Texas Department of State Health Services - Microbiology Lab Tests Coronavirus to Cytomegalovirus

Microbiology
Coronavirus (Serological – Forwarded by TDSHS to CDC for testing)
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Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: 3 weeks	Reference Range: Nonreactive
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type:
Volume/Amount Required: 10 mL whole blood	Preferred Specimen: Paired Sera
Collection/Preservation: Red top or tiger top tube	Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability:
Diagnostic Information: Prior notification is requested (512) 458-7760. A detailed patient history is required. Isolate and serum specimens are sent to the CDC with prior approval only. EM studies done with prior approval only. Specimens must be iced but not frozen.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Ambient temperature for specimens on the blood clot, separated serum at 2-8° C (refrigerated) or -20° C (frozen).	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8° C), or frozen (-20° C) and mailed on dry ice.
Billing
CPT Code: 86790	Fees:

Microbiology
Cryptococcosis (Culture - Isolation)
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Test Includes: Isolation of fungus and morphological and biochemical tests for identification to species level.
Reporting
Results Available: 14-21 days	Contact #s: Contact #s: 512-458-7455 for prior approval Technical questions: 512-458-7586
Reference
Method: Biochemical testing for identification
Turnaround Time: 14-21 days	Reference Range: Negative
Limitations: Delay in transport of specimen could compromise isolation of organism.	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type: Clinical Specimen
Volume/Amount Required: 3 mL to 15 mL	Preferred Specimen: Sputum; Tissue; Spinal Fluid; Blood
Collection/Preservation: No preservative	Storage Instructions: Transport specimen as soon as possible. Cryptococcus species do not survive refrigeration well.
Causes for Rejection: Specimens received frozen, in formalin, or in culture medium will be rejected. Swabs are discouraged unless the only specimen available; submit swabs in 5 mL sterile saline. Blood specimens less than 5 mL are not acceptable. Refrigerated blood specimens will be rejected.	Sample Container: Triple-contained. Sterile, leak-proof, 50 mL conical tube preferred for primary container. Add up to 10 mL sterile saline to tissue if needed to maintain moisture during transport. If blood, prefer yellow-top with ACD; may also contain SPS. Green-top is acceptable with lithium or heparin.
Sample Test Kit:	Availability: Testing available upon approval by Dr. Penfield
Diagnostic Information: Approval for this testing must be obtained prior to shipping by telephoning Dr. Susan Penfield at 512-458-7455.
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature: Ambient acceptable but 2-8º C preferred for non-sterile specimens.	Shipping Requirements: Triple-contained and packaged to meet requirements of DOT, USPS, PHS, and IATA for shipping of clinical specimens.
Billing
CPT Code: 87106	Fees:

Microbiology
Cryptococcosis (Culture - Identification)
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Test Includes: Morphological and biochemical testing for identification to species level.
Reporting
Results Available: 7-10 days	Contact #s: 512-458-7586
Reference
Method: Biochemical testing for identification
Turnaround Time: 7-10 days	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Pure Culture
Collection/Preservation: No preservative	Storage Instructions:
Causes for Rejection: Culture infested with mites.	Sample Container: Triple-contained
Sample Test Kit:	Availability: Tested 5 days/week: Monday-Friday
Diagnostic Information: Fungal isolates (pure culture) submitted to this Laboratory for definitive identification. Drug susceptibility testing on these organisms not available at TDSHS laboratory.
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature: Room temperature	Shipping Requirements: Triple-contained and packaged to meet rigorous performance tests as outlined in the DOT, USPS, PHS, and IATA regulations for shipping of infectious substances.
Billing
CPT Code: 87106	Fees:

Microbiology
Cryptococcosis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: 3 weeks	Reference Range: <1:16 (Nonreactive)
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type:
Volume/Amount Required: 10 mL whole blood	Preferred Specimen: Single Serum; Spinal Fluid
Collection/Preservation: Red top or tiger top tube	Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability:
Diagnostic Information: Prior notice is requested (458-7760). Specimen must be sent with a complete medical history. Cryptococcal antibody, primarily directed against a galactomannan capsular antigen, is often detectable in the early (pulmonary) phase prior to antigenemia.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Ambient temperature for specimens on the blood clot, separated serum at 2-8°C (refrigerated) or -20°C (frozen).	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.
Billing
CPT Code: 86641	Fees:

Microbiology
Cryptosporidiosis (Microscopic – Direct Concentration Acid Fast Stain)
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Test Includes: Acid Fast Stain
Reporting
Results Available: 3 days	Contact #s: (512) 458-7560
Reference
Method: Acid Fast Stain
Turnaround Time: 3 days	Reference Range: No parasites found
Limitations:	Interpretation: No parasites found indicates that there were no visible parasites consistent with Cryptosporidia. A negative test does not rule out the possibility of other parasitic infections.
Specimen Requirements
Specimen Collection: Feces	Sample Type: Fresh Feces
Volume/Amount Required: 15 mL stool, liquid stool, 15 gms	Preferred Specimen: Feces fresh (less than five hours) or formalin
Collection/Preservation: Fecal specimens must be sent in formalin.	Storage Instructions: ambient temperature
Causes for Rejection: Unpreserved stool > 5 hours old.	Sample Container: Formalin Transport for parasites.
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Fecal specimens must be sent in formalin. Specimens are accepted from public health officials. Referred material accepted from hospital, private, and reference labs.
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle body fluids using universal precautions. Formalin is a poison, handle with care.
Transport Temperature: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87015	Fees:

Microbiology
Cyclospora sp. (Microscopic – Direct Concentration Heat Infused Acid Fast)
Fecal Specimens must be sent in formalin
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Test Includes: Acid fast stain
Reporting
Results Available: 3 days	Contact #s: (512) 458-7560
Reference
Method: Acid fast stain
Turnaround Time: 3 days	Reference Range: No parasites found.
Limitations: Fecal specimens must be sent in formalin.	Interpretation: No parasites found indicates that there were no visible parasites consistent with Cyclospora. A negative test does not rule out the possibility of other parasitic infections.
Specimen Requirements
Specimen Collection: Feces	Sample Type: Feces in formalin
Volume/Amount Required: 15 mL liquid stool or 15 gram stool	Preferred Specimen: Feces in formalin
Collection/Preservation: Fecal specimens are collected and placed in formalin preservative.	Storage Instructions: ambient temperature
Causes for Rejection: feces > 5 hours old not in formalin.	Sample Container: Vial with formalin
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Fecal specimens must be sent in formalin. Specimens are accepted from public health officials. Referred material accepted from hospital, private, and reference labs.
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle body fluids using universal precautions. Formalin is a poison, handle with care.
Transport Temperature: Ambient temperature.	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87015	Fees:

Microbiology
Cysticercosis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: 3 weeks	Reference Range: Nonreactive
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation:
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type:
Volume/Amount Required: 10 mL whole blood	Preferred Specimen: Single Serum; Spinal Fluid
Collection/Preservation: Red top or tiger top tube	Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8° C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability:
Diagnostic Information: Prior notification is requested (512) 458-7760. A detailed patient history is required. Serum specimens are forwarded to the CDC. A Nonreactive serological result does not rule out the disease. Rare cross-reactions occur.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Triple contain, separated serum may be shipped on cold packs (2-8° C), or frozen (-20° C) and mailed on dry ice.	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8° C), or frozen (-20° C) and mailed on dry ice.
Billing
CPT Code: 86682	Fees:

Microbiology
Cysticercosis (Taenia Solium) (Microscopic – Direct Stained Slides)
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Test Includes: Microscopic examination
Reporting
Results Available: 1 day	Contact #s: (512) 458-7560
Reference
Method: Microscopic examination
Turnaround Time: 1 day	Reference Range: Specimen submitted was not a worm.
Limitations:	Interpretation: By report
Specimen Requirements
Specimen Collection: adult worms, tissue	Sample Type: Tissue; Worm (in alcohol, not formalin); Cross Sections
Volume/Amount Required: small amount of tissue; intact worm	Preferred Specimen: Tissue; Worm (in alcohol, not formalin); Cross Sections
Collection/Preservation: Collect worm and place in alcohol.	Storage Instructions: ambient temperature
Causes for Rejection: n/a	Sample Container: clean, leak-proof container
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Adult worms – Identification of scolex or clearing and examination of proglottids for uterine lateral branches.
Specimen Submission
Required Request Form: G-2B	Specimen Handling: n/a
Transport Temperature: Ambient temperature	Shipping Requirements: Ambient temperature
Billing
CPT Code: 87177	Fees:

Microbiology
Cytomegalovirus (Culture - Isolation)
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Test Includes: Cell Culture
Reporting
Results Available: 2-21 days	Contact #s: 512-458-7594
Reference
Method: Cell Culture
Turnaround Time: 2-21 days	Reference Range: No virus isolated
Limitations:	Interpretation: A result of “No virus isolated” does not necessarily mean absence of a viral agent. The success of virus isolation depends a great deal on the submission of the proper specimen, collected at the right time, adequately maintained, and shipped with the least possible delay.
Specimen Requirements
Specimen Collection: Specimens should be collected at an appropriate anatomic site and at the proper time after infection because infectious agents are generally shed for only a short period of time. Refer to Specimen Collection by Type table for additional instructions.	Sample Type: See preferred specimen
Volume/Amount Required: 10-20 mL of urine, tissue sample in enough viral transport media to prevent drying, swabs in 2-4 mL of viral transport media.	Preferred Specimen: Urine; Tissue; Saliva
Collection/Preservation:	Storage Instructions: Maintain specimens at 2-8° C immediately after collection. Ship specimens with the least possible delay. If freezing specimens for CMV isolation, use a cryoprotective agent such as 2SP.
Causes for Rejection: Specimens submitted on a preservative such as formalin.	Sample Container: Sterile container
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Isolation is done in conventional tube culture and shell vial cultures. Shell vial cultures are incubated for 2 days and then an immunofluorescence test using CMV-specific monoclonal antibody is performed. Tube cultures are held for 21days. If characteristic CPE is observed in the tube culture, an imunofluorescence test is performed using CMV-specific monoclonal antibody.
Specimen Submission
Required Request Form: G-2A	Specimen Handling:
Transport Temperature: 2-8° C, overnight delivery	Shipping Requirements: Ship specimens in compliance with governmental regulations.
Billing
CPT Code: 86645	Fees:

Microbiology
Cytomegalovirus (Culture - Identification)
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Test Includes: Immunofluorescence
Reporting
Results Available: 2-21 days	Contact #s: 512-458-7594
Reference
Method: Immunofluorescence
Turnaround Time: 2-21 days	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required: Fill monolayer tube with media if transporting at ambient temperature. If transporting on dry ice, send 1-2 mL.	Preferred Specimen: Cell culture isolate with CPE.
Collection/Preservation:	Storage Instructions: If shipment of cell culture isolate will be delayed, store at -70° C.
Causes for Rejection:	Sample Container: Cell culture tube or sterile cryovial.
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Identification based on immunofluorescence test using CMV-specific monoclonal antibody.
Specimen Submission
Required Request Form: G-2A	Specimen Handling:
Transport Temperature: Cell culture tube with CPE: ambient temperature. Frozen isolate: on dry ice.	Shipping Requirements: Ship specimens in compliance with governmental regulations.
Billing
CPT Code: 86644	Fees:

Microbiology
Cytomegalovirus (Serological – Enzyme Immunoassay– IgM and IgG)
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Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: 5-7 days	Reference Range: < 1.00
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system.	Interpretation:
Specimen Requirements
Specimen Collection: Venipuncture	Sample Type:
Volume/Amount Required: 2 mL serum	Preferred Specimen: Paired Sera; Single Serum (Transplant Patients only
Collection/Preservation: Samples that will be delivered to the laboratory within 8 hours of collection may be transported at room temperature in the original blood collection tube. If the samples are going to be shipped and will be delivered to the laboratory within 48 hours of collection, sera must be separated from the blood and shipped on cold packs, between 2° and 8° C. If the serum samples will not be delivered to the laboratory within 48 hours of collection at these temperatures, then the samples must be frozen at -20° C or lower and shipped on dry ice.	Storage Instructions: Separated serum may be held at 2-8° C, or frozen at -20° C.
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing, specimens received with extended transit time, or received at incorrect temperature.	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability:
Diagnostic Information: A positive EIA IgG index demonstrates prior infection with cytomegalovirus. Evidence of active or recent infection requires detectable IgM antibody and/or a 10% or greater increase in positive EIA IgG index values between acute and convalescent specimens. Sera must be collected 14 days apart. Significant rise in antibody level indicates recent infection or vaccination. In suspected congenital cases, sera from mother and infant must be submitted together. Test is performed once per week.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Cold (2-8º C) on ice packs if received within 48 hours from time of collection. Frozen (≤-20°) on dry ice if received more than 48 hours from time of collection.	Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8° C), or frozen (-20° C) and mailed on dry ice.
Billing
CPT Code: 86644, 86645	Fees:

Microbiology
Cytomegalovirus (Microscopic – Electron Microscopy)
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Test Includes: Electron microscopy
Reporting
Results Available: 1-2 days	Contact #s: 512-458-7594
Reference
Method: Electron microscopy
Turnaround Time: 1-2 days	Reference Range: Herpesvirus not detected
Limitations: Detection of herpesvirus particles by electron microscopy does not differentiate between CMV, VZ, Herpes simplex 1 and 2, and other members of the Herpesviridae family.	Interpretation:
Specimen Requirements
Specimen Collection: Specimens should be collected at the proper time after infection because viruses are generally shed for only a short period of time.	Sample Type: See preferred specimen.
Volume/Amount Required: 10-20 mL urine	Preferred Specimen: Urine
Collection/Preservation:	Storage Instructions: Maintain specimens at 2-8° C immediately after collection.
Causes for Rejection: Specimens submitted on a preservative such as formalin.	Sample Container: Sterile container
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Result is based on presence or absence of herpesvirus particles.
Specimen Submission
Required Request Form: G-2A	Specimen Handling:
Transport Temperature: 2-8° C , overnight	Shipping Requirements: Ship specimens in compliance with governmental regulations.
Billing
CPT Code: 88348	Fees:

Microbiology Laboratory Tests: Coronavirus to Cytomegalovirus