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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

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BACTERIA CULTURE, RESPIRATORY (Sputum, Tracheal, Bronchial Aspirate/Lavage)

Item Value
Available Stat? No
Test code RSPC, MC
Performed by? Microbiology (Bacteriology)
Sendout? no
Price range $$$
In House Availability 7 days
Principle Sputum specimens are Gram - stained and screened for the presence of polymorphonuclear leukocytes and epithelial cells. Specimens which contain a large proportion of epithelial cells are predominantly saliva and are not further processed. The service is notified that a specimen containing true sputum should be collected.

Specimens are inoculated onto appropriate media, Gram - stained, and incubated for a minimum of 2 days. Potential pathogens are identified and antimicrobial susceptibilities performed when appropriate. Presence or absence of normal upper respiratory flora will also be reported. Bronchoalveolar lavage specimens are often contaminated with oropharyngeal flora.

Anaerobic cultures will not be done on expectorated sputum or tracheal aspirations. If anaerobic culture is desired, collect an aspirate of abscess or biopsy.
Container type sterile, screw cap container
Collection Instructions 1. In acute lower respiratory tract infections, a single representative sputum specimen obtained by natural or induced cough or tracheal suction should be Gram - stained and cultured before treatment. Follow-up culture should be done only if response to treatment is inadequate, or superinfection is suspected. If pulmonary abscess is suspected, obtain a needle aspiration or biopsy for culture.

2. In chronic lower respiratory infections, a single representative sputum specimen should be Gram-stained and cultured before treatment. Follow-up culture should be obtained only if response to treatment is inadequate or clinical superinfection is suspected.
Special instructions The Pulmonary Diseases and Critical Care Medicine Service collects induced sputum and bronchoalveolar lavage and transbronchial biopsy specimens. Contact the Pulmonary Diseases Fellow if these specimens are necessary.
Synonyms BAL (Bronchoalveolar Lavage) Culture; Bronchoalveolar Lavage (BAL) Culture; Legionella Culture;
Stability Specimens should be refrigerated until brought to the Microbiology Laboratory (2M33). DO NOT INCUBATE.
Additional information Indicate on requisition if requesting Legionella culture, or culture for other special infectious agents.
References 1. Forbes, BA, et al. Bailey and Scott's Diagnostic Microbiology, 11th Ed., Mosby, St. Louis MO, 2002.

2. Murray, PR et al., Manual of Clinical Microbiology, 9th Ed., ASM Press, Washington, DC, 2007.
CPT coding 87070
Last Updated 7/22/2011 2:10:31 PM
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