Acid Fast Sputum AF SPT

Synonyms

Allscripts (AEHR) Order Name

Culture - Acid Fast - Sputum w/Smear

Sunrise Clinical Manager (SCM) Order Name

Culture - Acid Fast - Sputum w/Smear

EPIC Order Name

Sputum Mycobacterial (AFB) Smear and Culture

Clinical Info

Mycobacteria, particularly Mycobacterium tuberculosis,
pose a significant global public health challenge, with early diagnosis being
crucial for preventing transmission and initiating prompt treatment.
Additionally, approximately 200 known species of nontuberculous mycobacteria
(NTM), commonly found in the environment (soil and water), are emerging as
opportunistic human pathogens, with a rising prevalence of pulmonary NTM
infections. 

Specimen Type

Sputum

Specimen Volume

5-8 mL (minimum volume: 3 mL) Sputum, Induced sputum

Container

Sputum collection kit 

Collection Instructions

For diagnostic purposes, all persons suspected of having TB disease at any site should have sputum collected for TB culture. At least three consecutive sputum specimens are needed, each collected in 8- to 24-hour intervals, with at least one being an early morning specimen.

1. Collect 5-8 mL (minimum volume: 3 mL) of a first-morning “deep cough” sputum specimen into a Sputum Collection Kit.
2. Instruct patient to brush his/her teeth and/or rinse mouth well with water to minimize contaminating specimen with food particles, mouthwash, or oral drugs.
3. Have patient remove dentures.
4. Instruct patient to take a deep breath, hold it momentarily, then cough deeply and vigorously into Sputum Collection Kit.
5. Remove the funnel and discard. Using the cap provided, securly close the 50 ml conical tube.
5. Label the 50 ml conical tube with patient’s name (first and last), date and actual time of collection, and type of specimen.
6. Send specimen refrigerated.
7. Maintain sterility and forward promptly.
Note: Specimen source is required on request form for processing.
*Rejection Criteria: Quantity not sufficient, sputum not received in sputum collection kit, specimen leaking, unlabeled or mislabeled specimen, specimen without a minimum of 2 patient identifiers, specimen received after prolonged delay (more than 7 days), specimen in fixative.

Transport Instructions

Refrigerated (2°-8°C), transport to the laboratory as soon as possible.

Specimen Stability

Up to 3 days at 2-8C (refrigerated)

Methodology

The specimen is processed and an acid fast smear is performed to detect acid-fast bacilli. The first smear-positive sputum specimen from a patient is automatically reflexed to a PCR test to rapidly detect M. tuberculosis complex and rifampin resistance. All specimens (smear and PCR positive or negative) are cultured in broth and solid media for up to 6 weeks for the detection and identification of M. tuberculosis complex and nontuberculous mycobacteria.
First time M. tuberculosis complex isolates are referred to the department of
health for further speciation and susceptibility testing. 

Days Performed

Monday through Sunday

Performing Laboratories

Northwell Health Laboratories - Little Neck Parkway
If culture is positive, additional charge(s)/CPT code(s) may apply for identification
and/or antibiotic susceptibilities performed when appropriate.

CPT

87116 - culture
87206 - smear

PDM

6201256

Result Interpretation

Forms