CSF Culture and Gram Stain


Sunquest Code:CSFC  
Epic Code:LAB268 and LAB250Epic Name:CSF Culture with Gram Stain
Order Instructions:Order both a CSF culture (LAB268) and a gram stain (LAB 250) in Epic, use Epic Code 03046000109 for an inpatient or 04046000109 for an Ambulatory patient.
Synonyms:Cerebrospinal Fluid Culture
Methodology:Culture of spun sediment
Test Includes:Gram stain and culture for aerobic organisms. Anaerobic culture performed upon request. Requires anaerobic collection and transportation.
Turnaround Time:Performed 24 hours/day; preliminary results are reported within 24 hours. Care provider is contacted when culture is positive; negative results are reported within 6 days.
Special Instructions:Fungal culture, india ink preparation and bacterial antigen detection must be specifically requested if indicated. Anaerobic culture performed upon request and is recommended for shunt collections. Collect in anaerobic transport vial. (See CSF Culture, Anaerobic).


Collection Instructions

Specimen:CSF, Subdural fluid, Subarachnoid fluid
Optimal Volume:2 mL
Minimum\Peds Volume:0.3 mL
Container:Sterile tube
Collection Instructions:Wear gloves, gown and mask. Prepare skin as for blood culture. Drape surrounding skin with sterile linen. Ideally, separate tubes should be collected for bacteriology, hematology cell counts and chemistries. Deliver to laboratory immediately.
Patient Preparation:Apply 10% povidone iodophor solution (1% available iodine). Iodine must remain on skin 2-4 minutes for maximum effectiveness. Remove with 70% isopropyl alcohol. Do not touch prepared site before or during collection of specimen. Avoid contamination with normal flora from surrounding body surfaces. Note: If patient is allergic to iodine use chlorhexidine, remove with sterile water, and then 70% isopropyl alcohol.
Contraindications:Removal of iodine from the skin after the cleansing process is important as iodine contamination has been associated with false positive bacterial antigen results.


Processing and Shipping

Specimen Processing:Do not store; send to lab immediately. Perform gram stain before sending to IDDL.
Shipping Instructions:Ship at room temperature in red Stat bag. Must arrive within 24 hours.
Test Performed at or Referral Lab Infectious Diseases Diagnostic Laboratory  (Fairview Range - FRMC, UMMC-East Bank, Grand Itasca GICH)


Interpretive

Critical Range:Any bacterial isolate should be considered significant and evaluated in relation to patient's clinical state.
Reference Range:No growth.
Use:Isolate and identify all bacterial organisms present.


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