Enterohemorrhagic E coli (EHEC) Shiga Toxin, EIA

CPT: 87427
Updated on 11/1/2017
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Test Details

Synonyms

  • E coli O157
  • EHEC, Stool Culture
  • Shiga Toxin

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

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

Methodology

Detection of enterohemorrhagic E coli Shiga toxins by enzyme immunoassay (EIA)

Reference Interval

No enterohemorrhagic E coli Shiga toxin detected

Additional Information

Treatment of patients infected with Enterohemorrhagic E coli (EHEC) with antibiotics is contraindicated. Hemorrhagic colitis can be differentiated from other causes of diarrhea by its progression from watery to bloody diarrhea during 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.

Specimen Requirements

Specimen

Stool or rectal swab placed in stool culture transport vial

Volume

1 to 2 g, 1 to 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 (Para-Pak® 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

Clinical Information

References

Gavin PJ, 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 Nov 1; 109(9):705-712.3056169
Park CH, Kim HJ, Hixon DL et al. Importance of testing stool specimens for Shiga toxins. J Clin Microbiol. 2002 Sep; 40(9):3542-3543. Erratum: J Clin Microbiol. 2003 Jan; 41(1):526.. 12202617

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
180935 E coli Shiga Toxin EIA 21262-1 180935 E coli Shiga Toxin EIA 21262-1

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