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Epic Test Code LAB266 Acid-Fast Smear for Mycobacterium, Varies

Additional Codes

MML:SAFB

Reporting Name

Acid Fast Smear For Mycobacterium

Useful For

Detection of acid-fast bacilli in clinical samples

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies


Ordering Guidance


For the preferred test for rapid, direct detection of Mycobacterium tuberculosis from clinical specimens, order MTBRP / Mycobacterium tuberculosis Complex, Molecular Detection, PCR, Varies.



Necessary Information


Specimen source is required.



Specimen Required


Fresh tissue or body fluid are the preferred specimen types. Recovery of mycobacteria from swabs is generally very low yield.

 

Submit only 1 of the following specimens:

 

Preferred:

 

Specimen Type: Body fluid

Container/Tube: Sterile container

Specimen Volume: 1 mL

Collection Information: Saliva is not acceptable.

Additional Information: If a mycobacterial culture is also requested, collect 1.5 mL.

 

Specimen Type: Bone marrow

Container/Tube: Sterile container or green top (lithium heparin)

Specimen Volume: Entire collection

Collection Instructions:

1. Invert several times to mix bone marrow.

2. Send bone marrow specimen in original tube. Do not aliquot.

 

Specimen Type: Gastric washing

Container/Tube: Sterile container

Specimen Volume: 10 mL

Collection Instructions: Neutralize specimen within 4 hours of collection with 100 mg of sodium carbonate per 5 to 10 mL of gastric wash.

 

Specimen Type: Respiratory

Sources: Bronchoalveolar lavage fluid, bronchial washing, sputum

Container/Tube: Sterile container

Specimen Volume:  mL

Collection Instructions: Collect 3 respiratory specimens for acid-fast smears and culture in patients with clinical and chest X-ray findings compatible with tuberculosis. These 3 specimens should be collected at 8- to 24-hour intervals (24 hours when possible) and should include at least 1 first-morning specimen.

 

Specimen Type: Feces

Supplies: Stool Collection Kit, Random (T635)

Container/Tube: Sterile container

Specimen Volume: 5 to10 g

 

Specimen Type: Tissue

Container/Tube: Sterile container

Specimen Volume: 5 to10 mm

Collection Instructions: Collect a fresh, unfixed tissue specimen. Fixed tissue is not acceptable.

 

Specimen Type: Urine

Container/Tube: Sterile container

Specimen Volume: 2 mL

Collection Instructions: Collect a random urine specimen.

 

Acceptable:

 

Specimen Type: Swab

Sources: Wound, tissue, or body fluid

Container/Tube:

Preferred: Flocked swab (eg, Eswab)

Acceptable: Culture transport swab, noncharcoal (eg, Culturette)

Specimen Volume: Swab

Collection Instructions:

1. Before collecting specimen, wipe away any excessive amount of secretion and discharge, if appropriate.

2. Obtain secretions or fluid from source with sterile swab.

3. If smear and culture are requested or both a bacterial culture and mycobacterial culture are requested, collect a second swab to maximize test sensitivity.

4. Swabs from the following sources are not acceptable: respiratory fluid (eg, sputum), nasal, sinus, ear, mouth, throat, or scalp.


Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 7 days
  Ambient  7 days

Reference Values

Negative (reported as positive or negative)

Day(s) Performed

Monday through Sunday

CPT Code Information

87206

87176-Tissue processing (if appropriate)

87015-Mycobacteria culture, concentration (if appropriate)

Clinical Information

Mycobacterium tuberculosis is a leading infectious disease cause of death worldwide. The Centers for Disease Control and Prevention has reported a rise in the incidence of tuberculosis associated with AIDS, foreign-born cases, and increased transmission in high-risk populations. There has also been a rise in the number of M tuberculosis strains that exhibit resistance to one or more antituberculosis drugs. The public health implications of these facts are considerable. Because M tuberculosis is readily spread by airborne particles, rapid diagnosis and isolation of infected persons is important. Nontuberculous mycobacteria infections also cause significant morbidity and mortality in humans, particularly in immunocompromised persons. Detection of acid-fast bacilli in sputum and other specimens allows rapid identification of individuals who are likely to be infected with mycobacteria while definitive diagnosis and treatment are pursued.

Interpretation

Patients whose sputum samples are identified as acid-fast positive should be considered potentially infected with Mycobacterium tuberculosis, pending definitive diagnosis by molecular methods or mycobacterial culture.

Cautions

Artifacts may exhibit nonspecific fluorescence and be confused with organisms.

Report Available

1 day

Specimen Retention Time

3 to 7 days

Reject Due To

Specimen in viral transport medium (including but not limited to M4, M5, BD viral transport media, thioglycolate broth)
Wood shaft, charcoal or gel swab
Prepared slide, glass slide, microscope slide		  Reject

NY State Approved

Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
TBT Concentration, Mycobacteria No, (Bill Only) No
TISSR Tissue Processing No, (Bill Only) No

Testing Algorithm

When this test is ordered, the reflex tests may be performed at an additional charge.

 

For more information see Meningitis/Encephalitis Panel Algorithm

Method Name

Auramine-Rhodamine Stain

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Microbiology Test Request (T244)

-General Request (T239)