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This list is not exhaustive. If the
information you require is not listed here, please call the laboratory
at the following numbers:
Bacteriology/Parasitology 612-873-3033
Mycology/Mycobacteriology 612-873-8566
Virology 612-873-4750
Anaerobic Culture
Beta Strep Group B Culture
Blood Culture
Body Fluid Culture
Bordetella pertussis
Catheter Tip Culture
Chlamydia trachomatis
Clostridium difficile
Mycoplasma/Ureaplasma Culture
Neisseria gonorrhoeae
Respiratory Tract Culture (excluding sputum)
Sputum Culture
Stool Culture
Throat Culture/Antigen (Gp A Strep)
Tissue
Culture
Urine Culture
Wound Culture
Acid-Fast Smear
Acid-Fast Culture
M.tuberculosis Amplification Assay (MTDA)
M. tuberculosis Susceptibility Testing
Cryptococcal Antigen
Testing
Fungal Culture
Fungal Susceptibility Testing
Pneumocystis carinii
Cryptosporidium/Giardia
Antigen Testing
Malaria Testing
Ova and Parasite Examination
Viral Culture
Viral Antigen Detection
Molecular Virology
Specimen must be aspirated fluid or tissue transported to the laboratory
in an appropriate Port-A-Cul transport device. Specimens collected on
swabs and specimens from non-sterile sources are NOT acceptable for anaerobic
culture.
| Preliminary
Report: 48-72 hours |
Final
Report: 7 days
|
Separate swabs should be obtained from the vaginal and anorectal areas,
but both swabs may be submitted in the same culture tube.
| Preliminary
Report: 24 hours |
Final
Report: 48 hours
|
Blood cultures for evaluation of patients for bacteremia or candidemia
should be collected in the appropriate BacT/Alert
Blood Culture bottle.
To evaluate a patient for sepsis, TWO to THREE sets of AEROBIC/ANAEROBIC
blood cultures, collected either simultaneously from two venipuncture
sites, or at least 15 minutes apart from the same site, should be submitted.
No
more than THREE blood culture sets should be submitted in any 24h period.
| Preliminary
Report: 24 hours |
Final
Report: 5 days
|
Includes normally sterile body
fluids (eg CSF, peritoneal, pleural, synovial, amniotic, pericardial etc).
Does NOT include abscess drainage or other aspirates.
Gram-stains are routinely performed on concentrated material and positive
results called to the physician.
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Preliminary
Report: 24 hours
(positive results
called to physician)
|
Final
Report: 3 days
Gram stain TAT is <1 hour
|
Positive results are called to the
ordering physician.
ONLY acceptable specimen is a nasopharyngeal aspirate or swab (using wire
swab).
Combination of DFA and culture is recommended for optimal sensitivity
(TWO swabs need to be submitted).
| 1.Direct Fluorescent
Antibody (DFA) test |
Performed
every day, day shift only |
| 2. Culture |
Preliminary Result
24 hours
Final
Result 7 days
|
Submit a 2 inch length of catheter.
Gram stains will not be performed.
This type of culture quantitates only bacterial
growth on the outside surface of the catheter.
|
Preliminary
Report: 24 hours
|
Final
Report: 48 hours
|
1. DNA Amplification (ProbeTec).
See Molecular Diagnostics
2. Chlamydia trachomatis DFA (Direct
Fluorescent Antibody)
MicroTrak collection kit for Chlamydia DFA testing is available from the
Micro. Lab.
Recommended test for non-urogenital specimens (anorectal, respiratory,
ocular specimens). LCx testing is recommended for urogenital specimens
(endocervical/urethral swabs, first-void urine).
Final Report: <24 hours
3. Chlamydia trachomatis culture
Shell-vial culture for C. trachomatis generally only utilized for detection
of the organism in children (sexual abuse cases).
Specimen should be collected on a Dacron or rayon swab and submitted to
the laboratory in M4 transport media (can be obtained from Micro. lab).
Final Report: 48 hours
Clostridium difficile is detected in stool samples using an enzyme immunoassay
that detects both clinically important toxins (A and B). Testing is perfomed
daily Monday through Saturday.
Criteria for Specimen Acceptability:
Patient should be currently receiving antimicrobial therapy.
Stool should be loose or liquid (formed stools WILL NOT be tested).
A maximum of 1 specimen per day or 3 specimens per week will be accepted
for testing.
No specimens will be accepted after a positive result is reported.
Testing is NOT RECOMMENDED in children under 2 years of age because of
asymptomatic carriage of toxigenic C. difficile in this population.
Toxin testing CANNOT be used as a test-of-cure.
Final Report: 24-48 hours
Appropriate specimens include urogenital swabs, amniotic fluid, urine,
blood, and respiratory specimens (neonates ONLY).
If specimens are collected on a swab, the swab should have a plastic shaft
and be placed in M4 medium (Chlamydia transport medium) or delivered to
the laboratory immediately.
| Preliminary
Report: 48 hours |
Final
Report: 6 days
|
1. DNA Amplification (ProbeTec). See Molecular
Diagnostics .
2. Neisseria gonorrhoeae culture
Inoculate a Thayer-Martin media plate (obtained from Micro lab). Promptly
transport to the laboratory in a CO2 Biobag (obtained from Micro lab).
Culture is REQUIRED for testing for Neisseria gonorrhoeae in non-urogenital
specimens (eg anorectal, throat). Amplication testing is recommended for
urogenital specimens (endocervical/urethral swabs, first-void urine).
| Preliminary
Report: 24 hours |
Final
Report: 48-72 hours |
Appropriate specimens include bronchoalveolar lavage, bronchial wash,
lung aspirates, sinus aspirates, and quantitative bronchoalveolar lavage.
Nasal passages may also be cultured for the detection of MRSA or Neisseria
mengiditis carrier status.
Gram-stains are routinely performed on these specimens.
Routine evaluation of these specimens does NOT include examination for
Legionella sp, Chlamydia pneumoniae or Mycoplasma pneumoniae. Evaluation
for these pathogens requires specialized testing which is available upon
request.
| Preliminary
Report: 24 hours |
Final
Report: 3 days |
SPUTUM CULTURE
Routine sputum (or tracheal aspirate) culture requests should be limited
to a maximum of ONE per 72 hour time period.
Gram-stains will be performed on all sputum specimens prior to culture
set-up.
Specimens containing >10 epithelial cells per low-power field are considered
inappropriate for culture and will be rejected.
ONLY one sputum specimen per patient will be cultured per day.
| Preliminary
Report: 24 hours |
Final
Report: 2 to 3 days |
STOOL CULTURE
A single stool specimen is adequate to evaluate a patient for bacterial
gastroenteritis. Rectal swabs are acceptable, although not an optimal
specimen.
Stool specimens for bacterial culture submitted on patients hospitalized
for longer than 3 days will be rejected.
Routine bacterial culture of stool specimens includes examination for
Campylobacter sp., Salmonella sp., Shigella sp., and E. coli O157. If
other bacterial pathogens are suspected, a request to examine the specimen
for specific organisms should be made on the written order.
| Preliminary
Report: 24 hours |
Final
Report: 3 days |
THROAT
CULTURE/ANTIGEN (Group A Strep)
Rapid Antigen Test
The laboratory performs the BioStar OIA assay for detecting Group A Strep
antigen. We have demonstrated that this test has a sensitivity comparable
to routine throat culture, and thus a confirmatory culture is not required
for routine diagnosis.
To ensure optimal detection, collect and submit single dry swab labeled
"Themo BioStar".
Final Report 30-60 minutes
Throat
Culture
Unless otherwise indicated, will only be
evaluated for the presence or absence of Group A Strep. Should not be
used for routine diagnostic testing.
Culture is the appropriate request to determine therapeutic success. Specimens
must be collected using the red-capped wet culture swabs. Dry swabs are
not acceptable for culture.
| Preliminary
Report: 18 - 24 hours |
Final
Report: 3 days |
TISSUE
CULTURE
Specimens
are any piece of tissue, bone, or biopsy material. Gram stains are routinely
performed and called if specimen is from surgery. TAT < 1 hour.
|
Preliminary
Report: 24 hours
(positive results will be called to physician) |
Final
Report: 3 days |
URINE
CULTURE
Method of collection (midstream, indwelling catheter, straight catheter)
should be indicated on the order. Gram-stains are NOT performed on urine
specimens.
| Preliminary
Report: 24 hours |
Final
Report: 48 hours |
WOUND
CULTURE
Specimens should be collected using a red-capped wet BBL Culture swab.
Gram-stains are performed only on request.
| Preliminary
Report: 24 hours |
Final
Report: 48 hours |
ACID-FAST SMEAR
Concentrated smears are routinely performed on all specimens submitted
for AFB culture with the exception of blood, CSF and bone marrow.
Unconcentrated smears are not performed.
Final Report: 24-36 hours
ACID-FAST
CULTURE
All body sites are acceptable for AFB culture.
Since recovery of organisms is volume dependent, as much specimen as possible
should be submitted for culture. Swabs are unacceptable and will be rejected.
To optimize recovery of AFB from sputum or urine specimens, it is recommended
that a MINIMUM of 2 and a MAXIMUM of 3 first morning specimens be submitted.
| Preliminary
Report: As soon as positive is detected |
Final
Report: 6 weeks |
Blood Culture
for Mycobacteria (AFB)
Requires collection of 5ml of blood in BacTet 13A blood culture bottle
(obtained from Microbiology lab).
| Preliminary
Report: As soon as positive is detected |
Final
Report: 6 weeks |
M. TUBERCULOSIS AMPLIFICATION ASSAY (MTDA)
See Molecular Diagnostics
M. TUBERCULOSIS SUSCEPTIBILITY
TESTING
Antimicrobial susceptibility testing is routinely performed on all M.
tuberculosis isolates obtained from newly diagnosed cases of TB. Drugs
tested are isoniazid (INH), rifampin, ethambutol, and streptomycin.
If additional susceptibility testing is required, please contact the mycobacteriology
laboratory at 347-8566.
Final Report: Available 1-2 weeks
after isolation of organism.
CRYPTOCOCCAL
ANTIGEN TESTING
Test is a latex agglutination assay and is the recommended method for
diagnosing cryptococcal meningitis and cryptococcosis. For optimal diagnostic
sensitivity, BOTH CSF and serum should be submitted on patients at risk
for cryptococcal meningitis.
Cryptococcal antigen testing is performed on Tuesday and Thursday mornings,
but can be obtained stat (maximum 24h turnaround) by calling the mycology
laboratory (347-8566).
FUNGAL
CULTURE
All body sites are acceptable for Mycology culture. Since recovery of
organisms is volume dependent, as much specimen as possible should be
submitted for culture. Swabs are unacceptable and will be rejected. KOH
(Calcofluor) smears will be prepared on all specimens submitted for fungal
culture with the exception of blood, bone marrow and dermatologic specimens.
Requests for Nocardia should be included under Fungal Culture requests.
| Preliminary
Report: 7 days (or sooner if positive) |
Final
Report: 4-6 weeks |
YEAST CULTURE
To be used for detection of yeast; not systemic fungi. Specimens of choice
include throat/ mouth swabs, urine, genital swabs, feces, esophageal brushings.
| Preliminary
Report: 24 hours |
Final
Report: One week |
FUNGAL BLOOD CULTURE
Fungal blood cultures ARE NOT REQUIRED FOR RECOVERY
OF CANDIDA OR CRYPTOCOCCUS, and should be used ONLY for patients
at risk for systemic mycoses.
Blood (10ml) should be collected in an Isolator tube (available from Microbiology
laboratory). CAUTION: if less than 10ml is drawn into the Isolator, recovery
of organisms may be compromised (tubes containing less than 5ml will not
be processed). The Pediatric Isolator (1.5ml) is also available from the
Micro lab.
| Preliminary
Report: 7 days (or sooner if positive) |
Final
Report: 4 weeks |
FUNGAL
SUSCEPTIBILITY TESTING
Testing of in vitro susceptibility to antifungal drugs is performed by
the NCCLS approved microdilution method and is available for Candida sp.
and Cryptococcus neoformans. Drugs tested are amphotericin
B, fluconazole, itraconazole, and caspofungin.
Antifungal susceptibility testing is routinely performed on isolates from
normally sterile sources (including blood cultures). Testing on isolates
from other sources is available upon request (call 347-8566).
Final Report: 72-96 hours after isolation of
organism.
PNEUMOCYSTIS
CARINII
Direct fluorescent antibody (DFA) test is performed specifically for detection
of P. carinii. ONLY acceptable specimens are induced sputum for PCP (obtained
by respiratory therapy) or bronchoalveolar lavage.
Final Report: 3 hours (if received Mon through
Fri 0700-1400)
24 hours (if received evening/weekend)
CRYPTOSPORIDIUM/GIARDIA
DFA
Combination assay for the simultaneous detection of both Cryptosporidium
and Giardia lamblia in stool specimens. Stool preserved in 10% formalin
(PINK ParaPak vial) is the preferred specimen, although fresh stool is
acceptable if transported immediately. To obtain optimal sensitivity,
TWO independently collected stool specimens should be submitted for examination.
NOTE: Evaluation for Cryptosporidium is not included in a routine order
for Ova & Parasite Exam.
Test
may be used as a rapid, cost effective alternative to the complete parasite
exam if patient lacks travel history necessary for infection with other
intestinal parasites. The Giardia assay DOES NOT offer improved sensitivity
over a conventional O&P examination for diagnosis of giardiasis, and
the two tests should not both be ordered on the same specimen.
Final
Report: 24-72 hours
MALARIA
TESTING
Thick and thin-prep blood films should be collected by the blood drawing
staff. Two to three sets of blood smears should be performed over a 72
hour period to effectively rule out malaria.
Thick and thin smears are also acceptable for detection of Babesia,
microfilaria, and trypanosomes.
| Preliminary
Report: 24 hours |
Final
Report: 48 hours |
STOOL OVA
AND PARASITE EXAMINATION
Fresh stool samples (inpatient) or specimens collected in the ParaPak
preservative system (PINK and BLUE vials available from Microbiology)
should be submitted for ova and parasite examination.
TWO specimens collected on separate days should be submitted for optimal
detection of intestinal parasites. If more than two specimens are submitted
at the same time, specimens will be combined prior to examination.
Examination of specimens obtained from patients hospitalized for >72
hours will not be performed without approval of the Laboratory Director.
Final Report: 1-4 days.
VIRAL
CULTURE
If specimens are collected using a swab, plastic shafted culture swabs
should be used. Wooden-shafted swabs and calcium alginate swabs should
not be used. Order should specify source and viruses suspected. More specific
information can be obtained by calling the Virology laboratory (347-4750).
Virus-Specific Information
| CMV |
Appropriate specimens include urine, heparinized blood, tissue
and bone marrow. Both accelerated culture (antigen) and conventional
cultures are performed on all requests for CMV.
Final Result (antigen): 24-72 hours Final
Result (culture): 1-3 weeks
|
| Enterovirus |
Appropriate specimens include CSF,
blood, throat swab, stool specimen.
Final Result: 3-7 days |
| HSV |
Appropriate specimens include vesicle swab (oral or genital lesion),
blood (disseminated HSV), tissue. Optimal diagnosis of CNS infection
is achieved by HSV-PCR.
Vesicular material should be collected using a red-capped wet culture
swab. The swab should be moistened prior to collection.
Preliminary Report: 24-72 hours
Final Report: 7 days (genital source) 14 days (non-genital source)
|
| Respiratory Viruses |
Respiratory virus culture tests specimens
for the presence of Influenza A and B, Adenovirus,
RSV, and Parainfluenza 1, 2, and 3.
OPTIMAL specimens are nasopharyngeal washes or aspirates, sputum,
bronchial wash, BAL or lung tissue. Both accelerated culture (antigen)
and conventional cultures are performed on all requests for respiratory
virus culture.
Final Result (antigen): 2-5 days Final Result
(culture): 7-14 days |
INFLUENZA A and B ANTIGEN
An optical immunoassay used for detection of Influenza A and B in nasophary
aspirates, washes, or swabs.
Test is offered only during the respiratory viral season (typically November
through March) when influenza has been reported in Minnesota by the Department
of Health.
Negative-predictive value is INSUFFICIENT for the test to be used as a
rule-out. Not recommended as part of therapeutic decision making (see
Clinical Therapeutics guidelines).
Respiratory Virus Culture is the recommended method for optimal diagnosis
of viral respiratory tract infection.
Final Result: 30-60 minutes
RSV
ANTIGEN
An optical immunoassay and Direct Fluorescent Antibody
(DFA) methods are both used. Specimens of choice are nasopharyngeal aspirates
and washes.
EIA test is offered only during the respiratory viral season (typically
November through March) on the evening and night shifts when RSV has been
reported in Minnesota by the Department of Health. DFA testing is performed
during the day shift.
Respiratory Virus Culture is the recommended method for optimal diagnosis
of viral respiratory tract infection.
Final Result: 1 hour for DFA and 30 minutes for
EIA
ROTAVIRUS ANTIGEN
Enzyme immunoassay performed on fresh stool sample.
Final Result: 1-24 hours
Molecular testing is currently offered for HIV,
HCV, HSV
and Enterovirus.
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