Test ID: CFRC
Bacterial Culture, Cystic Fibrosis, 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
Detection of aerobic bacterial pathogens from cystic fibrosis patient specimens
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
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.
If susceptibilities are desired when this test is ordered, also order ZMMLS/8073 Antimicrobial Susceptibility, Aerobic Bacteria, MIC. Each pathogen isolated will then be tested with the appropriate susceptibility panel. Charges are added for each susceptibility test performed.
Forms: If not ordering electronically, submit a Microbiology Request Form (Supply T244) with the specimen.
Specimen must arrive within 48 hours of collection; specimen >48 hours will be rejected.
Specimen source is required.
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Sputum, expectorated or induced
Container/Tube: Sterile container
Specimen Volume: Entire collection
Acceptable:
Specimen Type: Bronchial aspirate or washing, bronchoalveolar lavage, endotracheal, or tracheal
Container/Tube: Sterile container
Specimen Volume: Entire collection
Specimen Type: Throat swab
Container/Tube: Modified Stuart transport device
Specimen Volume: Entire 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 | NA |
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 | 48 hours |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Life expectancy of patients with cystic fibrosis (CF) has increased steadily over the past 50 years, in large part due to improvements in the management of lung disease in this patient population. Still, chronic lung infection is responsible for 75% to 85% of deaths in patients with CF. Appropriate treatment for the causative organism can reduce morbidity and mortality.
The number of microbial species associated with CF lung disease is relatively limited. These include Pseudomonas aeruginosa (mucoid and nonmucoid), Staphylococcus aureus, Burkholderia cepacia complex, Stenotrophomonas maltophilia, other nonfermenting gram-negative rods, Haemophilus influenzae, and Streptococcus pneumoniae. Nontuberculous mycobacteria and Aspergillus species may also play a role in CF lung disease, in addition to common respiratory viruses. This culture, which is specifically designed for CF patients, utilizes conventional and additional selective media (compared to non-CF respiratory cultures) to isolate bacteria commonly associated with pulmonary disease in CF patients.
In selected centers, lung transplantation is performed on CF patients. This test is appropriate for lung transplant patients with underlying CF because they can continue to harbor the same types of organisms as they did pretransplantation. CF patients may be colonized or chronically infected by these organisms over a long period of time.
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
A negative test result is no growth of bacteria or growth of only usual flora. A negative result does not rule out all causes of infectious lung disease (see "Cautions").
For positive test results, pathogenic bacteria are identified. Because cystic fibrosis (CF) patients may be colonized or chronically infected by some organisms over a long period of time, positive results must be interpreted in conjunction with previous findings and the clinical picture to appropriately evaluate results.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Some bacterial agents that cause lower respiratory infections (eg, mycobacteria, Legionella species, Mycoplasma pneumoniae) are not detected by this assay and require special procedures. If the bacterial culture is negative, clinicians should consider additional testing to detect other bacterial, viral, or fungal agents.
Results must be interpreted in conjunction with clinical findings and previous culture results.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
Infections of the lower respiratory tract. In Bailey & Scott's Diagnostic Microbiology. 12th edition. Edited by B Forbes, D Sahm, A Weissfeld. St. Louis, Mosby Elsevier, 2002 pp 798-813
Method Description Describes how the test is performed and provides a method-specific reference
Standard media (5% sheep blood, chocolate, and eosin methylene blue [EMB] agar plates) used for respiratory cultures are inoculated. In addition, 2 selective agar plates are utilized to enable isolation of slower growing pathogens that may be easily overgrown by usual flora and the longstanding colonization by Pseudomonas aeruginosa. Burkholderia Cepacia Selective Agar plate is used for the isolation of Burkholderia cepacia complex, which includes 9 distinct species. Isolates of Burkholderia cepacia will be forwarded to the University of Michigan’s CFF Research Testing and Repository for genotyping. (There is no charge for this shipping/testing). A chromogenic Staphylococcus aureus agar is used to enhance the isolation of Staphylococcus aureus. Finally, a second chocolate blood agar plate is incubated in an anaerobic atmosphere. The anaerobic atmosphere allows for detection of Haemophilus species that may otherwise be overgrown by Pseudomonas aeruginosa. (Gilligan P: Section 3: Respiratory cultures from cystic fibrosis patients. In Clinical Microbiology Procedures Handbook. Vol. 1. 2nd edition. Edited by HD Isenberg. Washington DC. ASM Press, 2007 pp 3.11.3.1-3.11.3.9)
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, Cystic Fibrosis, 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 |
|---|---|---|
| CFRC | Bacterial Culture, Cystic Fibrosis | In Process |
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