Bacterial Culture, Aerobic, Respiratory
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
An aid in the diagnosis of lower respiratory bacterial infections including pneumonia
Reflex Tests Lists test(s) that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial test(s)
|Test ID||Reporting Name||Available Separately||Always Performed|
|COMM||Identification Commercial Kit||No, (Bill Only)||No|
|RMALD||Ident by MALDI-TOF mass spec||No, (Bill Only)||No|
|GID||Bacteria Identification||No, (Bill Only)||No|
|ISAE||Aerobe Ident by Sequencing||No, (Bill Only)||No|
|REFID||Additional Identification Procedure||No, (Bill Only)||No|
|SALS||Serologic Agglut Method 1 Ident||No, (Bill Only)||No|
|EC||Serologic Agglut Method 2 Ident||No, (Bill Only)||No|
|SHIG||Serologic Agglut Method 3 Ident||No, (Bill Only)||No|
|STAP||Identification Staphylococcus||No, (Bill Only)||No|
|STRP||Identification Streptococcus||No, (Bill Only)||No|
|BLA||Beta Lactamase||No, (Bill Only)||No|
|KPND1||KPC and NDM PCR||No, Internal (Bill Only); Yes External (Order KPNRP)||No|
|HODGB||Carbapenamase-Modified Hodge Test||No, Internal (Bill Only); Yes External (Order HODGE)||No|
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, the reflex tests may be performed and charged separately.
Conventional Culture Technique
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Bacterial Culture, Aerobic, Resp
Culture, General Bacteria, Sputum
General Bacteria Culture, Sputum
General Bacteria Culture, Sputum
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
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.
Additional Information: Specimen source is required.
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.
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.
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
Identification of probable pathogens
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.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Chapter 2: Introduction to Microbiology, Part II: Guidelines for the Collection, Transport, Processing, Analysis and Reporting of cultures from Specific Specimen sources. In Color Atlas and Textbook of Diagnostic Microbiology. Sixth edition. Edited by E Koneman. Lippincott, Philadelphia, PA, 2006, pp 67-79
2. York MK, Gilligan P, Church D: Lower Respiratory Tract Cultures. In Clinical Microbiology Procedures Handbook. Third edition. Edited by LS Garcia. Washington, DC, ASM Press, 2010, Section 3.11.2
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.
This test uses a standard method. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements.
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.
87070-Bacteria, Culture,Aerobic, Respiratory
87077-Identification Commercial Kit (if appropriate)
87077-Ident by MALDI-TOF mass spec (if appropriate)
87077-Bacteria Identification (if appropriate)
87153-Aerobe Ident by Sequencing (if appropriate)
87077-Additional Identification Procedure (if appropriate)
87147 x 5-Serologic Agglut Method 1 Ident (if appropriate)
87147-Serologic Agglut Method 2 Ident (if appropriate)
87147 x 5-Serologic Agglut Method 3 Ident (if appropriate)
87077-Identification Staphylococcus (if appropriate)
87077-Identification Streptococcus (if appropriate)
87185-Beta Lactamase (if appropriate)
87798 x 2-KPC and NDM PCR (if appropriate)
87185-Carbapenemase Detection, Modified Hodge Test (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||634-6|