Microbiology Laboratory Tests: I-L

Microbiology
Influenza (Culture – Isolation)
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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 influenza virus isolated
Limitations: Interpretation: A result of “No influenza 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, adequately maintained, 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 infection 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 specimens
Volume/Amount Required: Swabs in 2-4 mL of influenza transport media. Preferred Specimen:  Throat Swab, Nasopharyngeal Secretions, Nasopharyngeal aspirate, Nasal wash, Nasal swab.
Collection/Preservation: Influenza transport media, Viral transport media. Storage Instructions: Arriving < 72 hours after collection, store and send at 2-8° C. Arriving > 72 hours after collection, store and send at -70° C (dry ice).
Causes for Rejection: Specimens submitted on a preservative such as formalin. Sample Container: Sterile container
Sample Test Kit: Availability: Monday - Friday
Diagnostic Information:  Specimens are inoculated onto cell culture monolayers.  If characteristic CPE or hemadsorption is observed, confirmation of identification will be performed.

Specimen Submission
Required Request Form: G-2V Specimen Handling:
Transport Temperature:  
Arriving <72 hours:  2-8 °C (refrigerated)  
Arriving >72 hours send on dry ice		 Shipping Requirements: Ship specimens in compliance with governmental regulations.

Billing
CPT Code: 87252, 87253 Fees:

 

Microbiology
Influenza (Culture – Typing)
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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: 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 at -70° C.
Causes for Rejection: Sample Container: Sterile cryovial.
Sample Test Kit: Availability: Monday - Friday
Diagnostic Information:  Typing is based on immunofluorescence test using influenza A and influenza B monoclonal antibodies.

Specimen Submission
Required Request Form: G-2V Specimen Handling:
Transport Temperature:  Frozen isolate:  on dry ice Shipping Requirements: Ship specimens in compliance with governmental regulations.

Billing
CPT Code:  86710 Fees:

 

Microbiology
Isopora species (Microscopic – Direct Wet Smears Concentration)
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Test Includes: Microscopic examination

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

Reference
Method: Microscopic examination  
Turnaround Time:  3 days Reference Range: No parasites found
Limitations: Interpretation: No parasite found indicates that there were no visible parasites in the specimen submitted.

Specimen Requirements
Specimen Collection: Feces Sample Type: Feces
Volume/Amount Required: 15 mL liquid stool, 15 g stool Preferred Specimen:  Feces, formalin preserved
Collection/Preservation: Collect fresh stool in a clean, dry container. Immediately transfer stool to formalin preservative. Transport at ambient temperature. 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.  Specimens are accepted from public health officials.  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 temperature Shipping Requirements:  Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing
CPT Code: 87015 Fees:

 

Microbiology
Isopora species (Microscopic – Acid Fast Stain)
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Test Includes: Microscopic Examination

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

Reference
Method: Microscopic Examination  
Turnaround Time:  3 Days Reference Range:  No parasites found
Limitations: Interpretation:  No parasites found indicates that there were no visible parasites in the specimen submitted.

Specimen Requirements
Specimen Collection: feces Sample Type: feces in formalin
Volume/Amount Required: 15 mL liquid stool, 
15 g stool		 Preferred Specimen:   Formalin preserved feces.
Collection/Preservation:  Collect stool and immediately place in formalin preservative. Ship at ambient temperature. 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.  Specimens are accepted from public health officials.  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 temperature. Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing
CPT Code: 87177 Fees:

 

Microbiology
Legionellosis Culture (Identification)
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Test Includes: Conventional biochemicals; Direct Immunofluorescence Antibody Test (DFA)

Reporting
Results Available: 7-14 days Contact #s: (512) 458-7582

Reference
Method: Conventional biochemicals; Direct Immunofluorescence Antibody Test (DFA)
Turnaround Time:  7-14 days Reference Range:  By report
Limitations: Organism must be viable for culture studies to be performed. Interpretation:  By report

Specimen Requirements
Specimen Collection: Sample Type: Pure culture
Volume/Amount Required: one specimen per patient Preferred Specimen:  Pure cultures on appropriate media.
Collection/Preservation:  Ambient temperature Storage Instructions: Ambient temperature
Causes for Rejection:  Name on tube/specimen do not match; Broken in transport. Sample Container:  Agar slant in screw cap tube
Sample Test Kit: Availability: Monday-Friday
Diagnostic Information:  Legionella requires cysteine for growth and should be submitted on a media like BCYE agar to insure viability.

Specimen Submission
Required Request Form: G-2A 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:

 

Microbiology
Legionellosis (Serological - Immunofluorescence)
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Test Includes:

Reporting
Results Available: 3-5 days Contact #s:

Reference
Method: IFA  
Turnaround Time:  3-5 days Reference Range:  < 1:64 (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: 2 mL Serum Preferred Specimen:  Paired Sera; Single Serum
Collection/Preservation: Samples that will be delivered to the laboratory within 8 hours of collection may be transported at room temperature in the original blood collection tube. If the samples are going to be shipped and will be delivered to the laboratory within 48 hours of collection, sera must be separated from the blood and shipped on cold packs, between 2° and 8°C. If the serum samples will not be delivered to the laboratory within 48 hours of collection at these temperatures, then the samples must be frozen at -20°C or lower and shipped on dry ice. Storage Instructions:  Separated serum may be held at 2-8°C, or frozen at -20°C.
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing, specimens received with extended transit time, or received at incorrect temperature. Sample Container: Red top or tiger top tube
Sample Test Kit: Availability: Test run every Tuesday and Thursday
Diagnostic Information:  A single serum will be tested only if three or more weeks after onset.  Single titers of <1:64 are considered Nonreactive. Single titers between 1:64 and 1:128 are considered Nonreactive, but may warrant follow-up testing. Single titers >1:256 are considered evidence of infection at an undetermined time. A fourfold or greater titer increase between acute and convalescent sera provides evidence of recent infection. The test is performed twice 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: 86713 Fees:

 

Microbiology
Leishmaniasis (PCR – CDC through TDSHS)
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Test Includes: Specimens forwarded by TDSHS to CDC with prior arrangement

Reporting
Results Available: Contact #s:

Reference
Method:  
Turnaround Time: Reference Range:
Limitations: Interpretation:

Specimen Requirements
Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  Specimens forwarded by TDSHS to CDC with prior arrangement. Please call 512-458-7560 to make arrangements and instructions on specimen type and shipping temperatures.  If culture is positive, PCR can be performed for speciation.

Specimen Submission
Required Request Form: G-2A Specimen Handling:
Transport Temperature: Shipping Requirements:

Billing
CPT Code: 87797 Fees:

 

Microbiology
Leishmaniasis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes:

Reporting
Results Available: Contact #s:

Reference
Method:  
Turnaround Time:  3 weeks Reference Range:  >1:16 (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:  Specimens forwarded by TDSHS to CDC with prior arrangement. Prior notification is requested (512) 458-7760. A detailed patient history is required. Titers of >1:16 are considered positive. The diagnosis of dermal or cutaneous leishmaniasis is more difficult than the visceral form, since a detectable immune response is often absent. Cross reactions may occur with Chagas’ disease, malaria or schistosomiasis, so positive serological results provide only suggestive support for the diagnosis.  

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: 86717 Fees:

 

Microbiology
Leishmaniasis (Microscopic – Giemsa Stain)
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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:  Tissue
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  Specimens examined by TDSHS follow up cultures will be forwarded by TDSHS to CDC with prior arrangement.

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

Billing
CPT Code: 87177 Fees:

 

 

Microbiology
Leptospirosis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes:

Reporting
Results Available: Contact #s:

Reference
Method:  
Turnaround Time:  3 weeks Reference Range:  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. A detailed patient history is required. Sera are sent to the CDC.  Specimens positive in the Indirect Hemagglutination Test, qualitative screening test, are confirmed with a quantitative Microagglutination Test against a battery of antigens.  A fourfold increase in titer is evidence of current infection.  Extensive cross-reactions among leptospiral antigens are frequent.

Specimen Submission
Required Request Form: G-2A Specimen Handling: Use Universal Precautions
Transport Temperature:  Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice. 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: 86720 Fees:

 

Microbiology
Listeriosis Culture–(Isolation)
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Test Includes: Conventional biochemicals.

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

Reference
Method: Conventional biochemicals.  
Turnaround Time:  7-21 days Reference Range:  No Listeria monocytogenes isolated
Limitations: Organism must be viable in order to culture. Interpretation: Isolation of Listeria monocytogenes should always be considered significant.

Specimen Requirements
Specimen Collection: Venipuncture. Sample Type: Blood; Tissue.
Volume/Amount Required: 10 mL of whole blood, small piece tissue Preferred Specimen:  Blood; Tissue
Collection/Preservation: Blood may be kept at ambient temperature or refrigerated. Do not freeze whole blood. Refrigerate tissue. Storage Instructions: Do not freeze whole blood. Blood may be kept at ambient temperature or refrigerated. Refrigerate tissue.
Causes for Rejection: No identifying marks on sample and/or paperwork. Sample Container: Tiger or red top vacutainer, sterile leak-proof container.
Sample Test Kit: Availability: Tested Monday – Friday.
Diagnostic Information:  See Aerobic Bacterial Culture (Isolation).

Specimen Submission
Required Request Form: G-2B Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature:  Tissue 2-8 ° C; 
Blood 2-25° C		 Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing
CPT Code: 87046 Fees:

 

Microbiology
Listeriosis Culture –(Identification)
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Test Includes: Conventional biochemicals

Reporting
Results Available: 4-21 days Contact #s: (512) 458-7582

Reference
Method: Conventional biochemicals  
Turnaround Time:  4-21 days Reference Range:  By report
Limitations: Organism must be viable for culture studies. Interpretation: Identification of Listeria monocytogenes should always be considered significant.

Specimen Requirements
Specimen Collection: Dependent upon source of sample. 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: Store at ambient temperature.
Causes for Rejection: No identifying marks on sample and/or paperwork. Sample Container: Dependent upon type of transport.
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 agents.

Billing
CPT Code: 87077 Fees:

 

Microbiology
Listeriosis Culture (Typing)
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Test Includes: Isolates from outbreaks are sent to the CDC for typing.

Reporting
Results Available: Dependent on CDC report Contact #s: (512) 458-7185

Reference
Method: Serotyping, PFGE  
Turnaround Time:  Dependent on CDC report Reference Range:  By report
Limitations: Interpretation:

Specimen Requirements
Specimen Collection: Sample Type: Pure cultures
Volume/Amount Required: Preferred Specimen:  Pure cultures.
Collection/Preservation: Storage Instructions: Ambient temperature
Causes for Rejection: Insufficient information, Name on tube/form do not match. Sample Container: Agar slant in screw cap tube.
Sample Test Kit: Availability: Monday-Friday
Diagnostic Information:  Isolates from outbreaks are sent to the CDC for typing. Molecular typing performed at TDH Request molecular typing by indicating PFGE on submission form Request serotyping on submission form and include clinical history to be forwarded to the CDC.

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: 87147 Fees:

 

Microbiology
Loiasis (Microscopic – Direct Giemsa Stains)
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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 parasites found.
Limitations: Interpretation: No parasite found indicates that there were no visible parasites in the specimen submitted.

Specimen Requirements
Specimen Collection: venipuncture Sample Type: Blood
Volume/Amount Required: 20 mL whole blood Preferred Specimen:  Blood Purple Top collected between 10 am and 2 pm.
Collection/Preservation: Collect blood by venipuncture, preferably between 10 am and 2 pm, in a purple top vacutainer tube. Storage Instructions: Ambient temperature
Causes for Rejection: Incorrect collection tube, insufficient sample Sample Container: Purple top vacutainer
Sample Test Kit: Availability: Monday-Friday
Diagnostic Information:  2 thin and 2 thick smears should be examined.

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

Billing
CPT Code: 87102 Fees:

 

 

Microbiology
Lymphocytic Choriomeningitis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes:

Reporting
Results Available: Contact #s:

Reference
Method:  
Turnaround Time:  3 weeks Reference Range:  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, Spinal Tap Sample Type: Serum, CSF
Volume/Amount Required: 10 mL whole blood, 1.0 mL CSF Preferred Specimen:  Paired Sera; Spinal Fluid  
Collection/Preservation: Red top or tiger top tube, sterile collection tube for CSF Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C. Immediately freeze CSF.
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  Sera or CSF are forwarded to the CDC.

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: