Test ID: BARRP
Bartonella, Molecular Detection, PCR
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
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
Diagnosing Bartonella infection
Method Name A short description of the method used to perform the test
Rapid Polymerase Chain Reaction (PCR)
(PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.)
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
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.
Sources: Tissue or biopsy of heart valve, liver, lymph node, or spleen. Tissue specimen fixed in a paraffin block or ocular specimen (eg, vitreous humor fluid) is also acceptable.
Container/Tube: Sterile container
Specimen Volume: Entire collection
Specimen Stability Information:
Frozen (preferred)/Refrigerated <48 hours-Fresh tissue
Ambient (preferred)/Refrigerated-Paraffin block
Refrigerated (preferred)/Frozen-Vitreous humor or ocular fluid
Additional Information: The high sensitivity of amplification by PCR requires the specimen to be processed in an environment in which contamination of the specimen by Bartonella species DNA is not likely.
Forms: If not ordering electronically, submit a Microbiology Request Form (Supply T244) with the specimen.
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 | Tissue in formalin, formaldehyde or acetone |
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 | Varies | |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Bartonella henselae and Bartonella quintana are small, pleomorphic, Gram-negative bacilli that are difficult to isolate by culture due to their fastidious growth requirements. Bartonella henselae has been associated with cat scratch disease, bacillary angiomatosis, peliosis hepatitis, and endocarditis. Bartonella quintana has been associated with trench fever, bacillary angiomatosis, and endocarditis.
The diagnosis of Bartonella infection has traditionally been made by Warthin-Starry staining of infected tissue and and/or serology. However, these methods may be falsely negative or nonspecific, respectively. Culture is insensitive.
Evaluation of infected tissue using PCR has been shown to be an effective tool for diagnosing Bartonella infection. Mayo Medical Laboratories has developed a real-time PCR test that permits rapid identification of Bartonella species. The assay targets a unique sequence of the citrate synthase gene present in Bartonella species.
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.
Not applicable
Interpretation Provides information to assist in interpretation of the test results
A positive test indicates the presence of Bartonella species DNA.
A negative test indicates the absence of detectable DNA, but does not negate the presence of the organism or recent disease as false negative results may occur due to inhibition of PCR, sequence variability underlying primers and/or probes, or the presence of Bartonella DNA in quantities less than the limit of detection of the assay.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
This test does not differentiate between Bartonella henselae and Bartonella quintana. A negative result indicates the absence of detectable Bartonella DNA in the specimen but does not negate the presence of organism or active or recent disease and may occur due to inhibition of PCR, sequence variability, underlying primers and/or probes, or the presence of Bartonella species in quantities less than the limit of detection of the assay. Inhibition of <2% has been noted in formalin-fixed paraffin-embedded tissues. In a study of 178 ocular fluids, no inhibition was detected, although this is a possibility due to the relatively small number of specimens tested.
BART/81575 Bartonella Antibody Panel, IgG and IgM, Serum and/or 9943 Warthin-Starry Stain of tissue should be considered if PCR is negative and there is a strong suspicion of disease caused by these organisms.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Karem KL, Paddock CD, Regnery RL: Bartonella henselae, B. quintana, and B. bacilliformis: historical pathogens of emerging significance. Microbes Infect 2000 August;2(10):1193-1205
2. Agan BK, Dolan MJ: Laboratory diagnosis of Bartonella infections. Clin Lab Med 2002 December;22(4):937-962
3. Maguina C, Gotuzzo E: Bartonellosis. New and old. Infect Dis Clin North Am 2000 March;14(1):1-22
4. Vikram HR, Bacani AK, Devaleria PA, et al: Bivalvular Bartonella henselae prosthetic valve endocarditis. J Clin Microbiol 2007 December;45(12):4081-4084
5. Lin EY, Tsigrelis C, Baddour LM, et al: Candidatus Bartonella mayotimonensis and endocarditis. Emerg Infect Dis 2010 Mar;16(3):500-503
Method Description Describes how the test is performed and provides a method-specific reference
Bacterial nucleic acid is extracted from the specimen using the automated MagNA Pure instrument. The purified DNA is placed on the LightCycler instrument, which amplifies and monitors by fluorescence the development of target nucleic sequences after each PCR cycle. A specific target sequence from Bartonella species is amplified and the resulting segment is detected using specific hybridization probes. Detection of the Bartonella target is performed through melting curve analysis using the LightCycler software. (Cockerill FR, Uhl JR: Applications and challenges of real-time PCR for the clinical microbiology laboratory. In Rapid cycle real-time PCR methods and applications. Edited by Reischl U, Wittwer C, Cockerill F. Berlin, Germany, Springer-Verlag, 2002 pp 3-27)
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, Wednesday, Friday; 8 a.m.
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.
87798
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 |
|---|---|---|
| SRC51 | Specimen source | 31208-2 |
| 84440 | Result | 48864-3 |
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