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Epic Code LAB8770 Acid Fast Bacilli (AFB), Culture with smear

Test Name Alias

AFB and Smear Culture | TB Culture | Mycobactria Culture | MTB | Tuberculosis | 8866

Interface Order Alias

50000

Clinical Information

Nocardia and related species of aerobic actinomycetes grow well on mycobacterial media, so ordering AFB culture is recommended when infection with this group of organisms is suspected.

Ordering Instructions

Replicate specimens collected at the same time and with the same description (i.e. left leg tissue 1, 2, and 3) may be pooled for processing, and will be reported with a result comment indicating which orders were pooled.

Icons & Photos

 

Sterile Container ESwab

Urine collected in a gray top tube w/boric acid is an unacceptable specimen

Collection Instructions

Submit only one of the following specimens:

 

All specimen container/tubes should indicate source and be labeled with 2 patient identifiers (name & date of birth)

 

Sputum

Specimen Type: Sputum
Container/Tube: Sterile leak-proof container

Volume: 10 mL

Minimum Volume: 5 mL
Collection Instructions: Indicate source. Label with 2 patient identifiers. See also Special Collection Forms - Sputum Collection in the menu on the left

  1. Sputum must be first morning specimen.
  2. Prior to eating, rinse mouth with water.
  3. Expectorate into a sterile cup.
  4. Collect 5 to 10 mL of sputum in a sterile container in the morning.
  5. If the volume of sputum received is less than 1 mL, document on the report.
  6. Maximum of 3 expectorated sputum specimens, collected on separate days, will be tested on any one patient.
  7. If 2 or more specimens are received on a single day, the specimens will be combined before concentration.
  8. Specimens collected by bronchoscopy will be accepted even if the patient has had 3 sputum specimens cultured prior to bronchoscopy.
  9. After therapy is initiated, subsequent cultures to follow therapy will be accepted.

If sputum type is unavailable, see specimen type Gastric Lavage below

Transport Temperature: Refrigerated


 

Pleural, Pericardial, Peritoneal, Spinal Fluid, Other Body Fluids

Specimen Type: Pleural, Pericardial, Peritoneal, Spinal Fluid, Other Body Fluids
Container/Tube: Sterile container

Collection Instructions: Indicate source. Label with 2 patient identifiers.

  1. Large volumes are required for optimal processing and results.
  2. Up to 100 mL will be concentrated by centrifugation for media inoculation.  Sterile collection containers must be used.

Transport Temperature: Ambient for spinal fluid, refrigerated for all other body fluids.

 

 

Tissues and Biopsies

Specimen Type: Tissues and Biopsies
Container/Tube: Sterile container

Collection Instructions: Indicate source. Label with 2 patient identifiers.

  1. Collect aseptically and transported to the laboratory in a sterile container containing a small amount of sterile water or saline.
  2. Submitting surgically obtained material on a gauze pad should be strongly discouraged because the specimen will immediately begin to dry out.
  3. Such specimens should be place in a small sterile tube of sterile saline or water. Note: this may not be appropriate for histology specimens thereby requiring communications with the surgeon and pathologist to obtain a separate specimen for culture if possible.
  4. If there is not enough specimens to complete all the tests requested the Microbiology staff will call the floor and ask the physician to prioritize the order.

Transport Temperature: Refrigerated

 

 

Swab

Specimen Type: ESwab
Container/Tube: ESwab 

 

ESwab only. No other swab transport systems will be accepted.

 

Collection Instructions: Indicate source. Label with 2 patient identifiers.

  1. Use of swabs for submitting specimens usually provides an inadequate sample to rule out a Mycobacterial or fungal infection.
  2. ESwabs will be accepted if no other means of obtaining the specimen are available
  3. When an ESwab is submitted for the culture of mycobacteria, a disclaimer will be included with the report to indicate the inadequacy of swab specimens: “The sensitivity of this culture for the recovery of mycobacteria may be reduced because a swab was submitted, which often provides an inadequate collection.  Fresh tissue or body fluids are preferred specimen types."

 

Note: The ESwab fluid maintains the viability of diverse bacteria. Do not send a dry ESwab as this will lead to unsatisfactory results. If the tube spills its contents prior to inserting the swab, the liquid is non-toxic. Simply put the swab into another tube before sending it to the laboratory and discard the spilled tube

 

Transport Temperature: Refrigerated

 

Gastric Lavage

Specimen Type: Gastric Lavage - Collect if sputum is not obtainable
Container/Tube: Sterile container

Collection Instructions: Indicate source. Label with 2 patient identifiers.

  1. Gastric contents are cultured on the premise that they contain sputum which has been swallowed, and are the specimen of choice for patients under 12 years old.
  2. Collect gastric contents in a sterile container in the morning prior to breakfast.
  3. If the specimen cannot be delivered to the lab within 4 hours for pH neutralization, request a sterile container with 100 mg of sodium carbonate for specimen collection.

Transport Temperature: Refrigerated

 

 

Stool

Specimen Type: Stool
Container/Tube: Sterile container

Collection Instructions: Indicate source. Label with 2 patient identifiers.

  1. The laboratory will not routinely accept 24 hour stool specimens for culture.
  2. Stool specimens will be accepted only from patients suspected of having AIDS.
  3. Stool specimens will be given a direct examination with an acid-fast smear.  If the stain is negative, a culture will not be processed. 

Transport Temperature: Refrigerated

 

 

Urine

Specimen Type: Urine
Container/Tube: Sterile container

Collection Instructions: Indicate source. Label with 2 patient identifiers.

  1. An early morning, cleanly voided, mid-stream urine specimen collected in a sterile container and sent to the laboratory.
  2. Pooled 24 hour urine specimens will not be accepted.
  3. A maximum of three specimens, collected on separate days will be accepted.
  4. Volumes up to 100 mL will be concentrated by centrifugation for media inoculation.
  5. Urine collected in a gray top tube w/boric acid is an unacceptable specimen

Transport Temperature: Refrigerated

Rejection Criteria

  • Urine collected in a gray top tube w/boric acid is an unacceptable specimen
  • Incorrect swab or dry swab (eswab only)

Specimen Stability

Ambient: Send to laboratory as soon as possible - Preferred for Spinal Fluid

Refrigerate: 72 hour - Preferred for all other body fluids

Laboratory Retention: 3 days

Test Frequency

Available daily, usual TAT: AFB Stain-24 hours; Culture 42 days.

Reference Range

No Mycobacterium Isolated

Performing Department

MICROBIOLOGY

Performing Department Laboratory Location

Spectrum Health Regional Laboratory, Grand Rapids, MI

Methodology

Automated and Manual

CPT

87116

87015 as applicable

CDM Code

80102449

Epic Test ID

1230100543

Beaker LOINC

ACID FAST BACILLI CULTURE WITH SMEAR: 11545-1
ACID FAST STAIN: N/A

Mayo Access Code

SHO8866

Additional Information

Policy Tech Ref # 7552

Reviewed Date

7/31/2021

Beaker Names

Beaker Procedure Name: AFB AND SMEAR CULTURE
Beaker Display Name: AFB Culture and Smear
BEAKER TEST NAME: AFB CULTURE WITH SMEAR
BEAKER TEST REPORT NAME: AFB Culture with smear

Beaker Synonyms

No synonym on file

Beaker Location, Container and Temperature

BW MICROBIOLOGY: STERILE CONTAINER A (Preferred)-Ambient
BW MICROBIOLOGY: CSF TUBE R (Acceptable)-Ambient