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Shiga Toxin-producing E. coli Isolation from Enrichment Broth
 CDC-10105

Synonym(s)
Escherichia, STEC, E. coli, enrichment broth
CDC Pre-Approval Needed
Haley McKeel
(404) 639-1612
hvw0@cdc.gov
Nancy Strockbine
(404) 639-4186
nas6@cdc.gov
Supplemental Information Required
Complete one CDC 50.34 Specimen Submission Form per specimen and provide the following specimen information:  "Specimen source (type)" and "Transport medium/Specimen preservative." Provide any preliminary results in the "Previous laboratory results" section of the CDC 50.34 Specimen Submission Form.
Supplemental Form
Performed on Specimens from
Human, Animal, and Food/Environmental/Medical Devices/Biologics
Acceptable Sample/ Specimen Type for Testing

Submit only broths that are positive for Shiga toxins (Stx1/Stx2) or the genes encoding these toxins and produce growth on subculture. Consult with CDC POC before sending other specimen types or fecal specimens in enrichment broth that are Stx+/stx+ but no growth of STEC on subculture.

Minimum Volume Required
5 mL (broth)
Collection, Storage, and Preservation of Specimen Prior to Shipping
Refrigerate specimen at 2-8 °C.
Transport Medium
Gram Negative Broth (GN), MacConkey Broth, MacConkey Sorbitol Broth, or similar enrichment broth
Specimen Labeling
Research or surveillance specimens may be labeled according to protocol. Labels should not include personally identifiable information. The results reported should NOT be used for diagnosis, treatment, assessment of health or management of the individual patient.
Shipping Instructions which Include Specimen Handling Requirements
CDC does not accept routine shipments on weekends or holidays. Please make sure packages arrive Monday – Friday. Ship with ice-packs. Shiga toxin-positive broths should be shipped as Category A Infectious Substances.

Ship To:
[Insert CDC Point of Contact]
Centers for Disease Control and Prevention
RDSB / STATT Unit 7
1600 Clifton Road, NE
Atlanta, GA 30329
[Insert CDC Point of Contact’s Telephone Number]

All samples must be shipped in accordance with all applicable local, state and federal regulations.

Methodology
Isolation, Phenotypic or Genetic Identification and Subtyping, including Serotyping and Virulence Profiling
Turnaround Time
20 Weeks
Interferences & Limitations
Virulence and serotype modification genes encoded by mobile genetic elements (bacteriophages, plasmids and pathogenicity islands) may be spontaneously lost during transit and storage.  Conditions that induce a stress response in the bacterium can affect the stability of virulence factors and may affect the expression of O and H antigens.
Additional Information
A final report will be issued for broths that are not confirmed as positive by PCR for STEC or from broths that are confirmed as positive by PCR but from which an STEC isolate can not be obtained.  Identification, serotyping, and virulence profiling will be performed on recovered STEC isolates, and a final report will be issued when all testing is complete. Consult with Dr. Nancy Strockbine if a preliminary report is needed.
CDC Points of Contact
Nancy Strockbine
(404) 639-4186
nas6@cdc.gov
Haley McKeel
(404) 639-1612
hvw0@cdc.gov
Devon Stoneburg
(404) 639-2251
euo4@cdc.gov


Version
2.2