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Test Code SCAFB Culture, Acid-Fast and Smear

Important Note

Swabs are not an acceptable specimen, unless the sample is collected with an ESwab.  Each Acid Fast culture must have it's own ESwab.  Do not add on with other tests.

Methodology

Culture Isolation and Identification of Mycobacteria Species

Note: Analytic time for culture is 6-8 weeks.

Performing Laboratory

State Hygienic Laboratory (SHL)-Iowa City

Specimen Requirements

Acceptable Specimens:

Body fluids, bone marrow, bronchoscopy, draining wounds (excision biopsy), gastric aspirate, spinal fluid, sputum or tracheal aspirate, tissue (incision or biopsy), or urine.  ESwab is the only acceptable swab specimen.NOTE: if there is a delay in transport to the lab, specimen should be kept refrigerated until transport.

 

Body Fluid

1. Submit 3 mL to 10 mL of body fluid in a screw-capped, sterile container or capped syringe.

2. Maintain sterility and forward promptly.

Note: Indicate specimen source on specimen container and in computer.

 

Bone Marrow

1. Submit 2 mL to 3 mL of bone marrow in a sterile, screw-capped container. Specimen will be collected at patient’s bedside by physician or pathologist.

2. Maintain sterility and forward promptly.

Note: Indicate specimen source on specimen container and in computer.

 

Bronchoscopy

1. Submit 3 mL to 10 mL of aspirated bronchial secretions in a screw-capped, sterile container. (Avoid contamination with tap water.)
2. Maintain sterility and forward promptly.

Note: Indicate specimen source on specimen container and in computer.

 

Draining Wounds (Excision Biopsy)

1. Submit specimen in a screw-capped, sterile container or capped syringe, if aspirate. (Swab is not acceptable, unless it's an ESwab.)

2. Maintain sterility and forward promptly.

Note: Indicate specimen source on specimen container and in computer.

 

Gastric Aspirate

1. Submit 3 mL to 10 mL of gastric aspirate fluid (from nasogastric tube) in the early-morning in a screw-capped, sterile container.

2. Maintain sterility and forward promptly.

Note: Indicate specimen source on specimen container and in computer.

 

Spinal Fluid

1. Submit ≥3 mL of spinal fluid in a screw-capped, sterile container or capped syringe. 

2. Maintain sterility and forward promptly.

Note: Indicate specimen source on specimen container and in computer.

 

Sputum or Tracheal Aspirate

1. Submit 3 mL to 10 mL of sputum or tracheal aspirate collected each day for 3 to 5 successive mornings upon awakening in a screw-capped, sterile container. (Swab is not acceptable, unless it's an ESwab.)
2. Specimen should be a single, first-morning, “deep-cough” sputum or tracheal aspirate specimen.

3. Maintain sterility and forward promptly.  If there is a delay in specimen delivery, keep specimen refrigerated until transported.

Note: Indicate specimen source on specimen container and in computer.

 

Tissue (Incision or Biopsy)

1. Submit fresh tissue or tissue in a small amount of saline (no formalin) in a screw-capped, sterile container. (Swab is not acceptable, unless it's an ESwab.)

2. Maintain sterility and forward promptly.

Note: Indicate specimen source on specimen container and in computer.

 

Urine

1. Submit ≥40 mL of urine from the first-morning void in a screw-capped, sterile container. Collect 1 specimen each day for 3 consecutive days.

2. Maintain sterility and forward promptly.

Note: Indicate specimen source on specimen container and in computer.

Reference Values

Negative

Critical value: all positives

Day(s) Test Set Up

Monday through Friday; 0700 to 1530

Test Classification and CPT Coding

87015-Concentration

87116-Culture

87206-Smear

87118-Biochemical, definitive identification, each isolate (if appropriate)

87149-Identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed (if appropriate)