Microbiology Laboratory Tests: U-Z

Test Includes: Culture, Conventional biochemicals

Reporting

Results Available: 3-10 days

Contact #s: (512) 458-7582

Reference

Method: Culture, Conventional biochemicals

Turnaround Time:  3-10 days

Reference Range:  Negative for N. gonorrhoeae

Limitations: organism must be viable

Interpretation:

Specimen Requirements

Specimen Collection: urethral

Sample Type:  urethral swab, endocervical swab

Volume/Amount Required:

Preferred Specimen:  urethral swab, endocervical swab

Collection/Preservation:

Storage Instructions:

Causes for Rejection:

Sample Container:

Sample Test Kit:

Availability:

Diagnostic Information:  For clinical culture studies see Gonorrhea Culture (Isolation) For probe testing, see Gonorrhea (Culture – Genetic Probe).

Specimen Submission

Required Request Form:  G-2B

Specimen Handling:

Transport Temperature:

Shipping Requirements:

Billing

CPT Code: 87070, 87590, 87591

Fees:

Test Includes: Cell culture

Reporting

Results Available: 2-14 days

Contact #s: 512-458-7594

Reference

Method: Cell culture

Turnaround Time:  2-14 days

Reference Range:  No virus isolated

Limitations:

Interpretation: A result of “No virus isolated” does not necessarily mean absence of disease.  The success of virus isolation depends a great deal on the submission of the proper specimen, collected at the right time, and shipped with the least possible delay.

Specimen Requirements

Specimen Collection: Specimens should be collected at an appropriate anatomic site and at the proper time after infections because viruses are generally shed for only a short period of time. Refer to Specimen Collection by Type table for additional instructions. 

Sample Type: See preferred specimen

Volume/Amount Required: Swab in 1-2 mL of viral transport media.

Preferred Specimen:  Vesicle fluid, Skin scrapings

Collection/Preservation: Viral transport media

Storage Instructions: Maintain specimens at 2-8°C immediately after collection.  Ship with the least possible delay.  If storage is necessary, freeze at -70° C.

Causes for Rejection: Specimens submitted on a preservative such as formalin.

Sample Container: Sterile container

Sample Test Kit:

Availability: Monday - Friday

Diagnostic Information:  Isolation is done in conventional tube culture and shell vial culture.  If characteristic CPE is observed in the tube culture or after a 5-7 day incubation of the shell vial culture, immunofluorescence tests are performed using VZ-specific monoclonal antibody.

Specimen Submission

Required Request Form: G-2V

Specimen Handling:

Transport Temperature:  2-8° C, overnight

Shipping Requirements: Ship specimens in compliance with governmental regulations.

Billing

CPT Code: 87252

Fees:

Test Includes: Immunofluorescence

Reporting

Results Available: 2-14 days

Contact #s: 512-458-7594

Reference

Method: Immunofluorescence

Turnaround Time:  2-14 days

Reference Range:  By report

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type:

Volume/Amount Required: Fill monolayer tube with media if transporting at ambient temperature.  If transporting on dry ice, send 1-2 mLs.

Preferred Specimen:  Cell culture isolate with CPE.

Collection/Preservation:

Storage Instructions: If shipment of isolate will be delayed, store isolate at -70° C.

Causes for Rejection:

Sample Container: Cell culture tube or sterile cryovial.

Sample Test Kit:

Availability: Monday - Friday

Diagnostic Information:  Identification is based on immunofluorescence test using VZV-specific monoclonal antibody.

Specimen Submission

Required Request Form: G-2V

Specimen Handling:

Transport Temperature:  
Monolayer with CPE:  Ambient temperature. 
Frozen isolate:  on dry ice

Shipping Requirements: Ship specimens in compliance with governmental regulations.

Billing

CPT Code: 87253

Fees:

Test Includes: Conventional biochemicals

Reporting

Results Available: 4-7 days

Contact #s: (512) 458-7582

Reference

Method: conventional biochemical

Turnaround Time:  4-7 Days

Reference Range:  By Report

Limitations: Organism must be viable for biochemical studies

Interpretation: By Report

Specimen Requirements

Specimen Collection:

Sample Type: Pure Culture

Volume/Amount Required:  one specimen per patient

Preferred Specimen:  Pure Culture on agar slant

Collection/Preservation:

Storage Instructions: ambient temperature, never refrigerate or freeze

Causes for Rejection: Name on tube/form do not match, broken in transport

Sample Container: Agar slant in screw cap tube.

Sample Test Kit:

Availability: Monday-Friday

Diagnostic Information:  Pure cultures should not be refrigerated. See Vibrio cholerae (Culture-Identification)

Specimen Submission

Required Request Form: G-2B

Specimen Handling:  Infectious agent

Transport Temperature:  Ambient  temperature

Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87077

Fees:

Test Includes: Conventional biochemicals, serological typing

Reporting

Results Available: 4-7 days

Contact #s:  (512) 458-7582

Reference

Method:  conventional biochemicals, slide agglutination

Turnaround Time:  4-7 days

Reference Range:  By report  

Limitations:

Interpretation: Identification of Vibrio cholerae should always be considered significant.

Specimen Requirements

Specimen Collection:

Sample Type: Pure Culture

Volume/Amount Required:  one specimen per patient

Preferred Specimen:  Pure Culture on agar slant

Collection/Preservation:

Storage Instructions: Ambient temperature, do not refrigerate or freeze

Causes for Rejection: Name on tube/form do not match, broken in transport.

Sample Container: Agar slant in screw cap tube

Sample Test Kit:

Availability: Monday-Friday
Outbreak investigations with prior notification: Saturday-Sunday

Diagnostic Information:  Pure cultures should NOT be refrigerated.  Vibrio cholerae will be serotyped for O1 and O139 serotypes.  Requests for Toxin testing are forwarded to CDC.  Prior approval must be secured before submitting culture.  For Molecular analysis, see Molecular typing (PFGE)

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Infectious agent, Biosafety level 2

Transport Temperature:  Ambient temperature

Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code:

Fees:

Test Includes: Test not performed at TDSHS, Specimens submitted to the CDC with prior approval.

Reporting

Results Available:

Contact #s:

Reference

Method:

Turnaround Time:  Dependent on CDC report  

Reference Range:

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type:

Volume/Amount Required:

Preferred Specimen:  Pure Culture, safely contained

Collection/Preservation:

Storage Instructions:

Causes for Rejection:

Sample Container:

Sample Test Kit:

Availability:

Diagnostic Information:  Pure cultures should NOT be refrigerated.  Requests for Toxin testing are forwarded to CDC.  Prior approval must be secured before submitting culture.  For Molecular analysis, see Molecular typing (PFGE) Reference Range

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Infectious agent, biosafety level 2

Transport Temperature:  Ambient (Room) temperature

Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87077

Fees:

Test Includes: conventional biochemicals, serological typing

Reporting

Results Available: 3-7 days

Contact #s: (512) 458-7582

Reference

Method: Conventional biochemicals, slide agglutination

Turnaround Time:  3-7 days

Reference Range:  No Vibrio species isolated.

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection: stool

Sample Type: stool

Volume/Amount Required: >10 g

Preferred Specimen:  stool in Cary-Blair transport medium

Collection/Preservation: Collect stool in clean, dry container. Transfer to a Cary-Blair if in transport > 24 hours.

Storage Instructions: 2-8° C, Do not ship on dry ice.

Causes for Rejection:

Sample Container: Cary-Blair transport tube or leak-proof container.

Sample Test Kit:

Availability: Monday-Friday

Diagnostic Information:  See aerobic bacterial culture, stool. Pure cultures should NOT be refrigerated.  Requests for Toxin testing are forwarded to CDC.  Prior approval must be secured before submitting culture.  For Molecular analysis, see Molecular typing (PFGE)

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Handle body fluids using universal precautions

Transport Temperature:  Wet Ice (Ice packs)

Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87046

Fees:

Test Includes:

Reporting

Results Available:

Contact #s:

Reference

Method:

Turnaround Time:  7-11 days

Reference Range:  By report

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type:

Volume/Amount Required:

Preferred Specimen:  Pure Culture, safely contained

Collection/Preservation:

Storage Instructions:

Causes for Rejection:

Sample Container:

Sample Test Kit:

Availability:

Diagnostic Information:  PCR is performed at TDSHS for the virulence factor genes for detection of pathogenic Escherichia coli including heat stable and labile toxin, shiga toxin, invasion plasmid antigen, attaching and effacing gene and hemolysin. PCR may be performed from pure cultures or from original plating media used in stool screens.  For typing see Escherichia coli 0157:H7 or other Shiga toxin E. coli Culture (Typing) For toxin testing see Escherichia coli 0157:H7 or other Shiga toxin E. coli (Toxin Testing).

Specimen Submission

Required Request Form: G-2B

Specimen Handling:

Transport Temperature:  Ambient (Room) temperature

Shipping Requirements:

Billing

CPT Code:

Fees:

Test Includes: Colilert 18 hour (See Coliform- Total Colilert)

Reporting

Results Available:

Contact #s:

Reference

Method: MUG fluorescent

Turnaround Time: 1 day

Reference Range:  Negative for coliforms

Limitations: Water must be received within 30 hours of collection.

Interpretation: Negative test result indicates that there were no detectable coliforms in the sample submitted. The test does not detect an overall bacterial count or rule out other types of bacteria in the sample.

Specimen Requirements

Specimen Collection: In accordance with the package insert with collection bottle.

Sample Type: Water

Volume/Amount Required: 100 mL

Preferred Specimen:  Water

Collection/Preservation:

Storage Instructions: ambient temperature, < 30 hours old.

Causes for Rejection: > 30 hours old.

Sample Container: Leak proof container supplied by TDSHS.

Sample Test Kit: Colilert 18 hour

Availability: Monday- Sunday. Specimen must be received by 11 a.m on weekend to be tested that day.

Diagnostic Information:  Samples must be from portable water source in approved sample container and submitted within 30 hours.  Fee for service is charged.  See Coliform.

Specimen Submission

Required Request Form:  G-79

Specimen Handling: According to package insert with collection bottle.

Transport Temperature: ambient

Shipping Requirements: Within 30 hours of collection.

Billing

CPT Code:

Fees:

Test Includes: See Coliform- Total Colilert

Reporting

Results Available:

Contact #s:

Reference

Method:

Turnaround Time:

Reference Range:

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type:

Volume/Amount Required:

Preferred Specimen:  Water

Collection/Preservation:

Storage Instructions:

Causes for Rejection:

Sample Container:

Sample Test Kit:

Availability:

Diagnostic Information:  Samples must be from portable water source in approved sample container and submitted within 30 hours.  Fee for service is charged. See Coliform.

Specimen Submission

Required Request Form: G-79

Specimen Handling:

Transport Temperature:

Shipping Requirements:

Billing

CPT Code:

Fees:

Test Includes: See Coliform- Total Colilert

Reporting

Results Available:

Contact #s:

Reference

Method:

Turnaround Time:

Reference Range:

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type:

Volume/Amount Required:

Preferred Specimen:  Water

Collection/Preservation:

Storage Instructions:

Causes for Rejection:

Sample Container:

Sample Test Kit:

Availability:

Diagnostic Information:  Samples must be from portable water source in approved sample container and submitted within 30 hours.  Fee for service is charged.  Enumeration no longer done. See Coliform.

Specimen Submission

Required Request Form: G-79

Specimen Handling:

Transport Temperature:

Shipping Requirements:

Billing

CPT Code:

Fees:

Test Includes:

Reporting

Results Available:

Contact #s: (512) 458-7560

Reference

Method:

Turnaround Time:  5 days

Reference Range:

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type:

Volume/Amount Required:

Preferred Specimen:  Water filter

Collection/Preservation:

Storage Instructions:

Causes for Rejection:

Sample Container:

Sample Test Kit:

Availability:

Diagnostic Information:  Specimens accepted only through TCEQ.

Specimen Submission

Required Request Form: G-79

Specimen Handling:

Transport Temperature:  On Ice Packs  

Shipping Requirements:

Billing

CPT Code:

Fees:

Test Includes:

Reporting

Results Available: 1-3 days

Contact #s:

Reference

Method:

Turnaround Time:  1-3 days

Reference Range:  <2.00 (Nonreactive)

Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. May be cross reactivity with other arthropod borne viruses.

Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.

Specimen Requirements

Specimen Collection: Venipuncture

Sample Type:

Volume/Amount Required: 2 mL Serum

Preferred Specimen:  Paired Sera; Single Serum

Collection/Preservation: Red top or tiger top tube

Storage Instructions: Separated serum may be held at 2-8°C

Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing

Sample Container: Red top or tiger top tube

Sample Test Kit:

Availability: Test performed daily

Diagnostic Information:  West Nile Virus is a flavivirus recently associated with an outbreak of encephalitis in the Eastern United States. West Nile Virus IgM is usually detectable by the time symptoms appear, but IgG may not be detectable until day 4 or day 5 of illness. Antibodies induced by West Nile Virus infection show extensive crossreactivity with other flaviviruses, including Dengue Fever Virus and St. Louis Encephalitis Virus.

Specimen Submission

Required Request Form: G-1A

Specimen Handling: Use Universal Precautions

Transport Temperature: Cold (2-8º C) on ice packs if received within 48 hours from time of collection. Frozen (≤-20°) on dry ice if received more than 48 hours from time of collection.

Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.

Billing

CPT Code: 86790

Fees:

Test Includes: Microscopic Examination

Reporting

Results Available: 3 days

Contact #s: (512) 458-7560

Reference

Method: Microscopic Examination

Turnaround Time:  3 days

Reference Range:  Specimen was not a worm

Limitations:

Interpretation: By Report

Specimen Requirements

Specimen Collection: worm, Feces

Sample Type: Worm

Volume/Amount Required: One Worm

Preferred Specimen:  Worm (whole) in alcohol

Collection/Preservation: Place worm in ethyl alcohol

Storage Instructions: Ambient Temperature

Causes for Rejection:

Sample Container: Clean, leak-proof container; formalin transport for parasites.

Sample Test Kit:

Availability: Monday - Friday

Diagnostic Information:  Fecal specimens must be sent in fresh (less than five hours) or in formalin.  Adult worms should be submitted in ethyl alcohol.  Referred material accepted from hospital, private, and reference labs. 

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Handle body fluids using universal precautions.

Transport Temperature:  Ambient (Room) temperature

Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87015

Fees:

Test Includes:

Reporting

Results Available: 3 weeks

Contact #s:

Reference

Method: EIA

Turnaround Time:  3 weeks  

Reference Range:  <2.00 (Nonreactive)

Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.

Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.

Specimen Requirements

Specimen Collection: Venipuncture

Sample Type: Serum

Volume/Amount Required: 10 mL whole blood

Preferred Specimen:  Paired Sera

Collection/Preservation: Red top or tiger top tube

Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C

Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing

Sample Container: Red top or tiger top tube

Sample Test Kit:

Availability:

Diagnostic Information:  Prior notification is requested (512) 458-7760. Serum specimens are to be collected at least 14 days apart, and will be submitted to the CDC when accompanied by immunization, travel, and clinical history.  A fourfold titer increase is evidence of current infection.  Cross-reactions occur with Dengue Fever and immunization.

Specimen Submission

Required Request Form: G-2A

Specimen Handling: Use Universal Precautions

Transport Temperature:  Ambient temperature for specimens on the blood clot, separated serum at 2-8°C (refrigerated) or -20°C (frozen).

Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.

Billing

CPT Code: 86790

Fees:

Test Includes:

Reporting

Results Available:

Contact #s:

Reference

Method:

Turnaround Time:  3-10 days

Reference Range:  None isolated

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type:

Volume/Amount Required:

Preferred Specimen:  Blood, bubo aspiration, sputum, throat swabs, CSF; Swabs in Cary-Blair transport at autopsy: blood, tissue specimens from spleen, liver, lungs, buboes.

Collection/Preservation:

Storage Instructions:

Causes for Rejection:

Sample Container:

Sample Test Kit:

Availability:

Diagnostic Information:  Telephone Laboratory (512-776-3781) prior to shipping specimen.  Cultures must be held for 14 days before reporting as negative. Local and State health authorities must be immediately notified of suspected and presumptive cases of plague. Yersinia pestis is a pathogen in biohazard risk group III and should be handled in a containment laboratory.  Blood cultures should be taken (at least 3 in a 24 hour period). Stains of clinical material using Giemsa, Wright, or Wayson stains show small rods with bipolar “safety pin” staining.   Yersinia pestis is one of the agents listed on the Bioterrorism agents list.  See Bioterrorism agents (Clinical -Isolation) and Bioterrorism agents (Referred Identification - PCR)

Specimen Submission

Required Request Form: G-27A 

Specimen Handling:

Transport Temperature:  4ºC , ice packs

Shipping Requirements:

Billing

CPT Code: 87070

Fees:

Test Includes: Conventional biochemicals

Reporting

Results Available:  4-14 days

Contact #s: (512) 458-7582

Reference

Method: conventional biochemicals

Turnaround Time:  4-14 days

Reference Range:  No Yersinia species isolated.

Limitations:

Interpretation:  By report

Specimen Requirements

Specimen Collection:  feces

Sample Type: Feces in enteric transport media; Blood

Volume/Amount Required: 10 g stool or 10 mL liquid stool

Preferred Specimen:  Feces in enteric transport media; Blood

Collection/Preservation: Collect stool in dry, clean container. Transfer to enteric transport.

Storage Instructions:  2-8° C

Causes for Rejection:

Sample Container:  Enteric transport

Sample Test Kit:

Availability: Monday-Friday
Outbreak investigations with prior notification: Saturday-Sunday

Diagnostic Information:  Intestinal yersiniosis may present in three clinical forms: enteritis, terminal ileitis or mesenteric lymphadenitis causing "pseudoappendicitis", and septicemia.

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Handle body fluids using universal precautions

Transport Temperature:  2-8º C

Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87046

Fees:

Test Includes:  conventional biochemicals

Reporting

Results Available: 4-10 days

Contact #s:  (512) 458-7582

Reference

Method:  conventional biochemicals

Turnaround Time:  Identification 4-7 days.
 Serotyping: dependent on CDC report

Reference Range:  By report

Limitations:

Interpretation:  By report

Specimen Requirements

Specimen Collection:

Sample Type: Pure culture

Volume/Amount Required: one specimen per patient

Preferred Specimen:  Pure Culture on agar slant

Collection/Preservation:

Storage Instructions:  ambient temperature

Causes for Rejection:

Sample Container:  Agar slant in screw cap tube

Sample Test Kit:

Availability: Monday-Friday

Diagnostic Information:  Strains of Y. entercolitica can be characterized by their biotypes but any requests for serotyping of Yersinia enterocolitica are submitted to the CDC with prior approval.  Please call the Clinical Bacteriology Section, (512-568-7582) before submitting for serotyping.  Complete clinical information must be included with the specimens submitted for serotyping.

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Infectious agent, biosafety level 2

Transport Temperature:  Ambient temperature

Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87077

Fees:

Test Includes: Isolation of fungus and identification by morphological tests

Reporting

Results Available: 21-28 days

Contact #s: 512-458-7455 for prior approval
Technical questions:  512-458-7586

Reference

Method: Slide culture

Turnaround Time:  21-28 days

Reference Range:  Negative

Limitations: Delay in transport of specimen could compromise isolation of organism.

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type: Clinical Specimen

Volume/Amount Required: 3 mL to 15 mL

Preferred Specimen:  Tissue; Sputum; Scrapings

Collection/Preservation: No preservative

Storage Instructions: Transport specimen as soon as possible.  If transport is delayed over one hour, refrigerate specimen. 

Causes for Rejection: Specimens received frozen, in formalin, or in culture medium will be rejected.  Swabs are discouraged unless the only specimen available; submit swabs in 5 mL sterile saline.

Sample Container: Triple-contained.  Sterile, leak-proof, 50 mL conical tube preferred for primary container.  Add up to 10 mL sterile saline to tissue if needed to maintain moisture during transport.

Sample Test Kit:

Availability: Testing available upon approval by Dr. Penfield.

Diagnostic Information:  Approval for this testing must be obtained prior to shipping by telephoning Dr. Susan Penfield at 512-458-7455.

Specimen Submission

Required Request Form: G-2B

Specimen Handling:

Transport Temperature:  Ambient acceptable but 2-8º C preferred for non-sterile specimens.

Shipping Requirements: Triple-contained and packaged to meet requirements of DOT, USPS, PHS, and IATA for shipping of clinical specimens.

Billing

CPT Code: 87101, 87102, 87103

Fees:

Test Includes: Identification of fungus by morphological tests

Reporting

Results Available: 21-28 days

Contact #s: 512-458-7586

Reference

Method: Slide culture

Turnaround Time:  21-28 days

Reference Range:  By report

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type:

Volume/Amount Required:

Preferred Specimen:  Pure Culture

Collection/Preservation:

Storage Instructions:

Causes for Rejection: Culture infested with mites.

Sample Container: Triple-contained.

Sample Test Kit:

Availability: Tested 5 days/week: Monday-Friday

Diagnostic Information:  Fungal isolates (pure culture) submitted to this Laboratory for definitive identification. Drug susceptibility testing on these organisms not available at TDSHS laboratory. 

Specimen Submission

Required Request Form: G-2B

Specimen Handling:

Transport Temperature:  Room temperature

Shipping Requirements: Triple-contained and packaged to meet rigorous performance tests as outlined in the DOT, USPS, PHS, and IATA regulations for shipping of infectious substances.

Billing

CPT Code: 87101, 87102, 87103

Fees: