Body Fluid Culture, Routine

CERNER / EPIC MNEMONIC: C FLUID; C FLUIDGS
POE DESCRIPTION: CU FLUID AND GRAM STAIN; C FLUIDGS

CU FLUID; FLUID CULTURE

CPT CODE: 87071 (culture); 87205 (Gram stain)
TEST INFORMATION: Test includes a direct Gram stain, isolation and identification of microorganisms, and susceptibility testing, if appropriate. Other isolated organisms (i.e. fungi, mycobacteria) 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: Gram stain: 2 hours after receipt of the specimen in the laboratory. Preliminary culture reports available after 24 hours. Culture reports of no growth will be issued after 72 hours. Completion of culture reports may take 3-4 days after receipt of the specimen when multiple isolates are found.
SPECIAL INSTRUCTIONS: The specific anatomic site of the body fluid MUST be specified on the order or the requisition.
CONTAINER TYPE: Sealed sterile container; BacT/ALERT® SA (aerobic) and BacT/ALERT® SN(anaerobic); red top Vacutainer® tube; BBLTMCultureSwab-PlusTM II
COLLECTION: The specimen of choice is an aspirate, NOT a swab. Specimens are to be collected from a site prepared utilizing aseptic technique. Overlying and adjacent areas must be carefully prepared to eliminate surface (normal flora) organisms. Ideally, material obtained by needle aspiration through intact surface which has been cleaned with antiseptic, is put directly into a sealed, sterile container. Swabs should be used as a last resort due to the small volume of specimen obtainable by this method. If a swab must be used, use the Copan Swab® II collection device. Contamination with normal flora from skin or other body surfaces must be avoided since colonizing bacteria not involved in the infectious process may be introduced into the sample. Pulmonary samples may be obtained by transtracheal percutaneous needle aspiration.
SPECIMEN REQUIREMENTS: Aseptically aspirated body fluid
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, gross contamination of specimen, refrigerated specimen.
MINIMUM VOLUME: 1 mL sealed sterile container, 0.5 mL per Bact/Alert bottle
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature. Do NOT refrigerate. Clients: incubate Bact/Alert bottles if transportation is delayed more than 4 hours at 35°C.
REFERENCE RANGE: No growth
LIMITATIONS OF TEST: If anaerobes are suspected, either request an anaerobic culture or submit the specimen in aerobic and anaerobic Bact/Alert blood culture bottles. See listing for Body Fluid Anaerobic Culture. The use of blood culture bottles for submission of the specimen has some limitations: quantitation unavailable, Gram stain unavailable unless a separate sample is submitted. Use of the blood culture bottles does however increase the sensitivity of the culture procedure. Use of the blood culture bottles also eliminates the need to request a separate anaerobe culture when both aerobic and anaerobic media are inoculated.
METHODOLOGY: Inoculation of conventional culture media; automation (continuous monitoring) for Bact/Alert blood culture media.