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Test ID E157C Escherichia coli O157:H7 Culture, Feces


Additional Testing Requirements


In some cases, local public health requirements may impact Mayo Clinic Laboratories clients, requiring, for example, submission of isolates to public health laboratories. Clients should familiarize themselves with local requirements and are responsible for submitting isolates to appropriate public health laboratories. Clients can obtain isolates of Escherichia coli O157:H7 species recovered from specimens submitted to Mayo Clinic Laboratories by calling 800-533-1710 as soon as possible after reporting (to ensure viability of the bacterium).



Shipping Instructions


Specimen must arrive within 96 hours of collection.



Necessary Information


Specimen source is required.



Specimen Required


Patient Preparation: Medications: Do not use barium or bismuth before specimen collection.

Supplies: Culture and Sensitivity Stool Transport Vial (T058)

Container/Tube: Commercially available transport system specific for recovery of enteric pathogens from fecal specimens (15 mL of non-nutritive transport medium containing phenol red as a pH indicator, either Cary-Blair or Para-Pak C and S)

Specimen Volume: Representative portion of fecal specimen

Collection Instructions:

1. Collect fresh feces and submit 1 gram or 5 mL in container with transport medium.

2. Place feces in preservative within 2 hours of collection.

3. Place vial in a sealed plastic bag.


Secondary ID

606219

Useful For

Determining whether Escherichia coli O157:H7 may be the cause of diarrhea

 

Reflexive testing for Shiga toxin and/or E coli O157:H7 nucleic acid amplification test-positive feces

 

This test is generally not useful for patients hospitalized more than 3 days because the yield from specimens from these patients is very low, as is the likelihood of identifying a pathogen that has not been detected previously.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
GID Bacteria Identification No, (Bill Only) No
ISAE Aerobe Ident by Sequencing No, (Bill Only) No
REFID Additional Identification Procedure No, (Bill Only) No
EC Serologic Agglut Method 2 Ident No, (Bill Only) No
RMALD Ident by MALDI-TOF mass spec No, (Bill Only) No

Testing Algorithm

When this test is ordered, the reflex tests may be performed at an additional charge.

 

For more information see Laboratory Testing for Infectious Causes of Diarrhea.

Method Name

Conventional Culture

Reporting Name

E. coli O157:H7 Culture, F

Specimen Type

Fecal

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time
Fecal Ambient (preferred) 4 days
  Refrigerated  4 days

Clinical Information

Diarrhea may be caused by a number of agents, including bacteria, viruses, parasites, and chemicals; these agents may result in similar symptoms. A thorough patient history covering symptoms, severity and duration of illness, age, travel history, food consumption, history of recent antibiotic use, and illnesses in the family or other contacts will help the healthcare provider determine the appropriate testing to be performed.

 

Shiga toxin-producing Escherichia coli (STEC) are E coli strains capable of producing Shiga toxin, which can result in diarrhea that can be bloody. The incubation period between exposure and symptom onset is 1 to 9 days. Hemolytic-uremic syndrome (HUS) is a systemic complication of STEC infection and is characterized by kidney failure, microangiopathic hemolytic anemia, and nonimmune thrombocytopenia. HUS complicates approximately 15% of STEC infections in children younger than 10 years and 6% to 9% overall.

 

Treatment of STEC infection consists of supportive care. Antibiotic therapy is generally not beneficial in patients with STEC infection and has been associated with development of HUS in some studies. Thus, when STEC is clinically suspected, antibiotics should be withheld. Antiperistaltic agents also increase the risk of systemic complications and should be avoided.

Reference Values

No growth of pathogen

Cautions

The yield of Escherichia coli O157:H7 is reduced when specimens are delayed in transit to the laboratory (>2 hours from collection for unpreserved specimens).

 

Check local public health requirements, which may require submission of isolates to a public health laboratory.

 

Primary testing for Shiga toxin-producing E coli using Shiga toxin PCR and not specifically just for E coli O157:H7 is recommended because roughly half of Shiga toxin-producing E coli are not O157:H7.

 

Susceptibilities should not be performed on E coli O157:H7 since antibiotics are not used for treatment. Any healthcare provider contemplating a request for susceptibility testing on E coli O157:H7 should consult with the Laboratory Section Director for guidance.

Day(s) Performed

Monday through Sunday 

Report Available

2 to 4 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

87046-Escherichia coli O157:H7 Culture, Stool-with isolation and preliminary examination

87077-Bacteria Identification (if appropriate)

87153-Aerobe Ident by Sequencing (if appropriate)

87077-Additional Identification Procedure (if appropriate)

87147-Serologic Agglut Method 2 Ident (if appropriate)

87077-Ident by MALDI-TOF mass spec (if appropriate)

NY State Approved

Yes