Test Code LAB877 AFB Culture and Stain
Clinical System Name
AFB Culture and Stain
Synonyms
AFB Stain
AFB Smear
Acid Fast Stain
Acid Fast Bacteria
Auramine Stain
Modified Kinyoun
Mycobacteria Culture
TB
Mycobacterium tuberculosis
LAB877
Sample Requirements
Specimen:
- Tissue or Body Fluid: Piece of tissue, preferably 0.5 cm3,, or 1-3 ml of body fluid are preferred sample types.
Note: Swabs are suboptimal for recovery of Mycobacteria due to limited material on the swab and the hydrophobicity of the Mycobacterial cell envelope (can compromise the transfer from swabs onto media). The lab will only accept BD ESwabs in Amies media for AFB culture. Dry swabs are unacceptable and will be rejected due to low yield. - CSF: Minimum of 3 ml of fluid. Note: AFB culture of CSF requires Infectious Disease approval.
- Expectorated or Induced Sputum: Minimum 3 ml specimen, optimal 5-10 ml. Three consecutive sputum samples should be collected at a minimum of 8 hour intervals. Include at least one first morning specimen.
- CF Patient's Sputum: minimum of 0.5g (not necessary to collect 3 samples in this patient population)
- Gastric Aspirates: Prior to collecting sample, obtain 50 ml transport tube containing 100mg of Sodium Carbonate from Microbiology Lab (7-2585). Collect fasting gastric aspirate specimen (minimum of 5.0 ml) on 3 consecutive days (24 hours apart).
- Blood or Bone Marrow: See AFB Culture, Blood and Bone Marrow Culture, AFB for sample requirements.
- Urine: Minimum of 40 ml, first morning urine.
- Stool: Only available with ID consultat/approval. Submit 1 gram of stool. Culture is only set up on samples that are AFB stain positive.
Container: Sterile Container
Preferred Vol: See above
Minimum Vol: See above
Processing Instructions
CPA: Send sample to Microbiology for processing. If the sample is shared and only one tube, syringe or other container is received, affix shared sample label and send entire sample plus requisition to Microbiology.
Off-site collection: Off-site Children's Lab locations should send the sample to SCH Microbiology Laboratory for processing. If the sample has an additional bacterial culture request, refer to the specific protocol and set up culture in biological safety hood if appropriate. Sample should be kept refrigerated prior to and during courier transport to SCH Microbiology Laboratory for AFB set up.
Other off-site locations, refrigerate sample prior to and during courier transport to SCH Microbiology Laboratory.
Stability
Temp | Time |
---|---|
Room temp | 30 minutes |
Refrigerated |
24 hours Respiratory samples up to 5 days. |
Frozen | N |
Availability
Procedure | Performed | Turn Around Time (TAT) |
---|---|---|
Stain | 24/7 | 24 hours |
Culture | 24/7 | 8 weeks |
Performing Laboratory
Seattle Children's Laboratory
Department
Microbiology Laboratory
CPT Codes
87116
87206 (AFB stain)
87015 (if decontamination is necessary)
This test is not limited to the CPT codes listed. Others may be added as more testing is necessary and depending on the pathogens isolated (example: MIC's and ID codes)
Description
Includes Culture and Stain for Acid Fast Bacteria (Mycobacteria). Ordering a separate AFB Stain is not necessary.
Gastric aspirates are an acceptable alternative to sputum for babies and young children who cannot produce a sputum sample. See below for collection requirements.
If patient history is highly suspicious of Mycobacterium tuberculosis please communicate this information to the laboratory.
Notifiable Result
Mycobacterium tuberculosis is a notifiable condition under Washington State Law
See Link below for Notifiable Conditions for WA State:
https://doh.wa.gov/public-health-healthcare-providers/notifiable-conditions
See Link below for PDF of phone numbers for Local Health jurisdictions (by County) in WA State:
https://www.doh.wa.gov/Portals/1/Documents/1200/LHJCommunicableDiseaseReporting.pdf
Reporting Information
AFB Stain report: 24 hours
Negative Preliminary Report: 24 - 48 hours
Negative Final Report: 8 weeks
The report will be updated and the provider will be notified if growth is detected within the 8 week incubation period.