Microbiology Laboratory Tests: D-E

Test Includes:

Reporting

Results Available:

Contact #s:

Reference

Turnaround Time:  5-7 days

Reference Range:  <1.00

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

Interpretation:

Specimen Requirements

Specimen Collection: Venipuncture

Sample Type:

Volume/Amount Required: 2 mL Serum

Preferred Specimen:  Single Serum; Paired Sera

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

Diagnostic Information:  These assays detect IgM and IgG antibodies against all four Dengue fever types. Except for very early IgM responses, the immune response to Dengue fever is not type specific. While a single serum may be tested, a second serum collected 10-14 days later may be required for best evidence for current infection.  Paired sera are especially important when the acute phase sample is taken within the six days following onset of symptoms. In most patients, Dengue antibodies are detectable after the sixth day. Cross-reactions occur with Yellow Fever immunization and other arboviruses are known to occur, but the extent and degree of cross-reaction varies. This test is performed once per week.

Specimen Submission

Required Request Form: G-2A

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: 87252, 87253

Fees:

Test Includes: Microscopic examination

Reporting

Results Available: 3 days

Contact #s: (512) 458-7560

Reference

Method: Microscopic examination, Trichrome stain

Turnaround Time:  3 days

Reference Range: No parasites found

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection: Collect fresh feces and immediately place in PVA preservative.

Sample Type: Feces fresh (less than five hours) or in PVA

Volume/Amount Required: 15 mL liquid stool or 15 g stool

Preferred Specimen:  Feces fresh (less than five hours) or in PVA

Collection/Preservation: Collect fresh feces and immediately place in PVA preservative. Fresh stools not in PVA must be examined within 5 hours.

Storage Instructions: Ambient temperature

Causes for Rejection: Unpreserved stools > 5 hours old

Sample Container: PVA transport for Parasites

Sample Test Kit:

Availability: Monday-Friday

Diagnostic Information:  Fecal specimens must be sent in PVA.  Referred material accepted from hospital, private, and reference labs

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Handle body fluids using universal precautions. PVA is a poison, handle with care.

Transport Temperature:  Ambient  temperature

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

Billing

CPT Code: 87209

Fees:

Test Includes: Conventional biochemicals, toxigencity testing

Reporting

Results Available: 3-7 days

Contact #s: (512) 458-7582

Reference

Method: Conventional biochemicals

Turnaround Time:  3-7 days

Reference Range:  No C. diphtheriae isolated.

Limitations: Specimen should be taken prior to antimicrobial therapy. Organisms must be viable for culture studies.

Interpretation: No C. diphtheriae isolated indicates that no viable organism was present in the specimen submitted. If clinical symptoms are indicative of diphtheria infection, a specimen should be submitted to the CDC for PCR studies.

Specimen Requirements

Specimen Collection: Throat swab

Sample Type: Throat swab

Volume/Amount Required: One throat swab per patient.

Preferred Specimen:  Throat Swab submitted on Loeffler’s slant or in Amies or Stuart’s transport media.

Collection/Preservation: Collect by throat swab using a cotton-tipped or polyester-tipped swab. Swabs taken below the membrane are most valuable. A portion of the membrane may be submitted for culture, but these do not always yield C. diphtheriae.

Storage Instructions: Stored between 2-25°C.

Causes for Rejection: Incorrect source of specimen. Specimen > 24 hours not in transport medium.

Sample Container: Swab transport system.

Sample Test Kit:

Availability: Tested Monday – Friday.

Diagnostic Information:  Swabs should be submitted on Loeffler’s Slant or in Amies or Stuart transport medium.  Prior notification of the Clinical Bacteriology Section at 512-458-7582

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Handle body fluids using universal precautions.

Transport Temperature:  2-25° C

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

Billing

CPT Code: 87070

Fees:

Test Includes: Conventional biochemicals

Reporting

Results Available: 5-10 days

Contact #s: (512) 458-7582

Reference

Method: Conventional biochemicals

Turnaround Time:  5-10 days

Reference Range:  By report

Limitations: Organism must be viable.

Interpretation: Identification of C. diphtheriae must be considered significant. Toxin studies must be performed to demonstrate that the strain is toxigenic.

Specimen Requirements

Specimen Collection: Collect by throat swab using a cotton-tipped or polyester-tipped swab. Swabs taken below the membrane are most valuable. A portion of the membrane may be submitted for culture, but these do not always yield C. diphtheriae.

Sample Type: Pure culture.

Volume/Amount Required: One culture per patient.

Preferred Specimen:  Pure Culture on agar slant.

Collection/Preservation: Agar slant, preferably Loeffler’s media, ambient temperature.

Storage Instructions: Ambient temperature

Causes for Rejection: Broken or compromised container.

Sample Container: Agar slant in screw cap tube.

Sample Test Kit:

Availability: Tested Monday – Friday.

Diagnostic Information:  See Aerobic Bacterial Culture (Isolation).

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: 87070

Fees:

Test Includes:

Reporting

Results Available:

Contact #s: (512) 458-7560

Reference

Method: Microscopic – Direct Examination

Turnaround Time:  3 days

Reference Range:  No parasites found

Limitations: Fecal Specimens must be sent in Formalin

Interpretation:  No parasites found indicates that there were no visibly detectable parasites in the specimen.

Specimen Requirements

Specimen Collection: Fresh feces

Sample Type:  Feces; Proglottid Scolex

Volume/Amount Required: 15 mL liquid stool, 15 g stool

Preferred Specimen:  Feces; Proglottid Scolex

Collection/Preservation: Fecal specimens must be sent in formalin.

Storage Instructions: Ambient temperature

Causes for Rejection:  Unpreserved stool > 5 hours old .

Sample Container: Formalin transport for parasites.

Sample Test Kit:

Availability: Monday - Friday

Diagnostic Information:  Fecal specimens must be sent in formalin.  Proglottids must be sent in ethyl alcohol or formalin.  Referred material accepted from hospital, private, and reference labs.

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Handle body fluids using universal precautions. Formalin is a poison, handle with care.

Transport Temperature:  Ambient (Room) temperature

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

Billing

CPT Code: 87015

Fees:

Reporting

Results Available:

Contact #s:

Reference

Method:

Turnaround Time:  3 weeks

Reference Range:  <1:8

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

Interpretation:

Specimen Requirements

Specimen Collection: Venipuncture

Sample Type: Serum

Volume/Amount Required: 10 mL whole blood

Preferred Specimen:  Single Serum

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. A detailed patient history is required. Serum specimens are forwarded to the CDC.  Increasing antibody values between acute and convalescent specimens is considered evidence of recent or current infection. Liver cysts yield titers of 1:256 or higher; cysts at other sites stimulate antibody production less.  Titers persist for years even after surgical removal of cysts.  Cross-reactions to cysticercosis do occur.

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: 86682

Fees:

Test Includes:

Reporting

Results Available:

Contact #s:

Reference

Method:

Turnaround Time:  24 hours

Reference Range:

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type:

Volume/Amount Required:

Preferred Specimen:  Hydatid Cyst Aspirate

Collection/Preservation:

Storage Instructions:

Causes for Rejection:

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Sample Test Kit:

Availability:

Diagnostic Information:  Microscopic examination of hydatid cyst fluid may reveal the hydatid sand or, under certain circumstances, just the hooklets.

Specimen Submission

Required Request Form: G-2B

Specimen Handling:

Transport Temperature:  Ambient (Room) temperature

Shipping Requirements:

Billing

CPT Code: 87177

Fees:

Test Includes:

Reporting

Results Available:

Contact #s:

Reference

Method:

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Interpretation:

Specimen Requirements

Specimen Collection:

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Diagnostic Information:  For Salmonella, see SalmonellosisCulture–(Identification) For Shigella, See Shigellosis Culture (Identification) For Escherichia coli, Escherichia coli 0157:H7 Culture (Identification) Escherichia coli 0157:H7 or other Shiga toxin E. coli (Toxin Testing). For Vibrio species Vibrio cholerae, (Culture – Identification). For Yersinia, see Yersinia enterocolitica (Culture – Identification)

Specimen Submission

Required Request Form: G-2B

Specimen Handling:

Transport Temperature:

Shipping Requirements:

Billing

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

Fees:

Test Includes: Microscopic Examination

Reporting

Results Available: 1 day

Contact #s: (512) 458-7560

Reference

Method: Microscopic examination

Turnaround Time:  24 hours

Reference Range:  No pinworm eggs found.

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection: taped slide, worms

Sample Type:  perianal; worms

Volume/Amount Required: 1 tape slide

Preferred Specimen:  Taped Slide of perianal region; worms, pinworm prep kits

Collection/Preservation: using strip of clear cellulose tape sticky side outward on a microscope slide, press firmly against the perianal folds. The tape is then spread back over the slide adhesive side down. Ship in slide carrier.

Storage Instructions: Ambient temperature

Causes for Rejection:  Frosted tape used.

Sample Container:  Slide carrier

Sample Test Kit:

Availability:  Monday-Friday

Diagnostic Information:  Use only clear, cellophane tape or manufactured paddles.  Adult worms should be submitted in EtOH or formalin.

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Fecal specimen handled using universal precautions.

Transport Temperature:  Ambient temperature

Shipping Requirements:  Slide carrier

Billing

CPT Code: 87172

Fees:

Test Includes: Conventional biochemicals, EHEC toxin testing, PCR.

Reporting

Results Available: 5-10 days.

Contact #s: (512) 458-7582

Reference

Method: Conventional biochemicals, EHEC toxin testing, PCR.

Turnaround Time:  5-10 days

Reference Range:  No E. coli O157:H7 isolated. No Shiga Toxin demonstrated.

Limitations: Isolation of E. coli O157:H7 is dependent on viable organisms. Stool specimens should be collected prior to the initiation of antimicrobial therapy.

Premier EHEC will generate a positive signal when Shiga toxin is present in the specimen at detectable quantities. A positive test does not preclude the presence of other infectious organisms. Toxin expression may be lost upon serial passage.

Interpretation:  No E. coli O157:H7 means that there are no detectable (viable) organisms in the specimen submitted.

Absence of toxin means that there is no detectable shiga toxin in the specimen.

Specimen Requirements

Specimen Collection: fresh stool.

Sample Type: Stool, Rectal swab

Volume/Amount Required: > 10 mL liquid stool; > 20 g solid or semi-solid stool.

Preferred Specimen:  Fresh stool < 24 hours old; Rectal swab submitted in Cary-Blair, Stuart’s or Amies transport.

Collection/Preservation: Collect in dry, clean Leak proof container and store at 2-8° C.

Storage Instructions: Store stool at 2-8° C.

Causes for Rejection: Unpreserved stool > 24 hours old for culture. > 7 days for toxin assay.

Sample Container: Clean, dry leak-proof container; Enteric transport.

Sample Test Kit:

Availability:  Tested Monday – Friday. 
Outbreak testing: Saturday-Sunday with prior notification.

Diagnostic Information:  Stool specimens should be collected in the acute phase of the illness and submitted on ice packs within 24 hours of collection. See Aerobic Bacterial Culture, Stool (Isolation).

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Handle Body fluids using universal precautions. Stool and broth storage prior to premier EHEC testing: Stool specimens and broths may be held up to 7 days at 2-8° C before testing in the EIA. If testing is not performed within this time period, the specimens should be frozen at -70° C. Repeated freeze-thaws should be avoided.

Transport Temperature:  2-8° C 

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

Billing

CPT Code: 87046

Fees:

Test Includes: Conventional biochemicals, EHEC toxin testing, PCR.

Reporting

Results Available: 5-7 days

Contact #s: (512) 458-7582 

Reference

Method: Conventional biochemicals, EHEC toxin testing, PCR.

Turnaround Time:  5-7 days

Reference Range: By report: Genus, species, and serotype (if shiga toxin positive)

Limitations: Organism must be viable.

Interpretation: Identification of E. coli O157:H7 should 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: May be kept at ambient temperature.

Storage Instructions: Ambient temperature.

Causes for Rejection: Broken in transport, expired transport media used.

Sample Container: Agar slant in screw cap tube

Sample Test Kit:

Availability: Tested Monday – Friday.

Diagnostic Information:  See Aerobic Bacterial Culture (Identification).

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 agent.

Billing

CPT Code: 87077

Fees:

Test Includes: Premier EHEC EIA toxin test.

Reporting

Results Available: 2-5 days.

Contact #s: (512) 458-7582

Reference

Method: EIA toxin test

Turnaround Time:  2-5 days

Reference Range:  No Shiga toxin demonstrated

Limitations: Premier EHEC will generate a positive signal when Shiga toxin is present in the specimen at detectable quantities. A positive test does not preclude the presence of other infectious organisms. Toxin expression may be lost upon serial passage.

Interpretation: Negative results indicate lack of detectable amounts of Shiga toxin present in sample.

Specimen Requirements

Specimen Collection: Stool, Pure culture.

Sample Type: Fresh stool; Pure culture.

Volume/Amount Required: 10 g or 10 mL of fresh stool,

Preferred Specimen:  Fresh stool; Pure Culture.

Collection/Preservation: Keep stools between 2-8°C; Pure cultures may be kept at ambient temperature.

Storage Instructions: Store stools between 2-8° C or freeze at -70° C; Pure cultures may be stored at ambient temperature.

Causes for Rejection: Insufficient amount of sample to perform test; Specimens > 7 days unless frozen.

Sample Container: Leak-proof container

Sample Test Kit: Premier EHEC EIA toxin test

Availability: Tested Monday – Friday.
Outbreak situations –Saturday-Sunday- with prior notification.

Diagnostic Information:  Stools are accepted for testing with prior notification of the Clinical Bacteriology Section laboratory at 458-7582. Stools should be shipped on wet ice packs. Pure cultures for toxin testing should be shipped safely contained.

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Handle body fluids using universal precautions. Stool and broth storage prior to premier EHEC testing: Stool specimens and broths may be held up to 7 days at 2-8° C before testing in the EIA. If testing is not performed within this time period, the specimens should be frozen at 
-70° C. Repeated freeze-thaws should be avoided.

Transport Temperature:  2-8° C 

Shipping Requirements: Triple contained, In accordance with federal shipping regulations for infectious agent.

Billing

CPT Code: 87427

Fees:

Test Includes: Pulse Field Gel Electrophoresis (PFGE)

Reporting

Results Available: 4-7 days

Contact #s: (512) 458-7582

Reference

Method: Pulse Field Gel Electrophoresis (PFGE)

Turnaround Time:  4-7 days

Reference Range:  By report

Limitations:

Interpretation:

Specimen Requirements

Specimen Collection:

Sample Type: Pure culture

Volume/Amount Required:

Preferred Specimen:  Pure Culture on agar slants

Collection/Preservation:

Storage Instructions: ambient temperature

Causes for Rejection: Specimen broken in transport

Sample Container:

Sample Test Kit:

Availability: Monday-Friday

Diagnostic Information:  Molecular typing performed at TDSHS as part of the PulseNet program.

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Infectious agent, biosafety level 2.

Transport Temperature:  Ambient temperature

Shipping Requirements: Triple contained; infectious agent

Billing

CPT Code: 87077

Fees: