Test Order Name - Adult Clostridium botulinum Toxin Detection
Methodology - Mouse bioassay
Acceptable Specimen Type(s) for Testing - Pre-antitoxin serum (+/- stool). Alternative: gastric aspirate, excised tissues, post-antitoxin serum: please call for consultation.
Transport / Collection Medium -
Pre-antitoxin Serum: collect 15 milliliters of serum, NOT hemolyzed; submit in leak-proof container.
Stool: submit 10 to 25 grams of stool or enema in a clean, dry container without transport media
Storage and Preservation of Specimen - Refrigerate until transported to the laboratory (do not freeze). Serum and stool should be packaged and shipped on cold packs (not dry ice). Do not allow cold packs to directly contact the samples.
Minimum Volume Required - 15 milliliters of serum, 10 to 25 grams of stool or 20 milliliters of enema if solid stool cannot be obtained, ≥10ml of enriched broth.
Additional Collection Instructions -
Serum: Collect 30 ml of whole blood in Red, Yellow or Tiger top tubes. Centrifuge clot tubes to separate approximately 15 milliliters of serum and aliquot into transfer tubes before shipping or storage.
Enema: Collect an enema if patient is profoundly constipated. Collect fecal material using sterile, non-bacteriostatic water per rectum with a tube and syringe, or digital rectal examination. Do not use glycerin suppositories. Use a sterile urine cup as the primary collection container.
Storage conditions -
Serum: 7 days from time of collection when stored refrigerated at 2 to 8°C Do not freeze
Feces: 2 weeks from time of collection when stored refrigerated at 2 to 8°C Culture: Stable for 2 weeks from time of inoculation when stored refrigerated at 2 to 8°C, or incubated at 30 to 37°C
Additional Required Information - Consultation with San Francisco Communicable Disease Control at 628-217-6100 required.
Send Out? - Yes: Testing performed at the California Department of Public Health
Turnaround Time - Up to 15 days
Testing Restrictions - Consultation with San Francisco Communicable Disease Control required.
Limitations / Notes / Disclaimers - The following medications can interfere with the mouse bioassay to detect botulinum toxin: neostigmine bromide, neostigmine methyl sulfate, pyridostigmine bromide, edrophonium, ambenonium chloride. Note: botulinum toxin detection is not a rapid or STAT test; it is an "in-vivo reference test."