Shiga Toxins, EIA with Reflex to E.coli O157 Culture

Test Code

CPT Codes

If Shiga Toxin, EIA is Detected, then Escherichia coli O157, Culture will be performed at an additional charge (CPT code(s): 87046).

Preferred Specimen
Stool collected in Cary-Blair stool culture transport medium or C&S transport medium

Minimum Volume
1 gram • 1 mL • 40mm diameter of solid stool

Other Acceptable Specimens
Unpreserved stool (formed, liquid or semi-solid)

Collect in clean, dry container and then transfer a minimum of 1 gram or 1 mL into a Cary-Blair stool culture transport medium. Fluid level should reach line on vial.

Transport Temperature
Cary-Blair and C&S: Room temperature
Unpreserved: Refrigerated (cold packs)

Specimen Stability
Cary-Blair or C&S
Room temperature: 4 days
Refrigerated: 14 days
Frozen: 14 days

Unpreserved stool
Room temperature: Unacceptable
Refrigerated: 14 days
Frozen: 14 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Specimens in formalin or other fixatives

Non-frozen specimens: Broth Amplified Immunoassay with culture reflex
Frozen specimens: Direct detection without amplification or culture

Setup Schedule
Set up: Mon, Wed, Fri; Report available: 4 days

False-positives occur in patients infected with Pseudomonas aeruginosa.

Reference Range
See Laboratory Report

Clinical Significance
STEC cause foodborne and waterborne diarrheal disease worldwide which, if left undiagnosed, can progress to hemorrhagic colitis and/or hemolytic uremic syndrome (HUS). Since certain treatments and medications can increase the risk of HUS, prompt detection is necessary to prevent outbreaks and secondary transmission. STEC produce either one or both Shiga toxins (Stx1 and/or Stx2), both potent cytotoxins. By detecting the toxins, an EIA can detect STEC present in fecal samples or culture, regardless of the serotype or other virulence factors.

Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.