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Mycobacteria, Culture, with Fluorochrome Smear
Test CodeAFCSM
Includes
Acid fast stain, Mycobacterium culture; If culture is positive, identification will be performed
Preferred Specimen
Respiratory
Sputum: Instruct the patient to gargle with water and to cough deeply to collect 5-10 mL of a respiratory specimen into a sterile leak-proof container
Induced sputum: Have patient rinse mouth with water after brushing gums and tongue. With the aid of a nebulizer have patient inhale approximately 25 mL of 3-10% sterile saline. Instruct patient to cough deeply and collect 5-10 mL of specimen in a sterile leak-proof container.
Bronchial lavage, bronchial wash, or tracheal aspirate: Transfer 5-10 mL of an aspirate or wash into a sterile, leak-proof container. Place brush into sterile, leak-proof container with small amount of sterile saline/sterile water to prevent it from drying.
Lung biopsy: Transport in sterile leak-proof container with a small volume of sterile saline/sterile water to prevent tissue from drying.
Body fluids
Sterile screw-capped container, plastic centrifuge tube. If bloody, use SPS (yellow-top) or sodium heparin (green-top) tube. Requested volume is as much as possible.
CSF: 2 mL in a sterile screw-cap container, plastic vial or tube
Urine: 50 mL random urine, random clean catch, catheterized urine, or first void catch urine in a sterile screw-cap container
Gastric lavage fluid: 5-10 mL in a sterile screw-cap container. Must be neutralized with sodium bicarbonate within 4 hours of collection.
Sputum: Instruct the patient to gargle with water and to cough deeply to collect 5-10 mL of a respiratory specimen into a sterile leak-proof container
Induced sputum: Have patient rinse mouth with water after brushing gums and tongue. With the aid of a nebulizer have patient inhale approximately 25 mL of 3-10% sterile saline. Instruct patient to cough deeply and collect 5-10 mL of specimen in a sterile leak-proof container.
Bronchial lavage, bronchial wash, or tracheal aspirate: Transfer 5-10 mL of an aspirate or wash into a sterile, leak-proof container. Place brush into sterile, leak-proof container with small amount of sterile saline/sterile water to prevent it from drying.
Lung biopsy: Transport in sterile leak-proof container with a small volume of sterile saline/sterile water to prevent tissue from drying.
Body fluids
Sterile screw-capped container, plastic centrifuge tube. If bloody, use SPS (yellow-top) or sodium heparin (green-top) tube. Requested volume is as much as possible.
CSF: 2 mL in a sterile screw-cap container, plastic vial or tube
Urine: 50 mL random urine, random clean catch, catheterized urine, or first void catch urine in a sterile screw-cap container
Gastric lavage fluid: 5-10 mL in a sterile screw-cap container. Must be neutralized with sodium bicarbonate within 4 hours of collection.
Minimum Volume
Respiratory specimens: 2 mL
CSF: 1 mL
Urine: 40 mL
Gastric lavage: 5 mL
CSF: 1 mL
Urine: 40 mL
Gastric lavage: 5 mL
Other Acceptable Specimens
None
Instructions
Tissue and biopsy material: Sterile leak-proof container with small amount of saline, no fixative or preservative.
Gastric lavage fluid: Sterile leak-proof container. Must be neutralized with sodium bicarbonate within 4 hours of collection.
Expectorated sputum: Instruct patient to gargle with water and cough deeply. Three separate early morning collections on at least three consecutive days are recommended.
Gastric lavage fluid: Sterile leak-proof container. Must be neutralized with sodium bicarbonate within 4 hours of collection.
Expectorated sputum: Instruct patient to gargle with water and cough deeply. Three separate early morning collections on at least three consecutive days are recommended.
Transport Container
Refer to Preferred Specimen(s) and Collection Instructions
Transport Temperature
Refrigerated (cold packs)
Specimen Stability
Room temperature: Unacceptable
Refrigerated: 5 days
Frozen: Unacceptable
Refrigerated: 5 days
Frozen: Unacceptable
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
24 hour pooled urine or sputum • Dry swabs • Specimens received in alcohol, formalin, EDTA, lithium heparin or conventional blood culture bottles • Throat/oral/sputum swabs from non-cystic-fibrosis patients • Urine specimens in preservative • Specimens received in expired transport • Specimens that leaked during transit • Specimens broken in transit
Methodology
Continuous Monitoring Broth Culture System and Conventional Culture • Microscopic Exam with Fluorochrome Stain
Setup Schedule
Monday-Friday
Report Available
58 days
Reference Range
See Laboratory Report
Clinical Significance
There are more than 70 species of mycobacteria of which the primary pathogen is M. tuberculosis. Tuberculosis is a chronic, granulomatous disease caused by M. tuberculosis. Identification, and, if appropriate, antibiotic sensitivity, is required to initiate necessary therapy.
