Blood Culture, Mycobacterium

CERNER / EPIC MNEMONIC: C AFB BL
POE DESCRIPTION: CU MYCOBACTERIUM BLOOD; CU AFB BLOOD; CU ACID FAST BLOOD; C AFB BL
CPT CODE: 87116
TEST INFORMATION: The test includes inoculation of specific mycobacterial media after lysis centrifugation, identification of any mycobacteria isolated, and susceptibility testing, if appropriate. Other isolated organisms (i.e. aerobes, yeast, etc.) 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, 24 hours
TURNAROUND TIME: Preliminary culture reports are available after 1 week or when a mycobacterial isolate is detected. Negative cultures will be finalized after 6 weeks. Completion of culture reports may require additional time when mycobacteria are isolated.
SPECIAL INSTRUCTIONS: Request test specifically. Not a component of a routine blood culture. The specific site of the specimen (i.e. arterial, swan ganz, etc.) MUST be specified on the order or requisition.
CONTAINER TYPE:

Inpatients:  BD Bactec Myco/F Lytic bottle (available from Clinical
Microbiology, 312-942-5452); Clients: yellow top SPS Vacutainer®
(available from Client Services, 312-942-4942).

COLLECTION:

Swab the venipuncture site concentrically, starting at the center, with 4% chlorhexidine glucosate. After the disinfectant has dried, remove with an alcohol swab. The venipuncture site must not be palpated after preparation. Obtain 5 mL blood (adults)  1 mL (children). Inoculate the collection tube. Invert the tube 5-10 times to mix well. Blood cultures should be obtained prior to initiation of antifungal therapy. If more than one culture is ordered, the specimen should be obtained from separate venipuncture sites.  Disinfect the septum of the collection tube with alcohol. The time of collection must be indicated. Strict aseptic technique is essential

SPECIMEN REQUIREMENTS: Blood
REJECTION CRITERIA: Inappropriate specimen container, specimen received more than 8 hours after collection, insufficient specimen volume, refrigerated specimen, clotted specimen.
MINIMUM VOLUME: 3 mL; 1 mL peds
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature. Do NOT refrigerate.
REFERENCE RANGE: No mycobacteria isolated
METHODOLOGY: Lysis centrifugation followed by inoculation of conventional mycobacterial culture media, as well as a rapid medium for automated continuous analysis.
ADDITIONAL INFORMATION: Bacterial isolates will be referred to the Blood Culture workstation for identification and susceptibility testing, when appropriate. An additional charge(s) will be incurred. Fungal isolates will be referred to the Mycology laboratory for identification. An additional charge(s) will be incurred. Mycobacterial 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. 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. The battery of drugs routinely tested will vary by isolate and/or physician request. Patients from whom M. tuberculosis is isolated are reported to the City of Chicago Board of Health. This is mandated by law.
TEST SYNONYM(S):MAC Blood Culture; MAI Blood Culture; Mycobacterium Culture, Blood