Shiga toxin-producing Escherichia coli (NPHLBK) (HECCU)  

 
NPHL has moved to an electronic ordering system, NUlirt, and it is now the preferred method to order all tests. Once ordered, print a "batch list" (see NUlirt Guide).

Forms Required - NUlirt batch list of NPHL Test Request Form (completed in its entirety) must accompany the specimen to include the following information: symptoms and date of onset, pregnancy status, travel and vaccine history. Testing will not be performed without all required information.

Please call NPHL Client Services at 402-559-2440 or toll free at 800-334-0459 for further clarification.

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Test: Shiga toxin-producing Escherichia coli
  • No pre-approval needed
  • NUlirt order:
    • Isolate: NPHLBK
    • Stool: HECCU
 
Synonym: E. coli, O157:H7, Shigatoxin positive, non-O157 E. coli, STEC, hemorrhagic E. coli, Shiga toxin  
Method:
  • Stool: 
    • Standard culture isolation methods
  • Isolate:
    • Banking
    • Whole Genome Sequencing performed for epidemiology purposes only
 
Availability:
  • Test performed Monday - Friday
  • Turnaround time 1 - 7 days
 
Specimen:
  • Pure isolate
  • Stool
 
Collection Device:
  • Stool specimens should be collected in Cary Blair or Enteric Plus transport media according to manufacturer's instructions
    • If fresh stool is received, it should be placed into transport media within 2 hours of collection
    • Ratio of stool to Enteric Plus is 2:15 (0.5 mL stool to 3.75 mL Enteric Plus liquid media)
  • Isolates on a plate or slant
  • Test subject to CLIA regulations and requires 2 patient identifiers on specimen container and requisition forms
 
Volume: Stool samples minimum: 1 mL  
Storage/Transport:
  • For shipping of isolates, see Category A shipping instructions
  • For shipping of stool specimens, see Category B shipping instructions
  • Specimen Packaging & Shipping - NPHL
  • Seal tubes with Parafilm™ or tape and place in biohazard bag with absorbent material
  • NUlirt packing list or appropriate paperwork (completed in its entirety) must accompany specimens
 
Unacceptable:
  • Leaking specimen
  • Mixed isolates
  • Stool contaminated with urine
 
Specimen Stability:
  • Isolates stable at ambient air 15°-25° C
  • Stool stable at 2°-8° C up to 4 days
 
Comments:
  • Isolation of E. coli from stool performed at Nebraska Medicine
  • Banking and Whole Genome Sequencing performed at NPHL
  • Test results are to be used for epidemiological and infection control purposes only
 
Revised: 10/24/2025 
If you have questions about proper specimen collection, please call NPHL Client Services at 402-559-2440 or toll free at 800-334-0459.

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