Urine Culture, Mycobacterium

CERNER / EPIC MNEMONIC: CAFBSM
POE DESCRIPTION: CU MYCOBACTERIUM W SMEAR; CU AFB WITH SMEAR; C AFBSM
CPT CODE: 87117; 87206
TEST INFORMATION: Test includes culture and acid-fast stain (if specimen volume is adequate). Culture includes decontamination and concentration. If a mycobacterial species is isolated, the organism will be definitely identified. Susceptibility testing will be performed depending upon the isolate identification.
DAYS PERFORMED: Daily, 24 hours
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 issued after 8 weeks. Negative cultures with positive smears will be issued after 12 weeks. Completion of culture reports may require additional time when mycobacteria are isolated and susceptibility testing is performed.
SPECIAL INSTRUCTIONS: The specific anatomic site of the specimen MUST be specified on the requisition.
CONTAINER TYPE: Sealed, sterile urine container, no preservative.
SPECIMEN REQUIREMENTS: First morning voided urine
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, specimen received in a boric acid tube. 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: 80 mL needed
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate.
REFERENCE RANGE: No acid-fast bacilli observed on smear or isolated in culture
LIMITATIONS OF TEST: A single negative smear does not rule out the presence of mycobacterial infection.
METHODOLOGY: Acid-fast smear: fluorochrome stain. Culture: inoculation of conventional culture media and automation (continuous monitoring).
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 mycobacteria are observed by smear or isolated in culture are reported to the City of Chicago Board of Health. This is mandated by law.
TEST SYNONYM(S):AFB Culture, Urine; Mycobacterium Culture, Urine; TB Culture, Urine; Urine AFB Culture; Urine TB Culture