Bronchial Aspirate Culture, Routine

CPT CODE: 87071 (culture); 87025 (smear)
TEST INFORMATION: Test includes a direct Gram stain, isolation and identification of potential pathogens, 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 are available after 24-48 hours. Cultures with no growth or normal flora only will be finalized after 48 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 specimen MUST be specified on the order or requisition. Order or requisition must also state Cystic Fibrosis protocol, when appropriate, for cystic fibrosis patients.
CONTAINER TYPE: Sealed sterile container, no preservative; sterile sputum container; sterile Leuken`s tube
COLLECTION: Specimens are to be collected from a site prepared utilizing aseptic technique. Non-bacteriostatic sterile saline should be used when obtaining washings and/or lavage specimens. Material obtained by needle aspiration (transbronchial lung biopsy) is injected into a sealed sterile container.
SPECIMEN REQUIREMENTS: Bronchial aspirate, bronchial biopsy, bronchial brush, endotracheal aspirate, tracheal aspirate, transtracheal aspirate
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, specimen submitted in a preservative.
MINIMUM VOLUME: 2-10 mL or a piece of tissue
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature. Do NOT refrigerate.
REFERENCE RANGE: No growth or normal respiratory flora only
LIMITATIONS OF TEST: Anesthetic solutions used during the bronchoscopy procedure may inhibit growth of organisms. Bronchial brushes MUST be transported to the laboratory IMMEDIATELY to eliminate desiccation of the specimen. Specimens collected via bronchoscopy are contaminated with normal oral flora. Postbronchoscopy expectorated specimens may provide a better yield of organisms than those obtained during the bronchoscopy procedure.
METHODOLOGY: Inoculation of conventional culture media.
ADDITIONAL INFORMATION: Presence of normal respiratory flora will be reported. Normal flora includes alpha and nonhemolytic streptococci, saprophytic Neisseria species, coagulase-negative staphylococci, Micrococcus species, and diphtheroids. Bronchial specimens are not screened for specimen acceptability by means of a sputum screen.
TEST SYNONYM(S):Lower Respiratory Culture Aspirate