Microbiology Laboratory Tests: Acanthamoeba to Amebiasis Entamoeba histolytica

Microbiology
Acanthamoeba (Microscopic-Direct Exam; Trichrome Stained Slide)

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Test Includes:

Reporting

Results Available: Contact #s: 512-458-7560

Reference

Method:  
Turnaround Time:  Direct exam 24 hours Reference Range:
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Eye Wash; Cornial Biopsy; Contact Lens/Fluid
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  Eye washing and/or eye scraping will be examined as a direct wet smear and also set up for culture. A trichrome stained slide may be made to confirm positive specimens.

Specimen Submission

Required Request Form: G-2B Specimen Handling:
Transport Temperature:  Ambient (Room) temperature Shipping Requirements:

Billing

CPT Code: 87209 Fees:


Microbiology
Actinomycosis (Aerobic Culture - Identification)

Names of Related Agents:  Nocardia species, Actinomadura species, etc
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Test Includes: Various biochemical and physiological tests for identification to species level

Reporting

Results Available: 21-28 days Contact #s: 512-458-7586

Reference

Method: Biochemical testing  
Turnaround Time:  21-28 days Reference Range:  By report
Limitations: Some genera and species can only be differentiated with molecular analysis that is not available at TDSHS. Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Pure Culture
Collection/Preservation: No preservatives Storage Instructions:
Causes for Rejection: Sample Container: Triple-contained
Sample Test Kit: Availability: Tested 5 days/week: Monday - Friday
Diagnostic Information:   Aerobic culture submitted to this Laboratory for definitive identification. Drug susceptibility testing on these organisms not available at TDSHS laboratory.  Isolates may be forwarded by TDSHS laboratory to reference laboratory for susceptibility testing.  A handling fee may be charged.  Testing at other reference laboratories is subject to fees charge by those laboratories.

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: 87106 Fees:

  

Microbiology
Aerobic Bacterial Culture (Isolation)

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Test Includes: Conventional biochemical methods.

Reporting

Results Available:7-21 days Contact #s: (512) 458-7582

Reference

Method: Conventional biochemical methods.  
Turnaround Time:  7-21 days dependent on organism(s) isolated. Reference Range:  None isolated
Limitations: Quality of specimen collection will affect the ability to isolate pathogenic organisms from clinical specimens. Interpretation: Interpretation of test results is dependent on the organism isolated and the clinical history of the patient.

Specimen Requirements

Specimen Collection: 
Intestinal specimens:
 Should be obtained early in course of illness. Freshly passed stools are better than rectal swabs.

Blood: Should be collected by venipuncture in a tiger top or red top vacutainer

Sample Type: Blood; Body fluids; Bone marrow; CSF; Stool; Sputum; Throat swab; Tissue; Wound exudates
Volume/Amount Required: CSF 1-2 mL, Stool- 25 grams, Rectal swabs -visible fecal material on swab, blood -2-5 mL; tissue -small piece; bone marrow- small amount; Preferred Specimen:  Blood, Body fluids, Bone marrow, CSF, Stool, sputum, throat swab, tissue, wound exudates
Collection/Preservation: Collect blood by venipuncture, specimen held at ambient temperature. Storage Instructions: Do not freeze or refrigerate whole blood. Keep stools, tissue, body fluids, bone marrow, wound exudates, and sputum at 2-8°C.
Causes for Rejection: Insufficient amount of sample to test due to leakage or other circumstances; no identifying marks on sample and/or paperwork; name discrepancies, expired transport media. Sample Container: 
Stool -
 sterile feces container

Rectal swab - Aimes, Stuart’s or Cary-Blair transport tube

Blood: Tiger top or red top vacutainer

Body fluids: Sterile collection tube

Sample Test Kit: Availability: Tested Monday - Friday
Diagnostic Information:  Please indicate suspected organism(s) when submitting specimen.  Culture includes the isolation and identification of the predominant organism or pathogen(s).   Specimens should be collected in the acute phase of infection.  Transport to the laboratory as soon as possible, usually within 48 hours.    Sterile body fluids such as CSF and blood do not require any transport medium and should not be diluted

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handle as body fluid taking universal precautions.
Transport Temperature:  2-8°C (refrigerated), <24 hours unless in transport medium. Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Codes: 87081 (screening), 87040, 87045, 87046, 87070, 87071, 87073 87077, 87143, 87147, 87181, 87205, 87206, 87210, 87278, 87430, 87449 Fees:

 

Microbiology
Aerobic Bacterial Culture, Stool (Isolation)

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Test Includes: Conventional biochemicals, EHEC Toxin test, PCR

Reporting

Results Available: 3-7 days Contact #s: (512) 458-7582

Reference

Method: Conventional biochemical studies, EHEC Toxin test, PCR for virulence factors.  
Turnaround Time:  3-7 days dependent on organism(s) isolated. Reference Range:  Negative for enteric pathogens.
Limitations: Stools must be collected before antibiotic treatment is initiated for greatest chance of isolation of pathogens. Stool specimens must be in enteric preservative or shipped immediately overnight on ice packs. Preservatives used for parasite examinations are not acceptable for bacteriological examinations. Interpretation: Salmonella species, Shigella species, E. coli O157:H7, Shiga toxin producing E. coli; Campylobacter species, Vibrio species, Yersinia enterocolitica, Aeromonas species should be considered significant findings. Significance of other enteric organisms should be determined based on clinical information.

Specimen Requirements

Specimen Collection: Collection of fresh stool. Sample Type: Stool; rectal swabs.
Volume/Amount Required: >10mL for liquid stools; > 20 g solid or semi-solid stools. Preferred Specimen:  Stool in enteric transport media or on ice packs.
Collection/Preservation: Collect in appropriate container to avoid leakage and keep between 2-8°C. If not transported to the laboratory within 24 hours of collection, transfer specimen to an enteric transport media before transporting to the laboratory. Storage Instructions: Keep stools between 2-8°C.
Causes for Rejection: Submitted for culture studies: Unpreserved specimens not received on ice packs or 
> 24 hours old. Received in transport media not recommended for bacterial isolation or expired transport media.
Submitted for toxin studies: Specimen > 7 days old unless frozen at -70°C.
Sample Container: Sealable container that will avoid leakage; Transport media containers such as Cary-Blair, Aimes, or Stuart’s transport.
Sample Test Kit: Availability: Routinely Tested Monday – Friday.
Outbreak investigations may include testing outside these routine test dates.
Diagnostic Information:  Stool culture for isolation of Salmonella, Shigella, Campylobacter, Yersinia, Enterotoxigenic E. coli, E. coli O157:H7; Vibrio is performed by TDSHS in outbreak situations through TDSHS IDEAS department only.  Toxin Testing for Shiga toxin E. coli is available upon request.  See Escherichia coli 0157:H7 or other Shiga toxin E. coli (Toxin Testing). Please indicate suspected organism(s) when submitting specimen.  Culture includes the isolation and identification.  Specimens should be collected in the acute phase of infection.  Transport to the laboratory as soon as possible, usually within 48 hours.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Body fluids must be handled using universal precautions. Specimens should be collected in the acute phase of infection. Transport to the laboratory as soon as possible, within 24 hours unless in transport media.
Transport Temperature: 2-8° C, 24 hours Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87081 (screening), 87040, 87045, 87046, 87070, 87071, 87073 87077, 87143, 87147, 87181, 87205, 87206, 87210, 87278, 87430, 87449 Fees:

 

Microbiology
Amebiasis Entamoeba histolytical/Entamoeba disbar Staining (Identification)

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Test Includes: Concentration and trichrome staining

Reporting

Results Available: 3 days Contact #s: (512) 458-7560

Reference

Method: direct microscopic examination, concentration and trichrome stain,  
Turnaround Time:  3 days Reference Range: No parasites found
Limitations: The ability to detect parasites is limited by the quality of the specimen collection. Interpretation: Negative test results indicates there are no detectable parasites in specimen.

Specimen Requirements

Specimen Collection: Specimens should be collected during acute phase of illness if possible. If cannot be transported to laboratory within 5 hours, specimens should be placed in PVA and formalin immediately Sample Type: Feces (fresh, less than five hours), PVA and formalin preserved feces
Volume/Amount Required: >20 g fresh stool; follow instructions for PVA and formalin transport media. Preferred Specimen:  Feces (fresh, less than five hours), PVA and formalin preserved feces
Collection/Preservation: Collect stool during acute or symptomatic phase of illness if possible. Storage Instructions: ambient temperature
Causes for Rejection: Specimen too old Sample Container: PVA and formalin transport containers; sterile specimen container.
Sample Test Kit: n/a Availability: Test performed Monday-Friday
Diagnostic Information:  Fecal specimens must be sent in fresh (less than five hours from being passed) or PVA and formalin for concentration and trichrome staining. Referred material accepted from hospital, private, and reference laboratories.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Body fluids handled using universal precautions.
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87207 Fees:

 

Microbiology
Amebiasis Entamoeba histolytica/Entamoeba disbar (Serological - Forwarded by TDSHS to CDC for testing)

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Test Includes: Test not performed at TDSHS, specimen forwarded to the CDC for testing.

Reporting

Results Available: Contact #s: (512) 458-7560

Reference

Method:  
Turnaround Time:  3 weeks Reference Range:  Negative
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: venipuncture Sample Type: Serum
Volume/Amount Required: 10 mL whole blood Preferred Specimen:  Single Serum
Collection/Preservation: Collect blood by venipuncture, specimen held at ambient temperature. Separate serum and place in a sterile screw cap tube for shipment. Storage Instructions: Ambient temperature
Causes for Rejection: Clinical symptoms not consistent with amebiasis or detailed patient history not available for the CDC submission. Sample Container: Red or tiger top vacutainer
Sample Test Kit: Availability:  Specimens forwarded to the CDC Monday – Friday.
Diagnostic Information:  Serologic studies may be helpful in the diagnosis of invasive intestinal and extraintestinal amebiasis. Asymptomatic cyst passers usually have negative serologic tests. Eighty-five percent of patients with biopsy proven invasive intestinal amebiasis are antibody positive whereas 95-100% of patients with extra-intestinal amebiasis are positive. Values may remain elevated 6 to 18 months after invasive disease. Prior notification is requested (512) 458-7611.

A detailed patient history is required. Referred material accepted from hospital, private, and reference laboratories. However, since antibodies may persist for years after clinical cure, a reactive test may not indicate active infection.

Specimen Submission

Required Request Form: G-2A Specimen Handling: Body fluids handled using universal precautions
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87336 Fees: