title: Point: Should all stools be screened for Shiga toxin-producing Escherichia coli?
abstract: In October 2009, the Centers for Disease Control and Prevention recommended that clinical laboratories test all stools submitted for the detection of enteric bacterial pathogens for the presence of Shiga toxin-producing Escherichia coli (STEC). In order to do this, it is recommended that all stools be cultured for Escherichia coli O157:H7 on selective medium as well as that testing for the presence of Shiga toxin be done by immunoassay to detect non-O157 STEC (3). There are a variety of products that are FDA approved for detection of Shiga toxin. Further, it is recommended that Shiga toxin detection be done by testing overnight enrichment broth cultures of stools rather than directly examining stools for this toxin. This recommendation was made approximately 18 months ago. We have asked Mario Marcon of Nationwide's Children Hospital in Columbus, OH, to explain the rationale for his decision to follow this recommendation, while we have asked Deanna Kiska and Scott Riddell of Upstate University Hospital in Syracuse, NY, why these guidelines have not been adopted by their laboratory.
authors.affiliation: Department of Laboratory Medicine, Nationwide Children’s Hospital, Columbus, Ohio 43205, USA. mario.marcon@nationwidechildrens.org
authors.forename: Mario J
authors.initials: MJ
authors.lastname: Marcon
mesh_terms: D001431:Bacteriological Techniques / Q000191:economics / Q000379:methods*; D002487:Centers for Disease Control and Prevention, U.S.; D003470:Culture Media / Q000737:chemistry / Q000191:economics; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D005243:Feces / Q000382:microbiology*; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006801:Humans; D007118:Immunoassay / Q000191:economics / Q000379:methods; D015994:Incidence; D015995:Prevalence; D022621:Shiga Toxin / Q000032:analysis; D054323:Shiga-Toxigenic Escherichia coli / Q000302:isolation & purification*; D014481:United States / Q000453:epidemiology
chemical_list: D003470:Culture Media; D022621:Shiga Toxin