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Culture and Gram Stain, Aerobic, Respiratory
Test CodeAlias/See Also
Includes
Gram stain and Aerobic culture for bacterial respiratory pathogens
Preferred Specimen
Specimen Type: Respiratory
Sources: Sputum, bronchoalveolar lavage, trachea, endotracheal tube, etc
Collection Container: Sterile container
Specimen Volume: 2mL
Instructions
- Sputum, Expectorated: Patient should rinse mouth and gargle with sterile water prior to collection. Instruct the patient NOT to expectorate saliva or postnasal discharge into the container. Collect expectorated sputum into a sterile container with a screw cap
- Sputum, Induced: Using a wet toothbrush and sterile water or saline, brush the buccal mucosa, tongue, and gums for 5 to 10 minutes prior to the procedure. Rinse the patients mouth with sterile water or saline. Using an ultrasonic nebulizer, have the patient inhale approximately 20-30ml of 3% NaCl. Collect inducted sputum specimens into a sterile container with a screw cap • Endotracheal aspirate: Aspirate the specimen into a sterile sputum trap (i.e., Luken trap) and aseptically transfer the sputum sample to a sterile screw-cap container with the cap tightly secured before transport.
- ​Bronchial Wash, Transbronchial Biopsy, Bronchoalveolar lavage (BAL), Bronchial Brushing: Follow standard collection practices
Specimen Stability
Room temperature: Unacceptable
Refrigerated: 24 hours
Frozen: Unacceptable
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Sputum specimens with an abundance of squamous epithelial cells are considered to be contaminated with oral ?ora and not representative of deeply expectorated samples. These specimens will be rejected for culture and re-collection will be recommended on the laboratory report.
Methodology
Bacterial culture, organism identification and antibiotic susceptibility testing as appropriate for specimen source
Setup Schedule
Report Available
Negative or normal flora report is final at 2-3 days. Positive report depends on the extent of organism workup
Limitations
This culture method is not acceptable for detection of Legionella species, Bordetella pertussis, Mycoplasma pneumoniae, or Chlamydophila pneumoniae. Contact the laboratory if detection of these pathogens is required. If a quantitative BAL is required, it must be selected as a source or submitted as a separate order (Culture, Respiratory/BAL Quantitative). If a more comprehensive culture is required for a Cystic Fibrosis patient, it must be ordered as Culture, Cystic Fibrosis Respiratory.
Reference Range
Clinical Significance
Performing Laboratory
Inova Laboratories
2832 Juniper Street
Fairfax, VA 22031
Last Updated: February 15, 2024
Last Review: N. Wolford, May 15, 2023