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HelpTest Code AERS Culture, Aerobic - with Susceptibilities
Synonyms/Keywords
Aerobic culture, C and S
Specimen Requirements
| Fasting Required | Specimen Type | Preferred Container/Tube | Acceptable Container/Tube | Specimen Volume | Specimen Minimum Volume (allows for 1 repeat) |
Pediatric Minimum Volume (no repeat) |
|---|---|---|---|---|---|---|
| No | Aspirates and exudates | Sterile, leakproof container |
ESwab™ or
other Amies medium based swab |
1-10 mL or
1 swab |
0.5 mL or
1 swab |
0.5 mL or
1 swab |
| Bone Marrow | Sterile leakproof container or Vacutainer with SPS | 1-1.5 mL | 0.5 mL | 0.5 mL | ||
| Bronchial brush | Submit in 1 mL Sterile saline | 1 brush | 1 brush | 1 brush | ||
| Bronchial alveolar lavage (BAL), bronchial wash |
Sterile, screw-cap leakproof container (10 - 100 mL) |
1-10 mL | 0.5 mL | 0.5 mL | ||
| Catheter tip (other than Foley) | Sterile, wide-mouth screw-cap leakproof container | 1 tip | 1 tip | 1 tip | ||
| Endotracheal aspirate | Aspiration trap (Leuke trap) | 1-10 mL | 0.5 mL | 0.5 mL | ||
| Fluid (other than blood, urine and feces) | Sterile, leakproof container | 1-10 mL | 0.5 mL | 0.5 mL | ||
| Scrapings | Sterile, leakproof container | 1g | 1g | 1g | ||
| Sputum | Sterile, wide-mouth screw-cap leakproof container | 1-10 mL | 0.5 mL | 0.5 mL | ||
| Tissue, Bone, or Hardware |
Sterile, wide-mouth screw-cap leakproof container. For small tissues, add several drops of sterile saline to keep moist. |
1-10 g tissue or bone or
1 pc hardware |
0.5 g tissue or bone |
0.5 g tissue or bone |
||
| Upper respiratory secretions | Sterile, leakproof container | ESwab™, or other Amies medium based swab |
1-10 mL fluid or
1 swab
|
0.5 mL fluid or
1 swab
|
0.5 mL fluid or
1 swab
|
|
| Wound | Sterile, leakproof container | ESwab™, or other Amies medium based swab |
1-10 g tissue or
1 swab |
0.5 g tissue, 0.5 mL fluid or
1 swab
|
0.5 g tissue, 0.5 mL fluid or
1 swab
|
Acceptable Specimen Types
Bone, Bronchial, Catheter Tip, Fine Needle Aspirate, Fluid, Hardware, Respiratory Secretions, Skin Scraping, Swab, Synovial, and Tissue.
Collection/Processing Instructions
Specimens should be delivered to the microbiology laboratory as soon as possible. Culture of specimens older than 24 hours may lead to a reduction in recovery of microorganisms. Gram stains will routinely be performed if sufficient specimen is received.
Swabs:
- ESwab™: one swab can be collected for Gram stain, aerobic, anaerobic, and fungal cultures.
- Other Amies/Stuart medium swab types: collect one swab for every culture and stain (including Gram) to be ordered.
See eSwab Collection Video for more information
For blood, feces, and urine specimens, use tests specific to those specimen types.
Lower Respiratory Tract Secretions: Early morning specimens are preferred because secretions will have pooled overnight. However, samples may be obtained whenever the patient is productive. Sputum samples will be screened for suitability by Gram stain: samples found to be contaminated with saliva will be rejected.
For more information on Specimen Collection Media/Swab, see Specimen Transport Pictorial.
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
|
Swabs (single, dual) in gel or preservative media (Stuart, Amies) |
Room temperature | ≤ 4 hours |
| Refrigerated | <24 hours | |
| ESwab™ | Room temperature | ≤ 48 hours |
| Refrigerated | ≤ 48 hours | |
| Tissues, body fluids, aspirates | Refrigerated | > 4 hours |
| Catheter tips | Room temperature | ≤ 4 hours |
| Refrigerated | > 4 hours | |
| Gastric, biopsy or lavage | Room temperature | ≤ 4 hours |
| Refrigerated | > 4 hours | |
| Lower respiratory secretions (bronchial, sputum, endotracheal) | Room temperature | ≤ 4 hours |
| Refrigerated | > 4 hours | |
| Bone Marrow | Room temperature | ≤ 14 hours |
Rejection Criteria
| Contaminated expectorated sputum specimens per Gram stain screening procedure |
|---|
| Dry swabs |
| Swab specimens collected in preservative media (Amies/Stuart's) > 24 hours |
| ESwab™ specimens > 48 hours |
| Leaking specimens |
| Specimens older than 4 days |
Test Information
Gram stains will routinely be performed on all respiratory secretions, tissues, and fluids (other than blood, feces and urine), specimen volume permitting. A Gram stain will be performed on swab-collected specimens if an ADDITIONAL swab is submitted (i.e. one swab for aerobic culture and a second swab for Gram stain).
For Lower Respiratory Tract (LRT) Secretions:
Gram stains are routinely performed on sputum specimens to determine acceptability for culture. The reliability of culture is very dependent upon the method of collection, conditions of transport, and the quality of the specimen. Some organisms will not grow in routine culture, but can be a significant cause of lower respiratory tract disease. False-negative results may be obtained due to contamination of the specimen with normal oropharyngeal flora, or from previous antimicrobial therapy. False-positive results may be obtained when the culture is over-interpreted, or when potentially pathogenic organisms that are colonizers of the upper respiratory tract are recovered.
Antimicrobial Susceptibility Testing (AST) will be performed on significant bacterial isolates with unpredictable patterns if standardized methods are available based upon Clinical Laboratory Standards Institute guidelines. Methods used include disk diffusion, minimum inhibitory concentration (MIC) by broth microdilution, or MIC by ETEST®. A listing of the tested and reported antimicrobial agents can be seen at Antimicrobial Susceptibility Panels. If testing against a specific antimicrobial agent is desired, contact the microbiology laboratory.
The microbiology laboratory uses selective reporting of susceptibility results to promote rational antimicrobial usage. For more information on selective reporting, please contact the microbiology directors.
Standardized AST is not available for all bacterial species, in which case an MIC determined by a non-standardized method and without interpretation may be available upon request. Contact the microbiology laboratory for more information.
The microbiology laboratory publishes an annual cumulative antibiogram for commonly isolated bacteria, available at Cumulative Antibiogram Reports. Printed copies are also available from the microbiology laboratory.
ESwab™ is a trademark of Copan Diagnostics.
ETEST® is a registered trademark of bioMerieux Inc.
Reference Range Information
| Performing Location | Reference Range |
|---|---|
| All Performing Sites |
Sterile sites: No growth Non-sterile/mucosal sites: Mixed Indigenous Flora |
Marshfield Labs Performing Department
Marshfield Labs Microbiology
Performing Information
| Performing Location | Day(s) Test Performed | Analytical Time | Methodology/Instrumentation |
|---|---|---|---|
| Marshfield | Monday through Sunday | varies with specimen type (average 3-4 days) |
Conventional culture, microscopic exam, standard susceptibility testing, manual or automated identification methods, nucleic acid sequence analysis as needed. |
CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 87070 | 1 | Culture | ||
| 87205 | 1 | Gram stain | By specimen type | |
| 87176 | Homogenization, tissue | By specimen type | ||
| 87077 | Aerobic isolate, definitive ID | As needed | ||
| 87186 | 1-2+ | MIC susceptibility, micro-broth dilution | 1-2 per organism, as needed | |
| 87184 | KB (disk) susceptibility | As needed | ||
| 87181 | MIC susceptibility, ETEST® strip gradient | As needed | ||
| 87147 | Serotyping/grouping | As needed | ||
| 87185 | Enzyme detection | As needed | ||
| 87153 | ID by nucleic acid sequencing method | As needed |
Outreach CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 87070 | 1 | Culture | ||
| 87205 | 1 | Gram stain | By specimen type | |
| 87176 | Homogenization, tissue | By specimen type | ||
| 87077 | Aerobic isolate, definitive ID | As needed | ||
| 87186 | 1-2+ | MIC susceptibility, micro-broth dilution | 1-2 per organism, as needed | |
| 87184 | KB (disk) susceptibility | As needed | ||
| 87181 | MIC susceptibility, ETEST® strip gradient | As needed | ||
| 87147 | Serotyping/grouping | As needed | ||
| 87185 | Enzyme detection | As needed | ||
| 87153 | ID by nucleic acid sequencing method | As needed | ||
|
ESwab™ is a trademark of Copan Diagnostics. ETEST® is registered by BioMerieux Inc. |
||||
Ordering Applications
| Ordering Application | Description |
|---|---|
| Cerner | Aerobic Culture with Sensitivity (w/Gram Stain) |