Sereny Test: Detecting Shiga Toxin-Producing E. coli (STEC)
What Is the Sereny Test?
The Sereny test (Vero cell cytotoxicity assay) detects Shiga toxin–producing Escherichia coli (STEC) in stool samples. It identifies the cytotoxic effect of Shiga toxins (Stx1/Stx2) on Vero cells (African green monkey kidney cell line).
Principle
- Stool filtrate applied to Vero cell monolayer.
- If STEC present, Shiga toxins cause cytopathic effect (CPE): cell rounding, detachment, death.
- Cell death releases lactate dehydrogenase (LDH) into supernatant.
- LDH quantified spectrophotometrically → proportional to toxin concentration / STEC load.
Interpretation
- Positive: Significant CPE/LDH release → STEC detected.
- Negative: No CPE → STEC not detected (but doesn't rule out other pathogens).
Clinical Context
- Used in reference labs for outbreak investigation, severe cases (HUS risk).
- Complements culture (sorbitol-MacConkey) and PCR for stx genes.
- Not routine for all diarrheal stools; reserved for bloody diarrhea, HUS suspicion, epidemiological need.
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