Aerobic Bacterial Culture, General w/ Reflex*

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Category:

Turnaround Time: 3 - 5 days
CPT Code:

87070

Test Type: Swab or 0.5 mL aseptically aspirated pus or tissue
Reference Range:

No growth, routine/normal skin flora, routine/normal “body site” flora. Wounds often become colonized by multiple gram-negative rods and mixed culture results are common. A simultaneous Gram stain should always be prepared and performed (additional charge) to facilitate interpretation.

Eye: Routine flora of the eye may include Corynebacterium sp (diphtheroids), Staphylococcus epidermidis, saprophytic fungi, Moraxella (Branhamella) catarrhalis, Moraxella sp, Streptococcus sp (nonhemolytic), and gram-negative rods (rare). Abnormal ocular flora include Haemophilus influenzae, Haemophilus aegyptius, Streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus subtilis, Neisseria gonorrhoeae, and Mycobacterium chelonae.

Wound: Routine skin flora may include coagulase-negative staphylococci, Corynebacterium sp (diphtheroids), α-streptococci (Streptococcus viridans, or viridans streptococci).

Overview:

Isolate and identify potentially pathogenic aerobic organisms. Susceptibility test is performed at additional charge when organisms isolated meet microbiologic criteria for clinical significance.

Only rapid-growing, nonfastidious aerobic organisms can be recovered and identified by routine methods. Only organisms that predominate will be identified. Unless specifically requested by the physician, fastidious organisms may not be isolated. Anaerobic, fungal, and mycobacterial pathogens should be considered, and appropriate cultures requested if clinically indicated. The procedure will not detect Chlamydia, viruses, fungi, or mycobacteria.

Eye: The major modes of transmission of disease to the conjunctiva include the hands, airborne fomites, and spread for adjacent adnexal infections. Eye infections include eyelid infections, blepharitis, dacryocystitis, orbital cellulitis, conjunctivitis, keratitis, endophthalmitis retinitis, and chorioretinitis. Pinkeye is caused by adenovirus. It presents as bilateral conjunctivitis with a sudden onset. Herpes simplex and zoster present as periorbital or corneal infections. Nontuberculous mycobacterial keratitis may occur following trauma or surgery accompanied by the use of local corticosteroids.1

Wound: Susceptibility testing is usually performed. The majority of bacteria infecting surgical wounds are common airborne microörganisms.2 Effective treatment of wound infection usually includes drainage, removal of foreign bodies, infected prosthetic devices, and retained foreign objects such as suture material. Suction irrigation may be helpful in resolving wound infections. Species commonly recovered from wounds include Escherichia coli, Proteus sp, Klebsiella sp, Pseudomonas sp, Enterobacter sp, enterococci, other streptococci, Bacteroides sp, Prevotella sp, Clostridium sp, Staphylococcus aureus, and coagulase-negative Staphylococcus.

1. Bullington RH Jr, Lanier JD, Font RL. Nontuberculous mycobacterial keratitis. Report of two cases and review of the literature. Arch Ophthalmol. 1992 Apr; 110(4):519-524. PubMed 1562261

2. Whyte W, Hambraeus A, Laurell G, Hoborn J. The relative importance of the routes and sources of wound contamination during general surgery. II. Airborne. J Hosp Infect. 1992 Sep; 22(1):41-54. PubMed 1358946

Baker AS. Ocular infections: Clinical and laboratory considerations. Clin Microbiol Newsl. 1989; 11:97-101.

Cheadle WG. Current perspectives on antibiotic use in the treatment of surgical infections. Am J Surg. 1992 Oct; 164(4A Suppl):44S-47S. PubMed 1443360

Goldstein EJ. Management of human and animal bite wounds. J Am Acad Dermatol. 1989 Dec; 21(6):1275-1279. PubMed 2685062

Jones DB, Leisegang TJ, Robinson NM. Cumitech 17. In: Washington JA, ed. Laboratory Diagnosis of Ocular Infections. Washington, DC: ASM Press;1981 (review).

Kligman EW. Treatment of otitis media. Am Fam Physician. 1992 Jan; 45(1):242-250. PubMed 1728094

Macknin ML. Respiratory infections in children. What helps and what doesn't? Postgrad Med. 1992 Jan; 92(2):242-250. PubMed 1495881

Pollack AV, Evans M. Microbiologic prediction of abdominal surgical wound infection. Arch Surg. 1987 Jan; 122(1):33-37. PubMed 3541852

Randall DA, Fornadley JA, Kennedy KS. Management of recurrent otitis media. Am Fam Physician. 1992 May; 45(5):2117-2123. PubMed 1575107

Collection Details:

Patient Preparation:

Sterile preparation of the aspiration site is required.

Collection Instructions:

The test request form must state specific site of specimen, age of patient, and time of collection. Inclusion of current antibiotic therapy and clinical diagnosis may aid the laboratory in evaluating the specimen and work-up of the culture. If an unusual organism is suspected, this information must be specifically noted on the test request form (eg, Nocardia) and may result in additional charges. For extended incubation, order Aerobic Culture, Extended Incubation [180803].

Specimens from other sources, such as genital, stool, urine, upper and lower respiratory specimens, cannot be cultured under the aerobic bacterial culture test number. If specimens are incorrectly submitted with an order for aerobic bacterial culture, the laboratory will process the specimen for the test based on the source listed on the test request form. The client will not be telephoned to approve this change, but the change will be indicated on the report.

Sterile screw-cap container or bacterial swab transport; ESwab™ is acceptable.

Disinfect contiguous areas of skin or mucous membrane containing resident normal flora prior to culture collection. Collect exudates from the interior of productive lesions. Tissue samples must be kept moist. A thin, air-dried smear for Gram stain obtained from the same site as the culture is strongly recommended (additional test).

Maintain specimen at room temperature.