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CERNER / EPIC MNEMONIC / POE DESCRIPTION / CPT CODE / TEST INFORMATION / DAYS PERFORMED / TURNAROUND TIME / CONTAINER TYPE / COLLECTION / SPECIMEN REQUIREMENTS / REJECTION CRITERIA / MINIMUM VOLUME / HANDLING INSTRUCTIONS / REFERENCE RANGE / METHODOLOGY / ADDITIONAL INFORMATION / TEST SYNONYM(S)

Bone Marrow Culture, Mycobacterium (View in report form.)

CERNER / EPIC MNEMONIC: C AFBSM
POE DESCRIPTION: CU MYCOBACTERIUM W SMEAR; CU AFB W SMEAR; C AFBSM
CPT CODE: 87116 (culture); 87206 (smear)
TEST INFORMATION: Test includes culture and acid-fast stain (if specimen volume is adequate). If a mycobacterial species is isolated, the organism will be definitely identified. Susceptibility testing will be performed depending upon the isolate identification. Other isolated organisms (i.e. aerobes, fungi) may be referred for identification and/or susceptibility testing if medically indicated AND a separate culture procedure has NOT yielded the same organism(s).
DAYS PERFORMED: Daily
TURNAROUND TIME: Smear results: 24 hours after receipt of the specimen in the laboratory. Preliminary culture reports are available after 1 week or when a mycobacterial isolate is detected. Negative cultures with negative smears will be finalized after 8 weeks. Negative cultures with positive smears will be finalized after 12 weeks. Completion of culture reports may require additional time when mycobacteria are isolated and/or susceptibility testing is performed.
CONTAINER TYPE: Inpatients: IsolatorTM 10 mL tube; Clients: yellow top SPS Vacutainer® (available from Client Services, 312-942-4942)
COLLECTION: Specimens are to be collected from a site prepared utilizing aseptic technique. Material obtained by needle aspiration, is injected into the Isolator or yellow top SPS Vacutainer® tube. Invert the tube 5-10 times to mix well.
SPECIMEN REQUIREMENTS: Bone marrow
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, refrigerated specimen. Only three specimens per body site with negative acid-fast smears will be processed. Subsequent specimens will be rejected. Specimens from known positive patients will be accepted only once a week for culture and smear per body site.
MINIMUM VOLUME: 0.5 mL
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature. Do NOT refrigerate.
REFERENCE RANGE: No acid-fast bacilli observed on smear or isolated in culture
METHODOLOGY: Acid-fast smear: fluorochrome stain. Culture: inoculation of conventional culture media and a rapid medium for automated continuous analysis.
ADDITIONAL INFORMATION: DNA probes may be incorporated to aid with more rapid identification of mycobacterial isolates. This will generate an additional charge(s). Susceptibility testing will be performed only on the first Mycobacterium isolate from each specimen type per patient. Additional susceptibilities may be performed after a period of 4 weeks for patients with suspected treatment failure. Susceptibility testing is performed routinely only for M. tuberculosis complex, M. kansasii, M. chelonae complex, and M. fortuitum. Susceptibility testing for other Mycobacterium species is performed by special request only. The battery of drugs routinely tested will vary by isolate and/or physician request. Patients from whom M. tuberculosis is isolated in culture are reported to the City of Chicago Board of Health. This is mandated by law.
TEST SYNONYM(S):AFB Culture, Bone Marrow; Mycobacterium Culture, Bone Marrow; TB Culture, Bone Marrow

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