Test: Stool Culture for Enteric Pathogens, STOCU 
  Synonym: Enteric Pathogens Culture, Routine Stool, Feces Culture 
  Method: Standard culture for Salmonella, Shigella, and Campylobacter and qualitative Enzyme Immunoassay for Shiga-like toxin (Hemorrhagic E. coli
  Availability: Daily, final report at 2 days for negatives. Positives are reported as soon as detected. 
  Specimen: Stool 
  Collection Device: Stool container or enteric transport media e.g., Cary-Blair media 
  Volume: 1 - 5 mL fresh stool or 10.0 mL stool 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 in a 24 hour period), dry specimen, delayed transport to lab without use of appropriate preservative, specimen in diapers. 
  Specimen Stability: Fresh stools stable at room temperature for up to 2 hours. Preserved stool in transport media 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 for Salmonella, Shigella and Campylobacter and Shiga-like toxin 
  Reportable Disease: Positive result for Salmonella, Shigella and Campylobacter, or Shiga-like toxin is reportable. 
  Comments: A routine stool culture should be ordered for the primary diagnosis of an enteric bacterial pathogen.

The Shiga-like toxin EIA portion of this test will identify the presence of shigatoxin-positive E. coli in stool; however, it cannot determine the specific strain of E. coli (e.g. E. coli O157:H7).

The Shiga-like toxin EIA (SHIGA) test can be ordered as a single test in cases for proof-of-cure testing following a primary diagnosis of enterohemorrhagic E.coli-caused infection in an outbreak OR where a screen for the primary detection of a Shiga-like toxin-producing E. coli is requested.

All shigatoxin positive stools (preserved in enteric transport media, Cary-Blair media) should be sent to the NPHL for isolation of the shigatoxin positive E. coli for DNA fingerprinting (PFGE) and if not already determined, for serotyping (send as a Category B specimen). Order as E. coli (Hemorrhagic) Culture, Stool, HECCU.

Routine stool cultures are not recommended from patients hospitalized for greater than 3 days, unless the patient is known to be HIV positive or the request has been approved by the Microbiology Medical Director. 
  Revised: 2/2/2012