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Test Code CFRC Bacterial Culture, Cystic Fibrosis, Respiratory

Performing Laboratory

Mayo Medical Laboratories in Rochester

Reporting Name

Bacterial Culture, Cystic Fibrosis

Specimen Type

Varies


Advisory Information


If susceptibilities are desired when this test is ordered, also order ZMMLS / Antimicrobial Susceptibility, Aerobic Bacteria, MIC. Each pathogen isolated will then be tested with the appropriate susceptibility panel. Charges are added for each susceptibility test performed.



Shipping Instructions


Specimen must arrive within 48 hours of collection.



Necessary Information


Specimen source is required.



Specimen Required


Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Sputum, expectorated or induced

Container/Tube: Sterile container             

Specimen Volume: Entire collection

 

Acceptable:

Specimen Type: Bronchial aspirate or washing, bronchoalveolar lavage, endotracheal, or tracheal

Container/Tube: Sterile container     

Specimen Volume: Entire collection

 

Specimen Type: Throat swab

Supplies: Culturette (BBL Culture Swab) (T092)

Container/Tube: Culture transport swab (Dacron or rayon swab with aluminum or plastic shaft with either Stuart or Amies liquid medium [T092])

Specimen Volume: Swab


Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

Specimen >48 hours old; dry swab

Specimen Stability Information

Specimen Type Temperature Time
Varies Refrigerated 48 hours

Specimen Minimum Volume

2 mL

Day(s) and Time(s) Performed

Monday through Sunday; Continuously

Specimen Retention Time

1 day

Analytic Time

5 days

Reference Values

No growth or usual flora

Identification of probable pathogens

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
COMM Identification Commercial Kit No, (Bill Only) No
RMALD Ident by MALDI-TOF mass spec No, (Bill Only) No
GID Bacteria Identification No, (Bill Only) No
ISAE Aerobe Ident by Sequencing No, (Bill Only) No
REFID Additional Identification Procedure No, (Bill Only) No
SALS Serologic Agglut Method 1 Ident No, (Bill Only) No
EC Serologic Agglut Method 2 Ident No, (Bill Only) No
SHIG Serologic Agglut Method 3 Ident No, (Bill Only) No
STAP Identification Staphylococcus No, (Bill Only) No
STRP Identification Streptococcus No, (Bill Only) No
BLA Beta Lactamase No, (Bill Only) No
CARNP Carbapenemase-Carba NP Test Yes, External; No Internal (CARNB Bill Only) No
SIDC Ident Serologic Agglut Method 4 No, (Bill Only) No
PCRID Identification by PCR No, (Bill Only) No
GNRG Gram-Negative Resistance Genes, PCR Yes, External; No Internal No
OXVRP OXA-48 and VIM PCR Yes, External; No Internal (OXVM1 Bill only) No
KPNRP KPC and NDM PCR Yes, External; No Internal (KPND1 Bill Only) No

Useful For

Detection of aerobic bacterial pathogens from cystic fibrosis patient specimens

Testing Algorithm

When this test is ordered, the reflex tests may be performed and charged.

Method Name

Conventional Culture Technique

Test Classification

This test uses a standard method. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

87070-Bacteria, culture, cystic fibrosis, respiratory

87077-Identification commercial kit (if appropriate)

87077-Ident by MALDI-TOF mass spec (if appropriate)

87077-Bacteria Identification (if appropriate)

87077-Additional Identification procedure (if appropriate)

87077-Identification Staphylococcus (if appropriate)

87077-Identification Streptococcus (if appropriate)

87147 x 5-Serologic agglut method 1 ident (if appropriate)

87147-Serologic agglut method 2 ident (if appropriate)

87147 x 4-Serologic agglut method 3 ident (if appropriate)

87147 x 2-6 - Serologic Agglut Method 4 Ident (if appropriate)

87153-Aerobe Ident by sequencing (if appropriate)

87185-Beta lactamase (if appropriate)

87185-Carbapenemase detection, Carba NP test (if appropriate)

87798 x 2-KPC and NDM PCR (if appropriate)

87798-Identification by PCR (if appropriate)

87150-Gram-Negative Resistance Genes, PCR (if appropriate)

87798 x 2-OXA-48 and VIM PCR (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CFRC Bacterial Culture, Cystic Fibrosis 44798-7

 

Result ID Test Result Name Result LOINC Value
CFRC Bacterial Culture, Cystic Fibrosis 44798-7

Clinical Information

Life expectancy of patients with cystic fibrosis (CF) has increased steadily over the past 50 years, in large part due to improvements in the management of lung disease in this patient population. Still, chronic lung infection is responsible for 75% to 85% of deaths in patients with CF. Appropriate treatment for the causative organism can reduce morbidity and mortality.

 

The number of microbial species associated with CF lung disease is relatively limited. These include Pseudomonas aeruginosa (mucoid and nonmucoid), Staphylococcus aureus, Burkholderia cepacia complex, Stenotrophomonas maltophilia, other nonfermenting gram-negative rods, Haemophilus influenzae, and Streptococcus pneumoniae. Nontuberculous mycobacteria and Aspergillus species may also play a role in CF lung disease, in addition to common respiratory viruses. This culture, which is specifically designed for CF patients, utilizes conventional and additional selective media (compared to non-CF respiratory cultures) to isolate bacteria commonly associated with pulmonary disease in CF patients.

 

In selected centers, lung transplantation is performed on CF patients. This test is appropriate for lung transplant patients with underlying CF because they can continue to harbor the same types of organisms as they did pretransplantation. CF patients may be colonized or chronically infected by these organisms over a long period of time.

Interpretation

A negative test result is no growth of bacteria or growth of only usual flora. A negative result does not rule out all causes of infectious lung disease (see Cautions).

 

Organisms associated with lower respiratory tract infections are reported.

 

For positive test results, pathogenic bacteria are identified. Cystic fibrosis patients may be colonized or chronically infected by some organisms over a long period of time, therefore, positive results must be interpreted in conjunction with previous findings and the clinical picture to appropriately evaluate results.

Cautions

When culture of sputum is delayed, successful isolation of bacterial pathogens is less likely, due to the overgrowth of usual oropharyngeal flora.

 

Some bacterial agents that cause lower respiratory infections (eg, mycobacteria, Legionella species, Mycoplasma pneumoniae) are not detected by this assay and require special procedures. If the bacterial culture is negative, clinicians should consider additional testing to detect other bacterial, viral, or fungal agents.

  

Results must be interpreted in conjunction with clinical findings and previous culture results.

Clinical Reference

1. York MK, Gilligan P, Alby K: Lower Respiratory Tract Cultures. In Clinical Microbiology Procedures Handbook, Vol 1, Fourth edition. Edited by AL Leber. Washington DC, ASM Press, 2016, Section 3.11.2.

2. LiPuma JJ, Currie BJ, Peacock SJ, VanDamme PAR: Burkholderia, Stenotrophomonas, Ralstonia, Cupriavidus, Pandoraea, Brevumndimonas, Comamonas, Delftia, and Acidovorax. In Manual of Clinical Microbiology, Eleventh edition. Edited by Jorgensen JH and Pfaller MA. Washington DC, American Society for Microbiology Press, 2015, pp 791-812

Method Description

Standard media (5% sheep blood, chocolate, and eosin methylene blue [EMB] agar plates) used for respiratory cultures are inoculated. In addition, 2 selective agar plates are utilized to enable isolation of slower growing pathogens that may be easily overgrown by usual flora and the longstanding colonization by Pseudomonas aeruginosa. Burkholderia cepacia Selective Agar plate is used for the isolation of Burkholderia cepacia complex, which includes 9 distinct species. Isolates of Burkholderia cepacia will be forwarded to the University of Michigan's CFF Research Testing and Repository for genotyping. (There is no charge for this shipping/testing). A chromogenic Staphylococcus aureus agar is used to enhance the isolation of Staphylococcus aureus. Finally, a second chocolate blood agar plate is incubated in an anaerobic atmosphere. The anaerobic atmosphere allows for detection of Haemophilus species that may otherwise be overgrown by Pseudomonas aeruginosa.(Gilligan P, Alby K, York MK: Respiratory Cultures from Cystic Fibrosis Patients. In Clinical Microbiology Procedures Handbook, Vol 1, Fourth edition. Edited by AL Leber. Washington DC, ASM Press, 2016, Section 3.11.3)

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request Form (T244) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/microbiology_test_request_form.pdf).