EPIC Code

LAB3452
CAFB

Performing Lab

UCHealth University of Colorado Hospital Clinical Laboratory - Microbiology (BSL3)

Collect

Blood or bone marrow submitted in Bactec® Myco/F Lytic bottle (red top bottle). Contact local laboratory to request bottle.

Specimen Preparation

Collect 3-5 mL of blood or bone marrow into a syringe. Aseptically inoculate a Bactec® Myco/F Lytic bottle culture bottle (acquired from primary microbiology lab, see list below for corresponding contact information) following specimen collection instructions.

Do not overfill—bottle will accept more than the recommended maximum 5 mL volume.

Unacceptable Conditions

  • Insufficient or exceeding sample volume.
  • Refrigerated or frozen Bactec® Myco/F Lytic bottle culture bottle.
  • Sample not properly identified, incorrect container, insufficient volume, or past stability.

Storage/Transport Temperature

Internal: Deliver to lab immediately at ambient temperature.
Offsite: ASAP at ambient temperature.

Performed

Daily

Stability (from collection to initiation)

Room Temp: 24 hours
Refrigerated: Unacceptable
Frozen: Unacceptable
 

Remarks

  • Test includes culture and stain on positive bottles.
  • Physicians will be notified of all positive cultures and/or stains.
  • Negative cultures are reported at 6 weeks.
  • Antibiotic susceptibility testing is automatically ordered and performed on any isolates of Mycobacterium tuberculosis or rapidly-growing Mycobacterium species.
  • Antibiotic susceptibility testing on Mycobacterium species other than Mycobacterium tuberculosis or rapidly growing Mycobacterium species are available upon request. Contact the Microbiology Laboratory for additional information or to submit additional susceptibility orders.
  • Susceptibility testing is performed by a reference laboratory.

Notes

Stains are not performed on direct blood specimens due to the extremely low sensitivity of the test.

Performed

Daily

Methodology

Liquid culture media.

Nonradiometric, continuous monitor instrument, Bactec.

Organism(s) recovered in culture may be identified by morphology and/or MALDI-TOF. Identification by MALDI-TOF was developed and its performance characteristics determined by the University of Colorado Hospital Authority.  It has not been cleared or approved by the U.S. Food and Drug Administration.  The laboratory is regulated under CLIA as qualified to perform high-complexity testing.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.

Reported

Up to six weeks

Synonyms

  • Blood AFB Culture
  • Bone marrow AFB Culture

Ordering Recommendations

Include relevant patient history, previous mycobacterial infections, and include accurate Specimen Type/Source (Blood/Blood or Bone marrow/Bone marrow).

EPIC Code

LAB3452
CAFB

Interpretive Data

Cultures:
Preliminary Negative Culture report: Culture in progress, physician will be notified if culture is positive.
Negative Final Culture report: Negative for acid fast bacillus at 6 weeks.
Preliminary Positive Culture report:  Culture positive for acid fast bacillus, identification to follow.
Final Positive Culture report:  Culture positive for Mycobacterium… (reported to species or group if identification is possible by Maldi-tof).
First positive cultures are called to the caregiver and emailed to Infection Prevention unless physician and Infection Prevention were previously notified of positive MTB PCR.

CPT Codes

87116 AFB culture (culture, acid fast bacilli)
87206 Ziehl-Neelson stain (acid fast stain)
87206 Kinyoun stain (acid fast stain)
87118 AFB identification by Maldi-tof (mycobacterial, definitive identification, each isolate)
87186 Antimicrobial susceptibility test (performed by ARUP Lab)
Collection

EPIC Code

LAB3452
CAFB

Performing Lab

UCHealth University of Colorado Hospital Clinical Laboratory - Microbiology (BSL3)

Collect

Blood or bone marrow submitted in Bactec® Myco/F Lytic bottle (red top bottle). Contact local laboratory to request bottle.

Specimen Preparation

Collect 3-5 mL of blood or bone marrow into a syringe. Aseptically inoculate a Bactec® Myco/F Lytic bottle culture bottle (acquired from primary microbiology lab, see list below for corresponding contact information) following specimen collection instructions.

Do not overfill—bottle will accept more than the recommended maximum 5 mL volume.

Unacceptable Conditions

  • Insufficient or exceeding sample volume.
  • Refrigerated or frozen Bactec® Myco/F Lytic bottle culture bottle.
  • Sample not properly identified, incorrect container, insufficient volume, or past stability.

Storage/Transport Temperature

Internal: Deliver to lab immediately at ambient temperature.
Offsite: ASAP at ambient temperature.

Performed

Daily

Stability (from collection to initiation)

Room Temp: 24 hours
Refrigerated: Unacceptable
Frozen: Unacceptable
 

Remarks

  • Test includes culture and stain on positive bottles.
  • Physicians will be notified of all positive cultures and/or stains.
  • Negative cultures are reported at 6 weeks.
  • Antibiotic susceptibility testing is automatically ordered and performed on any isolates of Mycobacterium tuberculosis or rapidly-growing Mycobacterium species.
  • Antibiotic susceptibility testing on Mycobacterium species other than Mycobacterium tuberculosis or rapidly growing Mycobacterium species are available upon request. Contact the Microbiology Laboratory for additional information or to submit additional susceptibility orders.
  • Susceptibility testing is performed by a reference laboratory.

Notes

Stains are not performed on direct blood specimens due to the extremely low sensitivity of the test.
Ordering

Performed

Daily

Methodology

Liquid culture media.

Nonradiometric, continuous monitor instrument, Bactec.

Organism(s) recovered in culture may be identified by morphology and/or MALDI-TOF. Identification by MALDI-TOF was developed and its performance characteristics determined by the University of Colorado Hospital Authority.  It has not been cleared or approved by the U.S. Food and Drug Administration.  The laboratory is regulated under CLIA as qualified to perform high-complexity testing.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.

Reported

Up to six weeks

Synonyms

  • Blood AFB Culture
  • Bone marrow AFB Culture

Ordering Recommendations

Include relevant patient history, previous mycobacterial infections, and include accurate Specimen Type/Source (Blood/Blood or Bone marrow/Bone marrow).

EPIC Code

LAB3452
CAFB
Result Interpretation

Interpretive Data

Cultures:
Preliminary Negative Culture report: Culture in progress, physician will be notified if culture is positive.
Negative Final Culture report: Negative for acid fast bacillus at 6 weeks.
Preliminary Positive Culture report:  Culture positive for acid fast bacillus, identification to follow.
Final Positive Culture report:  Culture positive for Mycobacterium… (reported to species or group if identification is possible by Maldi-tof).
First positive cultures are called to the caregiver and emailed to Infection Prevention unless physician and Infection Prevention were previously notified of positive MTB PCR.
Administrative

CPT Codes

87116 AFB culture (culture, acid fast bacilli)
87206 Ziehl-Neelson stain (acid fast stain)
87206 Kinyoun stain (acid fast stain)
87118 AFB identification by Maldi-tof (mycobacterial, definitive identification, each isolate)
87186 Antimicrobial susceptibility test (performed by ARUP Lab)

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