.jpg){kind=logo}
| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
CULTURE, RESPIRATORY LOWER
MessageNotify laboratory if patient has Cystic Fibrosis
If a Mycobacterium species (AFB, TB), fungus or virus is suspected, refter to AFB Culture, Fungal Culture, or Viral Culture.
If a Mycobacterium species (AFB, TB), fungus or virus is suspected, refter to AFB Culture, Fungal Culture, or Viral Culture.
Test Code
RESC (Alverno)
Alias/See Also
Sputum
CPT Codes
87070, 87205
Includes
87070 Culture, bacterial; any other source except urine, blood, or stool with isolation and presumptive identification of isolates
87205 Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types
The following testing may be added as appropriate based on findings for organism identification (multiple additions are possible if more than one organism is identified) and to aid in patient treatment management.
87077 Aerobic isolate, additional methods required for definitive identification, each isolate if appropriate
87106 Culture, fungi, definitive identification, each organism, yeast if appropriate
87107 Culture, mold, definitive identification, each organism, mold if appropriate
87206 Smear, primary source with interpretation, fluorescent and/or acid fast stain for bacteria, fungi, or cell types if appropriate
87184 Susceptibility studies, disk method, per plate if appropriate
87185 Enzyme detection, per enzyme if appropriate
87186 Susceptibility studies, microdilution or agar dilution, each multiantimicrobial, per plate if appropriate
87205 Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types
The following testing may be added as appropriate based on findings for organism identification (multiple additions are possible if more than one organism is identified) and to aid in patient treatment management.
87077 Aerobic isolate, additional methods required for definitive identification, each isolate if appropriate
87106 Culture, fungi, definitive identification, each organism, yeast if appropriate
87107 Culture, mold, definitive identification, each organism, mold if appropriate
87206 Smear, primary source with interpretation, fluorescent and/or acid fast stain for bacteria, fungi, or cell types if appropriate
87184 Susceptibility studies, disk method, per plate if appropriate
87185 Enzyme detection, per enzyme if appropriate
87186 Susceptibility studies, microdilution or agar dilution, each multiantimicrobial, per plate if appropriate
Preferred Specimen
Sterile Container
Patient Preparation
Sputum (Expectorate)
1. Have patient rinse or gargle with water to remove superficial flora
2. Collect early morning specimen; Instruct patient in proper collection of specimen
3. Instruct patient to cough deeply to produce a lower respiratory specimen.
4. Exam specimen to make sure it contains thick muces. Do not submit saliva.
5. Collect the expectorated sputum in a sterile container.
1. Have patient rinse mouth with water after brushing gums and tongue.
2. With the aid of a nebulizer, have patients inhale about 25 mL of 3-10% Sterile Saline
3. Collect the induced sputum in a sterile container.
Minimum Volume
1-2 mL
Instructions
Document source
Transport Container
Sterile Container
Transport Temperature
Refrigerate specimen if there will be a delay in transportation or processing
Specimen Stability
- 2-8ºC up to 24 hours
- 15-30ºC up to 2 hours
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
- Sputum specimens heavily contaminated with saliva
- Improperly labeled specimen
- QNS
Methodology
Routine Culture
Setup Schedule
M, T, W, Th, F, Sa, Sun
Examined once per day for 2 days
Examined once per day for 2 days
Report Available
Preliminary report available at 24 hours; final report within 2-5 days
Clinical Significance
All Gram stains are scanned for the presence or absence of white blood cells which may be indicative of infection, as well as squamous epithelial cells which may be indicative of mucosal contamination. Sputum specimens showing >10 squamous epithelial cells per low power field, regardless of the number of white cells, indicates the specimen is grossly contaminated with saliva and the culture results cannot be properly interpreted.
Usual upper respiratory flora includes Alpha and Non-hemolytic streptococci, Micrococci, Cornyebacterium species, Coagulase negative staphylococci, Neisseria species, Lactobacillus species, Stomatococcus species, Streptococcal Pneumoniae, Actinomyces species, Haemophilus species, Moraxella Catarrhalis, and a few colonies of Staphylococcus Aureus, Gram negative rods, and Yeast. With current technology, normal respiratory isolates may be identified and reported to the species level, but clinical significance is to be determined by the provider. If present in significant numbers, Haemophilus Influenza, Strep. Pneumoniae, Staph. Aureus, and Moraxella Catarrhalis will be identified. Mucoid strains of Pseudomonas Aeruginosa are generally associated with cystic fibrosis.
Usual upper respiratory flora includes Alpha and Non-hemolytic streptococci, Micrococci, Cornyebacterium species, Coagulase negative staphylococci, Neisseria species, Lactobacillus species, Stomatococcus species, Streptococcal Pneumoniae, Actinomyces species, Haemophilus species, Moraxella Catarrhalis, and a few colonies of Staphylococcus Aureus, Gram negative rods, and Yeast. With current technology, normal respiratory isolates may be identified and reported to the species level, but clinical significance is to be determined by the provider. If present in significant numbers, Haemophilus Influenza, Strep. Pneumoniae, Staph. Aureus, and Moraxella Catarrhalis will be identified. Mucoid strains of Pseudomonas Aeruginosa are generally associated with cystic fibrosis.
Performing Laboratory
Alverno Central Lab
