Enterohemorrhagic E coli (EHEC) Shiga Toxin, EIA

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Turnaround Time: 2 - 3 days
CPT Code:


Test Type: 1 to 2 g, 1 to 2 mL, or one stool or rectal swab
Reference Range:

No enterohemorrhagic E coli Shiga toxin detected.


Detect the presence of Shiga-toxin-producing enterohemorrhagic E coli.

There are four types of pathogenic E coli (see table). This test detects only enterohemorrhagic E coli; tests are not available for the other pathogenic E coli.

Four Major Categories of Diarrheagenic E coli



Clinic Manifestation

Enterotoxigenic (ETEC)

Travelers' diarrhea and infant diarrhea in less developed countries

Enteropathogenic (EPEC)

Infant diarrhea

Enterohemorrhagic (EHEC)

Hemorrhagic colitis

Hemolytic uremic syndrome

Thrombotic thrombocytopenia purpura

Enteroinvasive (EIEC)


Treatment of patients infected with Enterohemorrhagic E coli (EHEC) with antibiotics is contraindicated. Hemorrhagic colitis can be differentiated from other causes of diarrhea by its progression from watery to bloody diarrhea during a few days' time. Fecal leukocytes are markedly increased. Fever is usually absent. The disease is mediated by the production of a Shiga-like toxin that interferes with colonic brush border cells, protein synthesis, and ultimately causes cell death. Enterohemorrhagic E coli (EHEC) differ from other strains of bacteria in the large amount of toxin they produce. Virtually all O157:H7 organisms and other EHEC strains have been shown to produce Shiga toxin.

Gavin PJ, Thompson RJ. Diagnosis of enterohemorrhagic Escherichia coli infection by detection of Shiga toxins. Clin Microbiol Newslet. 2004; 26:49-54.

Griffin PM, Ostroff SM, Tauxe RV, et al, Illnesses associated with Escherichia coli O157:H7 infections. A broad clinical spectrum. Ann Intern Med. 1988 Nov 1; 109(9):705-712. PubMed 3056169

Park CH, Kim HJ, Hixon DL et al. Importance of testing stool specimens for Shiga toxins. J Clin Microbiol. 2002 Sep; 40(9):3542-3543. Erratum: J Clin Microbiol. 2003 Jan; 41(1):526.. PubMed 12202617

Collection Details:

Collection Instructions:

Stool culture transport vial; culture collection swab may be used to collect rectal swabs or a swab of fecal material, then swab should be placed in stool culture transport vial (Para-Pak® orange).

Maintain specimen at room temperature.