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Culture, Respiratory

Throat, pharynx, pharyngitis, epiglottis, nasal sinuses, Nasopharynx, expectorated sputum, broncoscopy specimens (BAL, BW, Bronch Brush)

Test Codes

EPIC: LAB5500, SOFT: CXRES

Department

Microbiology

Specimen Collection Criteria

Collect: Upper or lower respiratory specimen using aseptic technique and placed in an appropriate sterile collection container. Specimen types and containers are given below.

Lower Respiratory

• Expectorated Sputum: Single productive cough specimen (not saliva) in a sterile collection container, preferably collected in the early morning. The patient should rinse his/her mouth with water prior to specimen collection.
• Bronchoscopy (bronch wash, BAL, bronch brushings): Submit in sterile, tightly capped collection container.
• Tracheal aspirate, trans-tracheal aspirate: Submit in sterile, tightly capped collection container.
• All Lower Respiratory specimens must be considered STAT. Transport to the Laboratory immediately after collection.

Upper Respiratory

• Throat, Nasopharynx (NP): Throat or NP specimen collected with an ESwab.
• Sinus Contents: Contents in a sterile cup or Eswab collection.
• Ear: Collect with an Eswab.

Physician Office/Draw Specimen Preparation

• Lower respiratory specimens: Deliver specimen to the Laboratory immediately after collection, refrigerated (2-8°C or 36-46°F). Courier Services must be contacted for a STAT pickup at 1-800-551-0488.
  
• Upper respiratory specimens: Specimens must be stored at room temperature (20-26°C or 68-78.8°F) until transport.

Preparation for Courier Transport

Transport: Lower respiratory specimens, refrigerated (2-8°C or 36-46°F), or upper respiratory specimens, at room temperature (20-26°C or 68-78.8°F).

Rejection Criteria

• Specimens submitted in containers with formalin or that ever-contained formalin.
• Expectorated sputum specimens in non-sterile or leaking containers.
• Non-productive sputum specimens consisting of saliva as indicated by Gram Stain result.
• Upper respiratory specimens delayed in transit (greater than 24 hours from time of collection).
• Lower respiratory specimens delayed in transit (greater than 2 hours from time of collection) will be tested, with reporting at the discretion of the Microbiology Medical/Technical Director.

Inpatient Specimen Preparation

Transport specimens immediately to the Laboratory for testing. 

In-Lab Processing

A Gram Stain will be performed on lower respiratory specimens.

Storage

Specimen Stability for Testing:

Lower Respiratory Specimens
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 8 hours
Frozen (-20°C/-4°F or below): Unacceptable

Upper Respiratory Specimens
Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 4 days

Laboratory

Royal Oak Microbiology Laboratory

Performed

Sunday – Saturday, 24 hours a day.
Preliminary results available within 24 hours. 

Reference Range

No pathogens recovered.

Test Methodology

Gram stain (lower respiratory specimens), aerobic culture, identification and susceptibility testing (if indicated).

Interpretation

The recovery of aerobic bacteria from an appropriate, properly collected specimen may be indicative of an infectious disease process.

Clinical Utility

This test is used to recover and identify aerobic bacteria that may be involved in human infections.

Reference

1. Vandamme, P.A.R., 2015. Specimen Collection, Transport, and Processing: Bacteriology, pg. 228-272. Jorgensen, J.H., Editor-in-Chief. Manual of Clinical Microbiology. 11^th Edition. ASM Press. Washington, D.C., p. 228-272.
2. Carson, J.A. 2016. Wound Abscess and Soft Tissue Cultures. Clinical Microbiology Procedures Handbook. 4^th Edition. Leber, A.L., Editor-in-Chief. ASM Press, Washington, D.C. Section 3.13.1.1.

CPT Codes

87070

Contacts

Last Updated

4/12/2024