The Clinical Guide to Services is a comprehensive reference guide of testing services, shipping information and submission requirements. Efforts have been made to be concise and current with all information, but as testing procedures and regulations change, some information may not be current. Many of these tests are only available with prior approval from MDH. It is impossible to address all situations in this guide, so please contact us with any questions.

Collection and Transport of
Samples for Botulism Testing

On this page:
Suspected Foodborne Botulism
Suspected Infant Botulism
Suspected Wound Botulism
Suspected Intentional Toxin Release
Shipping Requirements
Suspected Foodborne Botulism
Acceptable Specimens
Required Volume/Comments
Toxin Assay (T) or Culture (C) Performed
Serum (Priority Sample Type) 5 ml (less results in incomplete testing) T
Gastric contents 20 ml, anaerobic transport system
T, C
Vomitus 20 ml, anaerobic transport system
T, C
Stool 25-50 g (walnut-size) collected before anti-toxin treatment.
T, C
Sterile water enema


 Collect using a minimal amount of water, before anti-toxin treatment.
T, C
Implicated consumed food – commercial or home-prepared

 Leave foods in their original containers, if possible, or transfer to sterile, leak-proof containers. Empty containers with remnants of food are acceptable. T, C
Unopened home-prepared food from the batch consumed by the patient
 Leave foods in their original containers.
T, C
Unopened commercial products Products are referred immediately to the FDA. T, C
Back to Agent: Clostridium botulinum

Suspected Infant Botulism
Acceptable Specimens Required Volume/Comments Toxin Assay (T) or Culture (C) Performed
Stool (Priority Sample Type) As above.
T, C
Sterile water enema


 As above.
T, C
Serum

 3 ml (0.5 ml will allow screening but incomplete testing) T
Rectal Swab
 More useful for culture than toxin detection.
C
Potential Sources Include honey, opened formula (Unopened commercial products are referred to the FDA.), other foods/liquids fed to the infant. Environmental sampling is discouraged. C
Back to Agent: Clostridium botulinum

Suspected Wound Botulism
Acceptable Specimens
Required Volume/Comments
Toxin Assay (T) or Culture (C) Performed
Serum (Priority Sample Type) 5 ml (less results in incomplete testing)
T
Wound swab


 Anaerobic transport system
C
Tissue or exudate

 Anaerobic transport system C
Stool
 To rule out foodborne botulism. Collect as above
T,C
Back to Agent: Clostridium botulinum

Suspected Intentional Toxin Release
Acceptable Specimens Required Volume/Comments Toxin Assay (T) or Culture (C) Performed
Clinical material Serum, stool, sterile water enema as above.
T
Food


 As above.
T
Environmental swabs

 Send in individual clean, dry containers T
Back to Agent: Clostridium botulinum

Shipping Requirements

Notify the laboratory in advance (651-201-5253).
  • Collect and transport clinical samples in sterile, leak-proof containers.
  • Leave foods in their original containers, if possible, or place in sterile leak-proof, unbreakable containers. Place each container in a separate sealed plastic bag to prevent cross-contamination during shipping. Label completely.
  • Ship by the most rapid means available.
  • Store and ship specimens in anaerobic transport systems at room temperature.
  • Store and ship all other specimens at 4ºC.
  • Freezing should be avoided as it decreases recovery of C. botulinum and may decrease toxin activity. However, if a delay of more than several days cannot be avoided, freeze samples for storage and ship frozen.


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