Microbiology Laboratory Tests: Trypanosomiasis to Typhus
Microbiology
Trypanosomiasis (Microscopic – Direct Giemsa stained)
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| Test Includes: Microscopic examination | |
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Reporting |
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| Results Available: 3 days | Contact #s: (512) 458-7560 |
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Reference |
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| Method: Microscopic examination | |
| Turnaround Time: 3 days | Reference Range: No parasites found |
| Limitations: | Interpretation: Negative specimen indicates that there were no visible parasites in the specimen submitted. |
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Specimen Requirements |
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| Specimen Collection: venipuncture, biopsy, needle aspirates | Sample Type: blood, lymph node, aspirates |
| Volume/Amount Required: 10 mL whole blood; small piece of lymph node tissue; > 1 mL aspirate | Preferred Specimen: Blood thin and thick smears; Lymph Node; Aspirates |
| Collection/Preservation: Collect by venipuncture or capillary blood, blood to prepare two thick and two thin smears on a glass slide. Store at ambient temperature | Storage Instructions: Ambient temperature |
| Causes for Rejection: | Sample Container: Green or Purple top vacutainer |
| Sample Test Kit: | Availability: Monday-Friday |
| Diagnostic Information: See also Chagas’ Disease. | |
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Specimen Submission |
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| Required Request Form: G-2B | 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. |
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Billing |
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| CPT Code: 87177 | Fees: http://www.dshs.state.tx.us/lab/fees.shtm |
Microbiology
Tuberculosis (Culture – Susceptibility, Primary Drug Panel)
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| Test Includes: Drug Susceptibility Testing of Mycobacterium tuberculosis by Indirect Drug Susceptibility Test | |
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Reporting |
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| Results Available: 10-28 days | Contact #s: 512-458-7586 |
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Reference |
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| Method: BACTEC indirect drug susceptibility test system for M. tuberculosis complex. Agar proportion indirect drug susceptibility test system for confirmation of drug resistance. |
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| Turnaround Time: 10-28 days. Reports of drug resistance are telephoned to the submitter. | Reference Range: Susceptible |
| Limitations: Testing can only be performed on pure cultures of Mycobacterium tuberculosis complex. | Interpretation: Report states isolate is either susceptible or resistant to a specific drug at critical concentrations recommended by NCCLS. |
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Specimen Requirements |
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| Specimen Collection: | Sample Type: |
| Volume/Amount Required: | Preferred Specimen: Pure Culture |
| Collection/Preservation: No preservative. | Storage Instructions: |
| Causes for Rejection: | Sample Container: Triple-contained. |
| Sample Test Kit: | Availability: Test is set up 5 days/week: Monday- Friday. Test is run 7 days/week. |
| Diagnostic Information: Pure culture isolates of M. tuberculosis complex submitted or isolated at this Laboratory for drug susceptibilities. Isolates submitted for drug susceptibilities will be identified by this Laboratory. No fee will be charged for the identification test unless the AFB ID test is requested on form G-2B. Primary Panel for M. tuberculosis complex consists of Isoniazid, Ethambutol, and Rifampin by BACTEC susceptibility testing. Resistance to any of these drugs is confirmed by the agar proportion method. | |
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Specimen Submission |
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| Required Request Form: G-2B | Specimen Handling: |
| Transport Temperature: Ambient | 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. |
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Billing |
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| CPT Code: 87190, 87188 | Fees: http://www.dshs.state.tx.us/lab/fees.shtm |
Microbiology
Tuberculosis (Culture – Isolation –Direct Nucleic Acid Amplification Test (NAAT) for Mycobacterium tuberculosis complex)
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| Test Includes: Nucleic Acid Amplification Testing of Clinical Specimens for Mycobacterium tuberculosis complex | |
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Reporting |
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| Results Available: 48 hours | Contact #s: 512-776-7342 or 512-776-7580 |
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Reference |
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| Method: Cepheid GeneXpert PCR test amplifies and detects DNA of M. tuberculosis complex | |
| Turnaround Time: 48 hours from specimen receipt in this laboratory. Positive reports are communicated to the specimen submitter on day of testing. | Reference Range: Normal value = Negative |
| Limitations: Specimen must be sputum, induced or expectorated. AFB Smear and Culture always performed concurrently at this laboratory. A negative test does not mean the patient does not have M. tuberculosis disease.Test results must be confirmed by culture of specimen for the presence of mycobacteria. If a processed sputum sediment is submitted for NAAT only, the AFB culture must be in progress at the submitting laboratory site. | Interpretation: A Positive result means that the DNA of the M. tuberculosis complex is detected. A Negative result means that the DNA of the M. tuberculosis complex was not detected. A Negative result does not rule out the possibility of the presence of viable M. tuberculosis complex in the specimen. |
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Specimen Requirements |
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| Specimen Collection: Follow the Guidelines for Specimen Collection and Submission: Mycobacteriology (AFB) Collection, Transport, and Storage. | Sample Type: Clinical |
| Volume/Amount Required: 3 mL to 15 mL | Preferred Specimen: Sputum or processed sputum sediment. For all other specimen types, please contact 512-776-7342 or 512-776-7580. |
| Collection/Preservation: No preservative | Storage Instructions: Transport specimen as soon as possible. Diagnostic specimens should be shipped on cold pack overnight. |
| Causes for Rejection: Specimen leaked in transit. No identifier on specimen container. No test requested on G-MYCO requisition form. | Sample Container: Triple contained. Sterile, leak-proof, 50 mL conical tube preferred for primary container. |
| Sample Test Kit: | Availability: Monday through Friday |
| Diagnostic Information: There should be a high clinical suspicion of tuberculosis when ordering this test. NAA testing should be requested if the test results will make a difference to the patient’s treatment or if the test results will make a difference to the contact investigation. Patients should not have a laboratory diagnosis of tuberculosis disease already. | |
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Specimen Submission |
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Required Request Form: G-MYCO
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Specimen Handling: Follow the Guidelines for Specimen Collection and Submission: Mycobacteriology (AFB) Collection, Transport, and Storage. |
| Transport Temperature: Cold shipment (not frozen) recommended. | Shipping Requirements: Triple-contained and packaged to meet requirements of DOT, USPS, PHS, and IATA for shipping of clinical specimens. Please check with your courier. |
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Billing |
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| CPT Code: 87556 | Fees: http://www.dshs.state.tx.us/lab/fees.shtm |
Microbiology
Tuberculosis (Culture – DNA Fingerprinting)
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Reporting |
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| Results Available: approx. 10 business days | Contact #s: 512-458-7342 or 512-458-7580 |
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Reference |
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| Method: | |
| Turnaround Time: As directed | Reference Range: By report |
| Limitations: Test can only be performed on pure cultures of M. tuberculosis complex. | Interpretation: contact Tuberculosis Elimination Program for guidance |
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Specimen Requirements |
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| Specimen Collection: | Sample Type: |
| Volume/Amount Required: | Preferred Specimen: Pure Culture |
| Collection/Preservation: | Storage Instructions: |
| Causes for Rejection: | Sample Container: Triple-contained. |
| Sample Test Kit: | Availability: |
| Diagnostic Information: DNA Fingerprinting of M. tuberculosis is available at no charge from a reference laboratory. Please submit pure cultures of M. tuberculosis to this Laboratory and mark "Other" on the request form. Write the word "Genotyping" in the space for "other" tests. For more information, telephone 512-458-7342. | |
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Specimen Submission |
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| Required Request Form: G-2B | Specimen Handling: |
| Transport Temperature: ambient | 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. |
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Billing |
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| CPT Code: | Fees: http://www.dshs.state.tx.us/lab/fees.shtm |
Microbiology
Tularemia (Culture - Isolation)
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Reporting |
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| Results Available: | Contact #s: |
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Reference |
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| Method: | |
| Turnaround Time: 7-21 days | Reference Range: By report |
| Limitations: | Interpretation: |
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Specimen Requirements |
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| Specimen Collection: | Sample Type: |
| Volume/Amount Required: | Preferred Specimen: Culture; Blood Culture; Tissue; Lymph Node |
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| Causes for Rejection: | Sample Container: |
| Sample Test Kit: | Availability: |
| Diagnostic Information: See Aerobic Bacterial Culture (Isolation) Culture for isolation must be held 21 days before the specimen can be reported as negative. Francisella tularensis is one of the agents designated as a Bioterrorism agent. It sporadically occurs naturally. See Bioterrorism agents (Clinical -Isolation). | |
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Specimen Submission |
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| Required Request Form: G-27A | Specimen Handling: |
| Transport Temperature: 4º C, ice packs, NO dry ice. | Shipping Requirements: |
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Billing |
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| CPT Code: 87040, 87046, 87070 | Fees: http://www.dshs.state.tx.us/lab/fees.shtm |
Microbiology
Tularemia (Culture - Identification)
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Reporting |
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| Results Available: | Contact #s: |
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Reference |
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| Method: | |
| Turnaround Time: 7-14 days | Reference Range: By report |
| Limitations: | Interpretation: |
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Specimen Requirements |
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| 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: Francisella tularensis is one of the agents designated as a Bioterrorism agent. It sporadically occurs naturally. See Bioterrorism agents (Clinical -Isolation) For Referred cultures see Aerobic Bacterial Culture, (Identification). | |
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Specimen Submission |
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| Required Request Form: G-27A | Specimen Handling: |
| Transport Temperature: Ambient (Room) temperature | Shipping Requirements: |
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Billing |
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| CPT Code: 87077 | Fees: http://www.dshs.state.tx.us/lab/fees.shtm |
Microbiology
Tularemia (Serological - Agglutination)
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Reporting |
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| Results Available: 5-7 days | Contact #s: |
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Reference |
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| Method: Agglutination | |
| Turnaround Time: 5-7 days | Reference Range: <1:80 (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. |
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Specimen Requirements |
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| Specimen Collection: Venipuncture | Sample Type: Serum |
| 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 |
| Sample Test Kit: | Availability: Test performed once per week |
| Diagnostic Information: Tularemia antibody begins to appear 2-3 weeks post-onset and generally peaks 5 weeks into the disease. A titer of 1:320 or greater is significant. Serum specimens are to be collected at least 7 days apart. Fourfold titer increase is evidence of current infection. Cross-reactions occur with Brucella species. Telephone Laboratory prior to shipping specimen. The test is performed once per week. | |
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Specimen Submission |
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| 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. |
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Billing |
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| CPT Code: 86609 | Fees: http://www.dshs.state.tx.us/lab/fees.shtm |
Microbiology
Typhus (Serological – Immunofluorescence)
Related Agents: Rickettsia, Murine typhus
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Reporting |
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| Results Available: 3-5 days | Contact #s: |
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Reference |
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| 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. |
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Specimen Requirements |
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| Specimen Collection: Venipuncture | Sample Type: Serum |
| Volume/Amount Required: 2 mL Serum | Preferred Specimen: 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 twice per week |
| Diagnostic Information: The rickettsial micro IFA test is a standard two-step sandwich immunofluorescence technique. In the first stage the Rickettsia typhi (murine typhus) antigen is overlaid with dilutions of human serum. In the second stage, the antigen is overlaid with a fluorescein-conjugates antihuman globulin, so that the antigens are rendered fluorescent by positive sera. The most convincing evidence of recent rickettsiae infection of a four-fold rise in titer between the acute serum and the convalescent serum. Single titers of 1:128 are considered the minimum for significant titers. Serum specimens must be collected 14 days apart. The test is performed twice per week. | |
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Specimen Submission |
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| 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. |
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Billing |
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| CPT Code: 86757 | Fees: http://www.dshs.state.tx.us/lab/fees.shtm |