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Testing Results
IMPORTANT! Sites requesting testing must have approval from the appropriate state or local health department before submitting specimens. Approval must be sent to NPHL by email at or by calling (402) 559-9444.

A Special Microbiology Form must accompany the specimens. Some tests require additional forms and patient history. This will be listed below when applicable. When requested, testing will not be performed without all required information.

Please call NPHL Client Services at (402) 559-2440 or toll free at (866) 290-1406 for further clarification.


  Test: ShigaToxin EIA (E. coli) Proof-of-Cure, SHIGA 
  Synonym: Shigatoxin testing, E. coli 0157H7, Shiga-like toxin EIA 
  Method: Qualitative Enzyme Immunoassay 
  Availability: Daily; final report at days for negatives. Positives are reported as soon as detected. 
  Specimen: Stool 
  Collection Device: Stool container or enteric transport media (Cary-Blair media) 
  Volume: 1 - 5 mL fresh stool or 10 mL in transport media 
  Storage/Transport: Transport stool unpreserved at room temperature. If transport delayed > 2 hours, preserve stool in transport media (Category B shipment) 
  Unacceptable: Non-sterile or leaking container, multiple specimens (more than 1 stool in a 24 hour period), dry specimens, delayed transport to lab without use of appropriate preservative, specimen in diapers. GN or MAC and Blood Agar plates (BAP) strongly discouraged due to low recovery 
  Specimen Stability: Fresh stool stable at room temperature for up to 2 hours. Preserved stool in transport media is stable at room temperature for up to 48 hours, refrigerated for up to 4 days, and frozen for up to 1 week. 
  Reference Interval: Negative 
  Reportable Disease: Positive result is reportable 
  Comments: For primary diagnosis of an entire bacterial pathogen, a routine stool culture (STOCU) should be ordered which includes culture for Salmonella, Shigella, and Campylobacter as well as an EIA for Shiga-like toxin from E. coli.

The Shiga-like toxin EIA can be used as a test for proof-of-cure testing following a primary diagnosis of enterohemorrhagic E. coli-caused infection.

This test will identify the presence of Shiga-like toxin E. coli in stool; however, it cannnot determine the specific strain of E. coli (e.g. E. coli O157:H7).

This test can be performed on either a stool sample or on an actively growing isolate of E. coli in pure culture. Stool is shipped Category B and an isolate is shipped Category A.

See HECCU, Hemorrhagic E. coli culture, for culture confirmation orders. 
  Revised: 2/2/2012 


If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (866) 290-1406.