Test ID: SPUT
Bacterial Culture, Aerobic, Respiratory
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Aids in the diagnosis of lower respiratory bacterial infections including pneumonia
Method Name A short description of the method used to perform the test
Conventional Culture Technique
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
General Bacteria Culture, Sputum
50003-SPUT
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Specimen must arrive within 24 hours of collection.
Specimen Type: Respiratory
Sources: Sputum, bronchoalveolar lavage, trachea, endotracheal tube, etc.
Container/Tube: Sterile container
Specimen Volume: Entire specimen
Collection Instructions:
1. An early-morning expectorated sputum is preferred.
2. Having patient rinse his/her mouth with water immediately prior to specimen collection reduces the number of contaminating oropharyngeal bacteria.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | Specimen >24 hours |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Refrigerated | 24 hours |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Common bacterial agents of acute pneumonia include: Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Pseudomonas aeruginosa, and members of the Enterobacteriaceae (Escherichia coli, Klebsiella species, and Enterobacter species) Clinical history, physical examination, and chest X-ray are usually adequate for the diagnosis of pneumonia, and antimicrobial treatment is typically based on these findings.
Culture of expectorated sputum is used by some for the evaluation of pneumonia, although controversy exists regarding this practice; both sensitivity and specificity of sputum cultures are generally regarded as poor (<50%). Specificity is improved by collecting expectorated purulent matter from the lower respiratory tract and avoiding mouth and oropharyngeal matter, thereby reducing contamination. Prior to culture, the specimen should be examined for the presence of WBCs (evidence of purulent matter) and a paucity of squamous cells (evidence of minimal contamination by oral matter).
Blood cultures should be performed to establish the definitive etiology of an associated pneumonia. However, only 20% to 30% of patients with bacterial pneumonia are bacteremic.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
No growth or usual flora
Interpretation Provides information to assist in interpretation of the test results
Organisms associated with lower respiratory tract infections are reported.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
When culture of sputum is delayed, successful isolation of bacterial pathogens is less likely, due to the overgrowth of usual oropharyngeal flora.
Interpretation of lower respiratory cultures is often complicated by the presence of usual flora and the possibility of colonization, rather than infection. Results should always be evaluated in light of clinical information.
Method Description Describes how the test is performed and provides a method-specific reference
All specimens are screened microscopically by Gram stain to avoid culturing specimens that do not represent lower respiratory secretions; specimens with >25 squamous epithelial cells per low-power field will not be cultured.
Lower respiratory specimens are inoculated onto sheep blood agar, eosin methylene blue agar, and chocolate agar and are incubated for 18 to 24 hours. The following organisms are identified and reported: Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus species, Staphylococcus aureus, Moraxella catarrhalis, Neisseria meningitidis, gram-negative bacilli, and predominant yeast. Other organisms are classified as usual oropharyngeal flora.(Isenberg HD: Clinical Microbiology Procedures Handbook. Edited by HD Isenberg, Washington, DC, ASM Press, 1992, Section 1.15)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Sunday; Continuously
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
Bacteria, Culture,Aerobic, Respiratory
87070
Gram Negative Bacillus Ident
87077 (if appropriate)
Identification Commercial Kit
87077 (if appropriate)
Ident by MALDI-TOF mass spec
87077 (if appropriate)
Bacteria Identification
87077 (if appropriate)
Aerobe Ident by Sequencing
87153 (if appropriate)
Fluorescent Method Culture Typing
87140 (if appropriate)
Additional Identification Procedure
87077 (if appropriate)
Identification Staphylococcus
87077 (if appropriate)
Identification Streptococcus
87077 (if appropriate)
Beta Lactamase
87185 (if appropriate)
KPC PCR
87150 (if appropriate)
Hodge Test
87185 (if appropriate)
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| SPUT | Bacterial Culture, Aerobic, Resp | In Process |
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