Aerobic bacterial culture, stain-12423

Test info

  
Aerobic bacterial culture, stain
  
12423
  
LAB12423
  
ABC
  
ABC
Aerobic culture
Miscellaneous culture
  
  • Culture
  • Gram stain
  • Identification, susceptibilities and serogrouping will be performed on all microbiology isolates considered by the laboratory to be significant.

Specimen

  
Abscess
Aspirate
Cyst
Drainage
Ear
Eye (eyelid, conjunctiva corneal scrapings, vitreous or anterior chamber fluid)
Nasal - Nasal for S.aureus (MRSA/MSSA) detection only see MRSA/MSSA
Placenta
Skin
Sinus
Ulcer
Wound or other miscellaneous sources

  
  

Wash away surface contamination with sterile water or saline before culturing; do not use a bacteriostatic agent.

  
  • Specify source
  

ESwab standard tip collection kit (white)

  
Sinus swab
  

ESwab mini-tip collection kit (green or blue)

  

Other bacterial culture swab

Sterile container

   

  

Other bacterial culture swab or sterile container

  

ESwab (standard or mini):

Ambient - 48 hours

Refrigerated - 48 hours

Other swab:

Ambient - 24 hrs of collection

Sterile container:

Ambient - 24 hrs of collection

  
  • Improper label (unlabeled or mislabeled)
  • Time delay between time of collection and receipt of specimen
  • Inappropriate timing of collection
  • Improper transport container
  • Improper transport temperature
  • Interfering substances
  • Inappropriate specimen type
  • Expectorated sputum with oropharyngeal contamination
  • Leaking container

Performance

  
AHL - Microbiology: M
  
Daily
  
Preliminary: 1 day
Final: 5 days
  

Culture

Clinical and Interpretive info

  

Work up of ENT specimens in the clinical microbiology laboratory

ENT sites (sinus, tonsils, nasal, etc.) are typically predominantly colonized by normal flora. Allina Health Laboratory follows clinical infectious disease society of America (IDSA) guidelines, clinical laboratory standards of institute’s (CLSI) guidelines, and any pertinent laboratory regulatory standards for appropriate performance and reporting of test results for any cultures, including ENT samples.

  • Antimicrobial susceptibility testing is not performed for every organism/result that has been reported, because the growth of every organism does not always signify the cause of infection.
  • Our Laboratory follows guidelines in performing automated susceptibilities for potential pathogens. Any other reported organisms are not always considered “causation,” and more often, they represent colonizers. Patient management should be considered within the clinical context.
  • Routine Susceptibility testing is not recommended for such organisms from ENT sites.
  • Some potential pathogens commonly associated with ENT infections, such as Haemophilus influenzae, Moraxella catarrhalis, Actinomyces, or Nocardia, do not have susceptibility testing results as Ampicillin/Penicillin or sulfonamide is typically the drug of choice.
  • Quality samples in appropriate transport media will produce quality results.
  • For single organisms reported indicating predominant bacteria in the normal flora does not always indicate causative agent. Susceptibilities can be requested if clinically indicated.

According to IDSA guidelines and the American Thoracic Society’s report:

  • Sinus specimens: In order to maximize optimal sensitivity and specificity of culture results and appropriate workup, swabs are not recommended for collecting sinus specimens
    • Aspirate is much more productive of true etiologic agent(s) and is the specimen of choice.
  • Surgical procedure samples (Tissues, aspirates, drainage from endoscopic guidance, ): are preferred over swabs.
  • Nasal drainage: Examination of nasal drainage materials may be of no or little clinical values to determine the cause of maxillary sinusitis (IDSA).

Supplemental information:

  • Examples of common colonizers of ENT sites: Coagulase Negative Staphylococcus, Corynebacterium species, Streptococcus viridans, Saprophytic Neisseria, etc,.
  • The explanation of mixed or Normal flora in microbiology reports: Most ENT cultures are reported as “mixed flora” or normal flora, when there are no apparent pathogens and only have an overwhelming amount of mixed colonizing microorganisms. Antimicrobial susceptibility testing should not be performed on normal flora.

Society literature References for additional information:

Microbiology of Sinusitis | Proceedings of the American Thoracic Society (atsjournals.org)

Billing

  
87070
87205
Additional CPT codes:
87186 - Sensitivities (if appropriate)
87077 - ID (if appropriate)
this list may not be all inclusive if there is the need to send the ID or sensitivities out to a referral laboratory

Tracking

  
03/05/2014
  
03/24/2022
  
12/01/2021