AFB culture & smear
AFB culture & smear-6617
Mycobacteria
Mycobacterium
TB
Nocardia
Identification, susceptibilities and serogrouping will be performed on all microbiology isolates considered by the laboratory to be significant.
Isolation of Mycobacterium and Nocardia from clinical specimens.
Sterile container
| Specimen | Recommended quantity | Special instructions |
|---|---|---|
| Body fluid | Adult: >10mL Child (≤14 yrs): ≥1mL |
If specimen might clot, place in a sterile sodium heparin tube (Lithium heparin and EDTA are unacceptable). Transport refrigerated. |
| Bone marrow | As much as possible | Collect aseptically in sodium heparin (Lithium heparin is unacceptable). Do not refrigerate; transport at ambient (room) temperature. |
| Bronchial washing | Adult: ≥5mL Child (≤14 yrs): ≥1mL |
|
| Gastric | 5 – 10mL | Collect early morning fasting specimen on 3 consecutive days. Transport refrigerated. |
| Spinal fluid | 3 – 10mL | Transport refrigerated |
| Sputum | 5 – 10mL | Patient should rinse mouth out vigorously with water (not mouthwash), before producing sputum Obtain at least three consecutive sputum specimens, each collected in 8-24 hr intervals, with at least one being an early morning specimen because respiratory secretions pool overnight. Unacceptable : More than one specimen in an 8 hour period. Transport refrigerated. |
| Stool | Pea-sized amount | Transport refrigerated |
| Swab/skin | Swabs are the least desirable specimen for isolation of Mycobacteria. Whenever possible, tissue biopsies or aspirated material is recommended for skin lesions and other sources. Transport refrigerated |
|
| Tissue | ||
| Urine | Adult: >40mL Child (≤14 yrs): 10mL |
Three (3) clean catch early morning specimens are recommended. Transport refrigerated. |
Submit entire specimen
Sterile container
ESwab or other bacterial culture swab (acceptable, but not preferred)
ESwab or other bacterial culture swab (acceptable, but not preferred)
Refrigerated - 2 weeks
- 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
Culture - 6 weeks
Culture and acid fast stain
Tuberculosis is caused by Mycobacterium tuberculosis complex and ranges from asymptomatic infection to pulmonary disease, as well as infection of the genitourinary tract, lymph nodes, CNS, bones and joints, peritoneum, pericardium and larynx. M. tuberculosis is transmitted via droplet nuclei generated by coughing, and suspended by normal air currents. Nontuberculous mycobacteria are ubiquitous in the environment and may also cause disease, but are not usually transmitted from person-to-person. M. avium complex causes pulmonary infections and, in HIV-infected patients, disseminated disease. M. fortuitum, M.chelonae, M. abscessus, M. kansasii, M. marinum. M.szulgai, M. scrofulaceum, and other mycobacteria cause cutaneous, pulmonary, bacteremia, or other diseases. M. gordonae is typically nonpathogenic.
87015
87206
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