Test Details
Methodology
Culture
Result Turnaround Time
2 - 5 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Test Includes
Isolation and identification (additional CPT code) of aerobic bacteria considered pathogenic in the lower respiratory tract. Susceptibilities are performed, at additional charge, when appropriate.
Special Instructions
Sputum specimens should not be cultured under the test number for lower respiratory culture as this test does not include a Gram stain evaluation. Use test number 182352 Gram Stain Evaluation With Sputum Culture Reflex for sputum culture.
Limitations
In bronchoscopy and aspirated specimens reduction of contamination may be accomplished by a head-down position to reduce gravitational flow of saliva. Oral contamination may successfully be reduced by using a telescoping double catheter with a plug to protect the brush or a sheathed brush. The use of the telescoping plugged catheter (TPC) and bronchoalveolar lavage (BAL) increases the overall diagnostic yield, however, a high frequency of false-positives, circa 25%, is a drawback. Bronchial washings are unfortunately commonly diluted with topical anesthetics, which are bacteriostatic, and with irrigating solutions. If anaerobic bacteria are suspected in a transtracheal aspiration, a properly collected specimen for anaerobic culture should be submitted.
Custom Additional Information
Potential pathogens recovered by usual culture methods include Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus parainfluenzae, Pseudomonas aeruginosa, Escherichia coli, Proteus sp, Moraxella catarrhalis, and (rarely) many other organisms. Haemophilus sp and Neisseria sp may not be routinely isolated and identified. Thus, if their presence is clinically suspected, they should be specifically requested.
Agents such as Bordetella pertussis, Chlamydia pneumoniae, Corynebacterium diphtheriae, Legionella pneumophila, Mycoplasma pneumoniae, and Mycobacterium tuberculosis require special laboratory measures for isolation. Clinical suspicion of involvement by these agents should be communicated to the laboratory.
Specimen Requirements
Specimen
Aspirates, biopsy, tissue, bronchial washing
Volume
1 g tissue, 10 to 50 mL lavage fluid, 5 mL bronchial washing
Container
Sterile screw-cap container
Storage Instructions
Refrigerate at 2°C to 8°C
Causes for Rejection
Unlabeled specimen or name discrepancy between specimen and request label; inappropriate specimen transport device; leaking specimen; specimen received after prolonged delay (usually >72 hours)
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 180815 | Lower Respiratory Culture | 32355-0 | 180815 | Lower Respiratory Culture | 32355-0 | |
| Order Code | 180815 | |||||
| Order Code Name | Lower Respiratory Culture | |||||
| Order Loinc | 32355-0 | |||||
| Result Code | 180815 | |||||
| Result Code Name | Lower Respiratory Culture | |||||
| UofM | ||||||
| Result LOINC | 32355-0 |
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 180813 | Result | 180814 | Result 1 | 6463-4 | |
| Reflex 1 | ||||||
| Order Code | 180813 | |||||
| Order Name | Result | |||||
| Result Code | 180814 | |||||
| Result Name | Result 1 | |||||
| UofM | ||||||
| Result LOINC | 6463-4 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 180813 | Result | 180816 | Result 2 | 6463-4 | |
| Reflex 1 | ||||||
| Order Code | 180813 | |||||
| Order Name | Result | |||||
| Result Code | 180816 | |||||
| Result Name | Result 2 | |||||
| UofM | ||||||
| Result LOINC | 6463-4 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 180813 | Result | 180817 | Result 3 | 6463-4 | |
| Reflex 1 | ||||||
| Order Code | 180813 | |||||
| Order Name | Result | |||||
| Result Code | 180817 | |||||
| Result Name | Result 3 | |||||
| UofM | ||||||
| Result LOINC | 6463-4 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 180813 | Result | 180818 | Result 4 | 6463-4 | |
| Reflex 1 | ||||||
| Order Code | 180813 | |||||
| Order Name | Result | |||||
| Result Code | 180818 | |||||
| Result Name | Result 4 | |||||
| UofM | ||||||
| Result LOINC | 6463-4 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 180813 | Result | 180819 | Antimicrobial Susceptibility | 23658-8 | |
| Reflex 1 | ||||||
| Order Code | 180813 | |||||
| Order Name | Result | |||||
| Result Code | 180819 | |||||
| Result Name | Antimicrobial Susceptibility | |||||
| UofM | ||||||
| Result LOINC | 23658-8 | |||||