Acid-Fast Bacilli (AFB) Culture and Smear, Non-Blood

Abbrev Code:AFBC   
Order Code:LAB877Order Name:AFB Culture Non Blood
Synonyms:AFB Culture and Smear; Mycobacterium Culture; TB Smear; STAT AFB; AFBC; AFBSTS
Methodology:Standard reference procedures for stain and culture.
CPT Codes: 87116 x1, 87206 x1
Test Includes:Smear and culture for acid fast bacilli. Identification of AFB is ordered and billed separately. DNA probes are available for M. tuberculosis complex and M. avium-intracellular complex as indicated. DNA sequencing and other molecular techniques are used for identification of other mycobacteria species.
Turnaround Time:Specimens are sent to the reference laboratory Mon-Sun; routine smears are reported within 24 hours of receipt at reference lab; contact the IDDL if needed stat. Positive cultures are reported when detected, negative cultures in 8 weeks.
Special Instructions:A subsequent culture should be performed on specimens with a negative smear result. Indicate if Mycobacteria other than tuberculosis (MOTT) are suspected. Provide patient's PPD status, BCG immunization history and prior antituberculosis therapy.
Associated Links:

AFB Culture and Smear Workflow

Collection Instructions

Specimen:Body fluids, CSF, gastric aspirate, respiratory, sputum, tissue, urine, and bronchial brushes. ESwabs will be accepted for AFB testing ONLY from surgically collected specimens and performed with a disclaimer of decreased recovery. Dry swabs are not acceptable for AFB.
Optimal Volume:
  • Respiratory specimens:  5-10 mL
  • Body Fluids or CSF:  5 mL
  • Tissue: Sample must be visible. Sterile container with saline
  • Urine:  40 mL
Minimum\Peds Volume:If less than optimal volume is received, see "Causes for Rejection" and "Specimen Processing" sections below.
Container:50 mL conical tube, sterile
Alternate Containers: Plastic leakproof container, sterile for INPATIENT COLLECTION ONLY
Collection Instructions:
Causes for Rejection:ESwabs are not acceptable for AFB testing and will be rejected unless surgically collected.
Swabs or dry material collected and transported on a swab.
Acid Fast Stain will not be performed on: Stool, blood, bone marrow, grossly bloody specimens, CSF if less than 5 mL, or urine specimens if less than 40 mL, however these samples will be cultured.
Body Fluids: <1 mL
Respiratory Specimens: < 1 mL
Urine: <10 mL

Processing and Shipping

Specimen Processing:Place each specimen into a 50 mL sterile specimen transport tube and place in an individually sealed bag. Store in refrigerator. Gastric lavage specimens must be neutralized to a pH of 7 with sodium carbonate if transport is delayed for more than four hours.

Volumes below optimal should be sent directly to IDDL for processing, if IDDL in-house testing is also requested (with the Complex Processing Worksheet). At minimum, IDDL needs an additional 2 mL for all in-house testing requested. If volume below is optimal, and only AFB is ordered, this can be routed to Sendouts to go to ARUP without coming to IDDL.
*Sputum and Tissue: Do not manipulate. Send to IDDL directly.
Shipping Instructions:Ship at refrigerated temperature.
Stability:Non-respiratory specimens: 24 hours at room temperature; 1 week refrigerated; 1 week frozen.
Respiratory specimens: unacceptable at room temperature, 1 week refrigerated; 2 weeks frozen.  
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:60152


Critical Range:Positive/Growth
Reference Range:Negative/No growth

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