Culture for Leptospira

CPT CODE: 87081
TEST INFORMATION: Test includes culture for Leptospira ONLY.
DAYS PERFORMED: Monday-Friday, 0800-1400
SPECIAL INSTRUCTIONS: The Clinical Microbiology Laboratory MUST be contacted prior to submission of the specimen. The order or requisition MUST state specimen for Leptospira culture. If urine is submitted, the pH MUST be alkaline or neutral, since Leptospira do NOT survive in an acid pH. Repeat cultures may be necessary.
CONTAINER TYPE: Sterile urine container - do NOT use boric acid transport tube; [heparin Vacutainer® tube for blood (plasma), sealed sterile container for CSF

SPECIMEN REQUIREMENTS: Urine, blood (plasma), cerebrospinal fluid
REJECTION CRITERIA: Urine specimen submitted in a boric acid transport tube, urine specimen older than 1 hour, acidic urine, blood specimen collected in an inappropriate tube, insufficient specimen volume.
MINIMUM VOLUME: 1 mL urine, 5 mL blood (1 mL plasma), 1 mL CSF
HANDLING INSTRUCTIONS: Specimen must be transported directly to the Clinical Microbiology Laboratory, 1133 Jelke SC, within 1 hour of collection.
REFERENCE RANGE: No Leptospira isolated
LIMITATIONS OF TEST: Specimen will be cultured for Leptospira ONLY; no other organisms will be isolated or identified. Susceptibility testing will NOT be performed.
METHODOLOGY: Conventional culture in specialized medium
REFERRAL LABORATORY: Commercial Laboratory
ADDITIONAL INFORMATION: Leptospirosis in humans is usually associated with occupational exposure. Veterinarians, dairy workers, swineherders, abattoir workers, miners, fish, and poultry processors, and those who work in a rat-infected environment are at increased risk. Leptospiremia occurs during the septicemic acute phase of infection. This phase lasts 4-7 days after which organisms are not recoverable from blood. Culture of blood or cerebrospinal fluid should NOT be ordered after the first week of illness. During the first week of disease, the most reliable means of detecting spirochetes is by direct culturing of cerebrospinal fluid or blood. Urine does not become positive for Leptospira until the second week of disease and then can remain positive for several months. Concentrations of Leptospira in human urine is low and shedding may be intermittent. Therefore, repeated isolation attempts should be made. Serology (acute and convalescent) is recommended.