Texas Department of State Health Services - Microbiology Lab Tests

Microbiology
Influenza (Culture – Isolation)
< Return to Table of Contents

Test Includes: Cell Culture
Reporting
Results Available: 2-14 days	Contact #s: 512-458-7594
Reference
Method: Cell Culture
Turnaround Time: 2-14 days	Reference Range: No influenza virus isolated
Limitations:	Interpretation: A result of “No influenza virus isolated” does not necessarily mean absence of disease. 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 viruses are generally shed for only a short period of time. Refer to Specimen Collection by Type table for additional instructions.	Sample Type: See preferred specimens
Volume/Amount Required: Swabs in 2-4 mL of influenza transport media.	Preferred Specimen: Throat Swab, Nasopharyngeal Secretions, Nasopharyngeal aspirate, Nasal wash, Nasal swab.
Collection/Preservation: Influenza transport media, Viral transport media.	Storage Instructions: Arriving < 72 hours after collection, store and send at 2-8° C. Arriving > 72 hours after collection, store and send at -70° C (dry ice).
Causes for Rejection: Specimens submitted on a preservative such as formalin.	Sample Container: Sterile container
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Specimens are inoculated onto cell culture monolayers. If characteristic CPE or hemadsorption is observed, confirmation of identification will be performed.
Specimen Submission
Required Request Form: G-2A	Specimen Handling:
Transport Temperature: Arriving <72 hours: 2-8 °C (refrigerated) Arriving >72 hours send on dry ice	Shipping Requirements: Ship specimens in compliance with governmental regulations.
Billing
CPT Code: 87252, 87253	Fees:

Microbiology
Influenza (Culture – Typing)
< Return to Table of Contents

Test Includes: Immunofluorescence
Reporting
Results Available: 2-14 days	Contact #s: 512-458-7594
Reference
Method: Immunofluorescence
Turnaround Time: 2-14 days	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required: If transporting on dry ice, send 1-2 mLs.	Preferred Specimen: Cell culture isolate with CPE.
Collection/Preservation:	Storage Instructions: If shipment of isolate will be delayed, store at -70° C.
Causes for Rejection:	Sample Container: Sterile cryovial.
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Typing is based on immunofluorescence test using influenza A and influenza B monoclonal antibodies.
Specimen Submission
Required Request Form: G-2A	Specimen Handling:
Transport Temperature: Frozen isolate: on dry ice	Shipping Requirements: Ship specimens in compliance with governmental regulations.
Billing
CPT Code: 86710	Fees:

Microbiology
Isopora species (Microscopic – Direct Wet Smears Concentration)
< Return to Table of Contents

Test Includes: Microscopic examination
Reporting
Results Available: 3 days	Contact #s: (512) 458-7560
Reference
Method: Microscopic examination
Turnaround Time: 3 days	Reference Range: No parasites found
Limitations:	Interpretation: No parasite found indicates that there were no visible parasites in the specimen submitted.
Specimen Requirements
Specimen Collection: Feces	Sample Type: Feces
Volume/Amount Required: 15 mL liquid stool, 15 g stool	Preferred Specimen: Feces, formalin preserved
Collection/Preservation: Collect fresh stool in a clean, dry container. Immediately transfer stool to formalin preservative. Transport at ambient temperature.	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
Isopora species (Microscopic – Acid Fast Stain)
< Return to Table of Contents

Test Includes: Microscopic Examination
Reporting
Results Available: 3 days	Contact #s: (512) 458-7560
Reference
Method: Microscopic Examination
Turnaround Time: 3 Days	Reference Range: No parasites found
Limitations:	Interpretation: No parasites found indicates that there were no visible parasites in the specimen submitted.
Specimen Requirements
Specimen Collection: feces	Sample Type: feces in formalin
Volume/Amount Required: 15 mL liquid stool, 15 g stool	Preferred Specimen: Formalin preserved feces.
Collection/Preservation: Collect stool and immediately place in formalin preservative. Ship at ambient temperature.	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: 87177	Fees:

Microbiology
Legionellosis Culture (Isolation)
< Return to Table of Contents

Test Includes: Conventional biochemicals; Direct Immunofluorescent Antibody (DFA) test
Reporting
Results Available: 7-21 days	Contact #s: (512) 458-7582
Reference
Method: Conventional biochemicals; Direct Immunofluorescent Antibody (DFA) test
Turnaround Time: 7-21 days	Reference Range: No Legionella species isolated. Negative for Legionella species by Direct Immunofluorescent Antibody Test (DFA)
Limitations:	Interpretation: In areas of low prevalence, the positive predictive value of direct immunofluorescence is unacceptably low. The combination of low sensitivity and false-positive tests indicates that this test should not be performed in most clinical situations without the addition of culture.
Specimen Requirements
Specimen Collection: endoscopy, biopsy, sputum	Sample Type: Tissue; Pleural Fluid; Sputum; Bronchial Washings in sterile, leakproof container. Environmental samples include water, gaskets, or other water sources connected to a confirmed case
Volume/Amount Required: 2 mL minimum of washings or sputum. Tissue- small piece	Preferred Specimen: Tissue; Pleural Fluid; Sputum; Bronchial Washings in sterile, leakproof container. Environmental samples include water, gaskets, or other water sources connected to a confirmed case
Collection/Preservation: Collect washings using sterile water instead of saline. Saline is inhibitory to Legionella species. Keep at 2-8° C. Do not freeze.	Storage Instructions: 2-8° C. Do not freeze. Do not use dry ice.
Causes for Rejection: Insufficient quantity for testing.	Sample Container: Sterile, leak-proof
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Environmental samples are accepted only from health officials in the study of multi-case outbreaks. Isolation specimens must be on ice packs but not dry ice. Dry ice elevates the CO₂ level to a level toxic to Legionella.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature: 2-8° C (refrigerated) DO NOT SHIP ON DRY ICE.	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87070	Fees:

Microbiology
Legionellosis Culture (Identification)
< Return to Table of Contents

Test Includes: Conventional biochemicals; Direct Immunofluorescence Antibody Test (DFA)
Reporting
Results Available: 7-14 days	Contact #s: (512) 458-7582
Reference
Method: Conventional biochemicals; Direct Immunofluorescence Antibody Test (DFA)
Turnaround Time: 7-14 days	Reference Range: By report
Limitations: Organism must be viable for culture studies to be performed.	Interpretation: By report
Specimen Requirements
Specimen Collection:	Sample Type: Pure culture
Volume/Amount Required: one specimen per patient	Preferred Specimen: Pure cultures on appropriate media.
Collection/Preservation: Ambient temperature	Storage Instructions: Ambient temperature
Causes for Rejection: Name on tube/specimen do not match; Broken in transport.	Sample Container: Agar slant in screw cap tube
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Legionella requires cysteine for growth and should be submitted on a media like BCYE agar to insure viability.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Infectious agent, biosafety level 2
Transport Temperature: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.
Billing
CPT Code: 87077	Fees:

Microbiology
Legionellosis Culture (Typing)
< Return to Table of Contents

Test Includes: Direct Immunofluorescent Antibody Test (DFA)
Reporting
Results Available: 7-14 days	Contact #s: (512) 458-7582
Reference
Method: Direct Immunofluorescent Antibody Test (DFA)
Turnaround Time: 7-14 days	Reference Range: By report.
Limitations: The number of serogroups is limited by the commercially available FITC conjugates. Rare serogroups cannot be typed at this location. These organisms will be forwarded to the CDC for typing.	Interpretation: By report.
Specimen Requirements
Specimen Collection:	Sample Type: Pure cultures on appropriate media,
Volume/Amount Required: One specimen per patient.	Preferred Specimen: Pure cultures on appropriate media.
Collection/Preservation:	Storage Instructions: Ambient temperature
Causes for Rejection: Specimen broken in transport, expired transport media.	Sample Container: Agar slant in screw cap tube.
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: See Legionellosis (Microscopic – Direct Fluorescent Antibody)
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Infectious agent, Biosafety level 2
Transport Temperature: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.
Billing
CPT Code: 87147	Fees:

Microbiology
Legionellosis (Serological - Immunofluorescence)
< Return to Table of Contents

Test Includes:
Reporting
Results Available: 3-5 days	Contact #s:
Reference
Method: IFA
Turnaround Time: 3-5 days	Reference Range: < 1:64 (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: Serum
Volume/Amount Required: 2 mL Serum	Preferred Specimen: Paired Sera; Single Serum
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: Test run every Tuesday and Thursday
Diagnostic Information: A single serum will be tested only if three or more weeks after onset. Single titers of <1:64 are considered Nonreactive. Single titers between 1:64 and 1:128 are considered Nonreactive, but may warrant follow-up testing. Single titers >1:256 are considered evidence of infection at an undetermined time. A fourfold or greater titer increase between acute and convalescent sera provides evidence of recent infection. The test is performed twice 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: 86713	Fees:

Microbiology
Legionellosis (Microscopic – Direct Fluorescent Antibody)
< Return to Table of Contents

Test Includes: Direct Immunofluorescent Antibody Test (DFA)
Reporting
Results Available: 1-3 days	Contact #s:
Reference
Method: Direct Immunofluorescent Antibody Test (DFA)
Turnaround Time: 1-3 days	Reference Range: By report
Limitations: Direct Immunofluorescent Antibody Test (DFA) conjugates are commercially available for a limited number of serogroups. Rare or newly discovered serogroups will not be detected using these reagents.	Interpretation: In areas of low disease prevalence the positive predictive value is unacceptably low. The combination of low sensitivity and false-positive tests in a low-prevalence environment indicates that this test should not be performed in most clinical situations without culture.
Specimen Requirements
Specimen Collection: Tissue; Pleural Fluid; Sputum; Bronchial Washings, Pure cultures.	Sample Type:
Volume/Amount Required: 2 mL washings, fluid, or small piece of tissue.	Preferred Specimen: Tissue; Pleural Fluid; Sputum; Bronchial Washings Pure cultures.
Collection/Preservation: Collect bronchial washings using sterile water instead of saline.	Storage Instructions: Ambient temperature.
Causes for Rejection: Name on specimen/form do not match; Broken in transport.	Sample Container: Sterile, leak-proof container.
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Environmental samples are accepted only from health officials in the study of multi-case outbreaks. Isolation specimens must be iced but not frozen. Direct Immunofluorescence Antibody (DFA) tests allow for typing of Legionella pneumophila 1-6, L. micdadei, L. bozemanii, L. jordanii, L. longbeachea, Legionella dumoffii, Legionella gormanii. All isolates that are non reactive with the above DFA conjugates are submitted to the CDC for further typing.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature: 2-8 ° C DO NOT SHIP ON DRY ICE. Pure cultures: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87278	Fees:

Microbiology
Leishmaniasis (Culture – Isolation)
< Return to Table of Contents

Test Includes: Specimens forwarded by TDSHS to CDC with prior arrangement.
Reporting
Results Available:	Contact #s: 512-458-7560
Reference
Method:
Turnaround Time:	Reference Range:
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen:
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Specimens forwarded by TDSHS to CDC with prior arrangement. Please call 512-458-7560 to make arrangements and instructions on specimen type and shipping temperatures.
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature:	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87081	Fees:

Microbiology
Leishmaniasis (PCR – CDC through TDSHS)
< Return to Table of Contents

Test Includes: Specimens forwarded by TDSHS to CDC with prior arrangement
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time:	Reference Range:
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen:
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Specimens forwarded by TDSHS to CDC with prior arrangement. Please call 512-458-7560 to make arrangements and instructions on specimen type and shipping temperatures. If culture is positive, PCR can be performed for speciation.
Specimen Submission
Required Request Form: G-2A	Specimen Handling:
Transport Temperature:	Shipping Requirements:
Billing
CPT Code: 87797	Fees:

Microbiology
Leishmaniasis (Serological – Forwarded by TDSHS to CDC for testing.)
< Return to Table of Contents

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: Serum
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: Specimens forwarded by TDSHS to CDC with prior arrangement. Prior notification is requested (512) 458-7760. A detailed patient history is required. Titers of >1:16 are considered positive. The diagnosis of dermal or cutaneous leishmaniasis is more difficult than the visceral form, since a detectable immune response is often absent. Cross reactions may occur with Chagas’ disease, malaria or schistosomiasis, so positive serological results provide only suggestive support for the diagnosis.
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: 86717	Fees:

Microbiology
Leishmaniasis (Microscopic – Giemsa Stain)
< Return to Table of Contents

Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: 24 hours	Reference Range:
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Tissue
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Specimens examined by TDSHS follow up cultures will be forwarded by TDSHS to CDC with prior arrangement.
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature: Ambient (Room) temperature	Shipping Requirements:
Billing
CPT Code: 87177	Fees:

Microbiology
Leishmaniasis (Microscopic – H & E Stain)
< Return to Table of Contents

Test Includes: Microscopic examination
Reporting
Results Available: 1 day	Contact #s: (512) 458-7560
Reference
Method: Microscopic examination
Turnaround Time: 24 hours	Reference Range: No parasites found
Limitations:	Interpretation: No parasites found indicates that there were no visible parasites in the specimen submitted.
Specimen Requirements
Specimen Collection: biopsy, fine needle aspiration.	Sample Type: Tissue, lymph node aspirates, liver biopsy, sternal or iliac crest bone marrow.
Volume/Amount Required: small piece of tissue	Preferred Specimen: Tissue
Collection/Preservation: Specimens may be collected from the margin of the lesion by aspiration, scraping, or punch biopsy. If material is to be cultured, it must be collected aseptically.	Storage Instructions: Ambient temperature
Causes for Rejection: Insufficient specimen, Name on specimen/form do not match.	Sample Container: Sterile, leak-proof container.
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Specimens examined by TDSHS follow up cultures will be forwarded by TDSHS to CDC with prior arrangement.
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.
Billing
CPT Code: 87177	Fees:

Microbiology
Leprosy (Microscopic and Animal Studies)
Names of Related Agents: Mycobacterium leprae
< Return to Table of Contents

Test Includes:
Reporting
Results Available:	Contact #s: Hansen’s Disease Program Coordinator at 512-458-7447
Reference
Method:
Turnaround Time:	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Tissue; Skin Scrapings; Slides smeared with exudates
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Skin scrapings, smears, and biopsy material go to: National Hansen's Disease Programs/Clinical Lab, Baton Rouge, Louisiana. For more information telephone 1-800-642-2477.
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature: As directed per case	Shipping Requirements:
Billing
CPT Code: 87206	Fees:

Microbiology
Leptospirosis (Serological – Forwarded by TDSHS to CDC for testing.)
< Return to Table of Contents

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: Serum
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. Sera are sent to the CDC. Specimens positive in the Indirect Hemagglutination Test, qualitative screening test, are confirmed with a quantitative Microagglutination Test against a battery of antigens. A fourfold increase in titer is evidence of current infection. Extensive cross-reactions among leptospiral antigens are frequent.
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: 86720	Fees:

Microbiology
Listeriosis Culture–(Isolation)
< Return to Table of Contents

Test Includes: Conventional biochemicals.
Reporting
Results Available: 7-21 days	Contact #s: (512) 458-7582
Reference
Method: Conventional biochemicals.
Turnaround Time: 7-21 days	Reference Range: No Listeria monocytogenes isolated
Limitations: Organism must be viable in order to culture.	Interpretation: Isolation of Listeria monocytogenes should always be considered significant.
Specimen Requirements
Specimen Collection: Venipuncture.	Sample Type: Blood; Tissue.
Volume/Amount Required: 10 mL of whole blood, small piece tissue	Preferred Specimen: Blood; Tissue
Collection/Preservation: Blood may be kept at ambient temperature or refrigerated. Do not freeze whole blood. Refrigerate tissue.	Storage Instructions: Do not freeze whole blood. Blood may be kept at ambient temperature or refrigerated. Refrigerate tissue.
Causes for Rejection: No identifying marks on sample and/or paperwork.	Sample Container: Tiger or red top vacutainer, sterile leak-proof container.
Sample Test Kit:	Availability: Tested Monday – Friday.
Diagnostic Information: See Aerobic Bacterial Culture (Isolation).
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature: Tissue 2-8 ° C; Blood 2-25° C	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87046	Fees:

Microbiology
Listeriosis Culture –(Identification)
< Return to Table of Contents

Test Includes: Conventional biochemicals
Reporting
Results Available: 4-21 days	Contact #s: (512) 458-7582
Reference
Method: Conventional biochemicals
Turnaround Time: 4-21 days	Reference Range: By report
Limitations: Organism must be viable for culture studies.	Interpretation: Identification of Listeria monocytogenes should always be considered significant.
Specimen Requirements
Specimen Collection: Dependent upon source of sample.	Sample Type: Pure culture.
Volume/Amount Required: one specimen per patient.	Preferred Specimen: Pure culture on agar slant.
Collection/Preservation: May be kept at ambient temperature.	Storage Instructions: Store at ambient temperature.
Causes for Rejection: No identifying marks on sample and/or paperwork.	Sample Container: Dependent upon type of transport.
Sample Test Kit:	Availability: Tested Monday – Friday.
Diagnostic Information: See Aerobic Bacterial Culture, (Identification)
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Infectious agent, Biosafety level 2.
Transport Temperature: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.
Billing
CPT Code: 87077	Fees:

Microbiology
Listeriosis Culture (Typing)
< Return to Table of Contents

Test Includes: Isolates from outbreaks are sent to the CDC for typing.
Reporting
Results Available: Dependent on CDC report	Contact #s: (512) 458-7185
Reference
Method: Serotyping, PFGE
Turnaround Time: Dependent on CDC report	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type: Pure cultures
Volume/Amount Required:	Preferred Specimen: Pure cultures.
Collection/Preservation:	Storage Instructions: Ambient temperature
Causes for Rejection: Insufficient information, Name on tube/form do not match.	Sample Container: Agar slant in screw cap tube.
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Isolates from outbreaks are sent to the CDC for typing. Molecular typing performed at TDH Request molecular typing by indicating PFGE on submission form Request serotyping on submission form and include clinical history to be forwarded to the CDC.
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Infectious agent, Biosafety level 2
Transport Temperature: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.
Billing
CPT Code: 87147	Fees:

Microbiology
Loiasis (Microscopic – Direct Giemsa Stains)
< Return to Table of Contents

Test Includes: Microscopic examination
Reporting
Results Available: 1 day	Contact #s: (512) 458-7560
Reference
Method: Microscopic examination
Turnaround Time: 24 hours	Reference Range: No parasites found.
Limitations:	Interpretation: No parasite found indicates that there were no visible parasites in the specimen submitted.
Specimen Requirements
Specimen Collection: venipuncture	Sample Type: Blood
Volume/Amount Required: 20 mL whole blood	Preferred Specimen: Blood Purple Top collected between 10 am and 2 pm.
Collection/Preservation: Collect blood by venipuncture, preferably between 10 am and 2 pm, in a purple top vacutainer tube.	Storage Instructions: Ambient temperature
Causes for Rejection: Incorrect collection tube, insufficient sample	Sample Container: Purple top vacutainer
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: 2 thin and 2 thick smears should be examined.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87102	Fees:

Microbiology
Lobomycosis (Culture - Isolation)
< Return to Table of Contents

Test Includes: Tissues are forwarded to the CDC for fluorescence.
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time:	Reference Range:
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection: biopsy	Sample Type:
Volume/Amount Required: small piece of tissue	Preferred Specimen: Isolate; Tissue
Collection/Preservation: ambient temperature	Storage Instructions: ambient temperature
Causes for Rejection:	Sample Container: Sterile, leak-proof container
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Tissues are forwarded to the CDC for fluorescence.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Handle body fluids using universal precautions
Transport Temperature:	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87102	Fees:

Microbiology
Lobomycosis (Culture - Identification)
< Return to Table of Contents

Test Includes: Tissues are forwarded to the CDC for fluorescence.
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time:	Reference Range:
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection: biopsy	Sample Type: Isolate; Tissue
Volume/Amount Required: small piece of tissue	Preferred Specimen: Isolate; Tissue
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container: Sterile, leak-proof container
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Tissues are forwarded to the CDC for fluorescence.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Handle body fluids using universal precautions
Transport Temperature: ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87102	Fees:

Microbiology
Lobomycosis (Microscopic – Direct Fluorescent Antibody)
< Return to Table of Contents

Test Includes: Tissues are forwarded to the CDC for fluorescence
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time:	Reference Range:
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type: Tissue
Volume/Amount Required:	Preferred Specimen: Tissue
Collection/Preservation:	Storage Instructions: Ambient Temperature
Causes for Rejection:	Sample Container: Sterile, leak-proof container
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Tissues are forwarded to the CDC for fluorescence
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Handle body fluids using universal precautions
Transport Temperature:	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87206	Fees:

Microbiology
Lyme Disease (Serological – Enzyme Immunoassay)
< Return to Table of Contents

Reporting
Results Available:	Contact #s:
Reference
Method: EIA
Turnaround Time: 3-5 days	Reference Range: <1.00 (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: 2 mL Serum	Preferred Specimen: Single Serum; Paired Sera
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: Test run every Tuesday and Thursday
Diagnostic Information: The Borrelia burgdorferi antibody EIA detects both IgG and IgM antibodies. IgM-specific titers usually peak 4 to six weeks after the onset of infection and may persis in the presence of disease. IgG levels tend to rise above background levels about 2-3 weeks after infection and may remain elevated in cases of prolonged disease. Seronegative cases of Lyme Disease have been reported. Serum from patients with other spirochetal diseases, mononucleosis, and some autoimmune diseases may give false positive results. Since elimination of cross-reactive syphilitic serum from syphilis patients, increases the test specificity to 97%, all lyme reactive specimens are tested for the presence of regains and treponemal specific antibodies. Patients with early lyme disease may have undetectable antibody levels. Treatment with antibiotics early after onset of ECM can also prevent development of antibodies. Test is run twice 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: 86618	Fees:

Microbiology
Lymphocytic Choriomeningitis (Serological – Forwarded by TDSHS to CDC for testing.)
< Return to Table of Contents

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, Spinal Tap	Sample Type: Serum, CSF
Volume/Amount Required: 10 mL whole blood, 1.0 mL CSF	Preferred Specimen: Paired Sera; Spinal Fluid
Collection/Preservation: Red top or tiger top tube, sterile collection tube for CSF	Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C. Immediately freeze CSF.
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Sera or CSF are forwarded to the CDC.
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 Laboratory Tests: I-L