transport vial; culture collection swab may be used to collect rectal swabs or a swab of fecal material, then swab should be placed in stool culture transport vial (ParaPak orange). |
| Storage Instructions | | Maintain specimen at room temperature. |
| Causes for Rejection | | Specimen received in grossly leaking transport container; diapers; dry specimen; specimen submitted in fixative or additive; specimen received in expired transport media or incorrect transport device; inappropriate specimen transport conditions (not in a C&S vial or in an overfilled C&S vial); specimen received after prolonged delay in transport (usually more than 72 hours); specimen stored or transported frozen; wooden shaft swab in transport device; unlabeled specimen or name discrepancy between specimen and request label |
| Reference Interval | | No enterohemorrhagic E. coli Shiga toxin detected |
| Use | | Detect the presence of Shiga-toxin-producing enterohemorrhagic E. coli |
| Limitations | | There are four types of pathogenic E. coli. See table. This test detects only enterohemorrhagic E. coli; tests are not available for the other pathogenic E. coli. Four Major Categories of Diarrheagenic E. coli
| Category | Abbreviation | Clinic Manifestation | | Enterotoxigenic | ETEC | Travelers diarrhea and infant diarrhea in less developed countries | | Enteropathogenic | EPEC | Infant diarrhea | | Enterohemorrhagic | EHEC | Hemorrhagic colitis
Hemolytic uremic syndrome
Thrombotic thrombocytopenia purpura | | Enteroinvasive | EIEC | Dysentery |
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| Methodology | | Detection of enterohemorrhagic E. coli Shiga toxins by enzyme immunoassay (EIA) |
| Additional Information | | Hemorrhagic colitis can be differentiated from other causes of diarrhea by its progression from watery to bloody diarrhea over a few days time. Fecal leukocytes are markedly increased. Fever is usually absent. The disease is mediated by the production of a Shiga-like toxin that interferes with colonic brush border cells, protein synthesis, and ultimately causes cell death. Enterohemorrhagic E. coli (EHEC) differ from other strains of bacteria in the large amount of toxin they produce. Virtually all O157:H7 organisms and other EHEC strains have been shown to produce Shiga toxin. |
| References | | Gavin PJ and Thompson RJ, “Diagnosis of Enterohemorrhagic Escherichia coli Infection by Detection of Shiga Toxins,” Clin Microbiol Newslet, 2004, 26:49-54. Griffin PM, Ostroff SM, Tauxe RV, et al, “Illnesses Associated With Escherichia coli O157:H7 Infections. A Broad Clinical Spectrum,” Ann Intern Med, 1988, 109(9):705-12 (review). Park CH, Kim HJ, Hixon DL et al, “Importance of Testing Stool Specimens for Shiga Toxins,” J Clin Microbiol, 2002, 40(9):3542-3. |
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