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Class IgE kU/L Interpretation<br />

0 Negative<br />

1 0.35-0.69 Equivocal<br />

2 0.70-3.49 Positive<br />

3 3.50-17.4 Positive<br />

4 17.5-49.9 Strongly positive<br />

5 50.0-99.9 Strongly positive<br />

6 > or =100 Strongly positive Reference values<br />

apply to all ages.<br />

Clinical References: Homburger HA: Allergic diseases. In Clinical Diagnosis and Management by<br />

Laboratory Methods. 21st edition. Edited by RA McPherson, MR Pincus. New York, WB Saunders<br />

Company, 2007, Chapter 53, Part VI, pp 961-971<br />

800071 Shiga Toxin Escherichia coli Antigen, Feces<br />

Clinical Information: Shiga toxin-producing Escherichia coli (STEC) have been recognized as<br />

agents of diarrhea and of sporadic cases and serious outbreaks of life-threatening hemorrhagic colitis and<br />

hemolytic uremic syndrome (HUS). Escherichia coli O157:H7 is the most frequently isolated<br />

enterohemorrhagic Escherichia coli (EHEC) serotype, but at least 50 serotypes have been implicated in<br />

the production of cytotoxins and development of complications. Conventional testing methods for<br />

Escherichia coli O157: H7 involve isolation of the organism from fecal cultures followed by biochemical<br />

and immunologic confirmation. This method usually requires 72 hours for complete identification. At this<br />

time, because antimicrobial therapy does not appear to be useful for treating the disease and may even<br />

increase the risk of HUS, recovery of Escherichia coli O157: H7 by culture for antimicrobial<br />

susceptibility testing is not necessary. The rapid diagnosis of Escherichia coli O157:H7 directly from fecal<br />

specimens is preferred to avoid unnecessary diagnostic procedures and inappropriate antimicrobial<br />

therapy and to identify common sources linked to transmission.<br />

Useful For: Rapid screening for EHEC serotypes including Escherichia coli O157:H7. This test should<br />

serve as an adjunct to culture. However, in some situations when recovery of the organism by culture is<br />

not optimal (e.g. delayed transport of the specimen or transport of the specimen in preservative), or when<br />

isolation of the organism is not required for epidemiologic studies, this test may be considered as the<br />

preferred diagnostic method.<br />

Interpretation: A positive result suggests the presence of Shiga-like toxin 1 or 2. It is recommended<br />

that all positive specimens be cultured to confirm the presence of enteropathogenic coli. A negative result<br />

does not rule out the presence of enteropathogenic Escherichia coli; detectable antigen levels may not be<br />

produced until 3-6 days after the development of symptoms.<br />

Reference Values:<br />

Negative<br />

Clinical References: 1. Karmali MA: Infection by verocytotoxin-producing Escherichia coli. Clin<br />

Microbiol Rev 1989;2:15-38 2. Karmali MA, Petric M, Lim C, et al: The association between idiopathic<br />

hemolytic uremic syndrome and infection by verotoxin-producing Escherichia coli. J Infect Dis<br />

1985;151:775-782 3. Griffin PM, Ostroff SM, Tauxe RV, et al: Illnesses associated with Escherichia coli<br />

O157:H7 infections. A broad clinical spectrum. Ann Intern Med 1988;109:705-712 4. Wong CS, Jelacic<br />

S, Habeeb RL, et al: The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia<br />

coli O157:H7 infections. N Engl J Med 2000;342:1930-1936<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 1590

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