Ordering Guidance

For the preferred test for rapid, direct detection of Mycobacterium tuberculosis from clinical specimens, order MTBRP / Mycobacterium tuberculosis Complex, Molecular Detection, PCR, Varies.

Necessary Information

Specimen source is required.

Specimen Required

Fresh tissue or body fluid are the preferred specimen types. Recovery of mycobacteria from swabs is generally very low yield.

Submit only 1 of the following specimens:

Preferred:

Specimen Type: Body fluid

Container/Tube: Sterile container

Specimen Volume: 1 mL

Collection Information: Saliva is not acceptable.

Additional Information: If a mycobacterial culture is also requested, collect 1.5 mL.

Specimen Type: Bone marrow

Container/Tube: Sterile container or green top (lithium heparin)

Specimen Volume: Entire collection

Collection Instructions:

1. Invert several times to mix bone marrow.

2. Send bone marrow specimen in original tube. Do not aliquot.

Specimen Type: Gastric washing

Container/Tube: Sterile container

Specimen Volume: 10 mL

Collection Instructions: Neutralize specimen within 4 hours of collection with 100 mg of sodium carbonate per 5 to 10 mL of gastric wash.

Specimen Type: Respiratory

Sources: Bronchoalveolar lavage fluid, bronchial washing, sputum

Container/Tube: Sterile container

Specimen Volume:  mL

Collection Instructions: Collect 3 respiratory specimens for acid-fast smears and culture in patients with clinical and chest X-ray findings compatible with tuberculosis. These 3 specimens should be collected at 8- to 24-hour intervals (24 hours when possible) and should include at least 1 first-morning specimen.

Specimen Type: Feces

Supplies: Stool Collection Kit, Random (T635)

Container/Tube: Sterile container

Specimen Volume: 5 to10 g

Specimen Type: Tissue

Container/Tube: Sterile container

Specimen Volume: 5 to10 mm

Collection Instructions: Collect a fresh, unfixed tissue specimen. Fixed tissue is not acceptable.

Specimen Type: Urine

Container/Tube: Sterile container

Specimen Volume: 2 mL

Collection Instructions: Collect a random urine specimen.

Acceptable:

Specimen Type: Swab

Sources: Wound, tissue, or body fluid

Container/Tube:

Preferred: Flocked swab (eg, Eswab)

Acceptable: Culture transport swab, noncharcoal (eg, Culturette)

Specimen Volume: Swab

Collection Instructions:

1. Before collecting specimen, wipe away any excessive amount of secretion and discharge, if appropriate.

2. Obtain secretions or fluid from source with sterile swab.

3. If smear and culture are requested or both a bacterial culture and mycobacterial culture are requested, collect a second swab to maximize test sensitivity.

4. Swabs from the following sources are not acceptable: respiratory fluid (eg, sputum), nasal, sinus, ear, mouth, throat, or scalp.