Respiratory Aerobic Bacterial Culture


Abbrev Code:RESPCX   
Order Code:LAB801Order Name:Respiratory Aerobic Bacterial Culture
Order Instructions:To include a gram stain with culture, select "with Gram Stain" at time of order. Indicate in the ask at order questions if patient has cystic fibrosis, or if Ventilator associated pneumonia is suspected.
Synonyms:RESPCXSTN; CFRESPCX; CFRESPCXSTN; BROC; EARC; SPTC; TC; TAC; CFC; NOSEC; SINUSC
Methodology:Culture
CPT Codes: 87070 x1, 87070 x1, 87070 x1, 87070 x1, 87070 x1, 87070 x1, 87070 x1, 87077 x1, 87205 x1
Test Includes:Gram stain screen for expectorated samples.
Turnaround Time:Performed daily; results are reported within 3 days for routine cultures, an 5 days for Cystic Fibrosis patients.
Special Instructions:AFB culture requires a separate request form (see AFB Culture and Stain).
Associated Links:

IDDL (Microbiology/Virology) Collection Container Guidelines


Collection Instructions

Collection Instructions:
Specimen Type Instructions Volume Container Alternate Container
Aspirate (Tracheal)  
Collect in sterile leakproof container.
 		 Optimal:
3 mL
 
Minimum:
0.5mL		 Sterile Container
 N/A
Bronchial Alveolar Lavage
Washing (Bronchial)
 
Brushing (Bronchial) Bronchial Brush: Using standard bronchoscopy technique, identify the lesion in question and obtain a brushing sample of the lesion. Upon withdrawing the brush, agitate the brush vigorously in a 5-10 mL vial of sterile saline. Transport to the laboratory immediately, specimen should arrive within 3 hours.
 
Sputum
 		 Expectorated sputum is not recommended for routine bacterial/fungal culture because of unavoidable contamination with upper respiratory flora. If possible, have the patient rinse mouth and gargle with water first. Ask the patient to cough deeply and expectorate coughed-up material into a sterile container. In seriously ill or debilitated patients, a transtracheal aspirate may be necessary.
Causes for Rejection:  More than 10 epithelial cells per low power field, appearances of saliva.
Sinus Contents or Stripping (Sinus) Clean Surface with sterile sponge and sterile water.
If purulent material is available to be Aspirated collect in Sterile Container for improved sensitivity.
 		 Optimal:
3 mL
 
Minimum:
0.5mL
 		 Sterile Container
 Eswab
Throat Swab Collect one swab; collect second swab if also collecting rapid strep screen. Place each swab in culture container to ensure proper preservation of specimen. Collection technique for throat: Depress tongue and rub swab vigorously over each tonsillar area and posterior pharynx. Any exudate should be touched, and care should be taken to avoid tongue and uvula. N/A Eswab White
 Eswab Blue
Ear Swab Place swab in culture container to ensure proper preservation of specimen. Specimen can be divided for aerobic culture or fungus culture and stain if ordered and there is sufficient volume.
  • INTERNAL: Cleanse external canal with mild antiseptic. Insert sterile funnel and swab from ear drum or beyond.
  • EXTERNAL: Cleanse external canal with mild antiseptic. Swab or scrape from active margin, preferably including fresh secretion from deeper areas.
 N/A Eswab Blue
 		 Eswab White
 
Nasal Swab All Patients: Must clear mucus and/or bloody nose before specimen collection. Have patient tilt head back. Using the same swabs for left and right anterior nares, insert swab 1-2 cm in each nostril. Rotate swabs against the inside of the nostril for 3 seconds. Apply slight pressure with a finger on the outside of the nose for good contact. N/A Eswab White
 		 Eswab Blue
 
Causes for Rejection:For Sputum and Endotracheal aspirates, specimens collected within 24 hours via the same collection method will be canceled as duplicates.


Processing and Shipping

Specimen Processing:Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature. Must arrive within 24 hours.
Test Performed at or Referral Lab Infectious Diseases Diagnostic Laboratory   (Grand Itasca, Range, UMMC East Bank)


Interpretive

Reference Range:No growth, normal flora
Use:Lower respiratory cultures aid in the differential diagnosis of bacterial and tuberculosis, fungal, and nonbacterial pneumonia. If stains and cultures are negative for pathogens, the physician is alerted to look for other causes of chest disease, i.e., tumors, viral diseases.


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