Texas Department of State Health Services

Microbiology
Salmonellosis Culture –(Isolation)
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Test Includes: Conventional biochemicals, serological typing
Reporting
Results Available: 4-7 days	Contact #s: (512) 458-7582
Reference
Method: Conventional biochemicals, serological typing
Turnaround Time: 4-7 days	Reference Range: No Salmonella isolated.
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection: Stool, blood	Sample Type:
Volume/Amount Required: > 10 grams stool, 20 mL whole blood	Preferred Specimen: Stool in enteric transport; Blood;
Collection/Preservation: Collect stool and place in enteric transport such as Cary-Blair, Aimes, or Stuart’s transport.	Storage Instructions: 2-8° C
Causes for Rejection: Unpreserved stools > 48 hours	Sample Container: Enteric transport container
Sample Test Kit:	Availability: Monday-Friday Outbreak situations prior arrangements- Saturday-Sunday.
Diagnostic Information: Fecal specimens are accepted only from public health officials. For food analysis see Food Poisoning (Culture - Isolation) For Fecal Specimens see Aerobic Bacterial Culture, Stool (Isolation) For Molecular analysis Molecular typing (PFGE).
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature: 2-8° C	Shipping Requirements: Triple contained, overnight on ice.
Billing
CPT Code: 87045	Fees:

Microbiology
Salmonellosis Culture–(Identification)
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Test Includes: Conventional biochemicals, serological typing
Reporting
Results Available: 4-7 days	Contact #s: (512) 458-7582
Reference
Method: Conventional biochemicals, serological typing
Turnaround Time: 4-7 days	Reference Range: No Salmonella isolated.
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type: Pure culture
Volume/Amount Required: One specimen per patient	Preferred Specimen: Pure culture
Collection/Preservation:	Storage Instructions: Ambient temperature
Causes for Rejection: Name on tube/form do not match	Sample Container:
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: For Food analysis see Food (Culture –(Identification) For Clinical isolates see Aerobic Bacterial Culture, (Identification) For Molecular analysis, see Molecular typing (PFGE).
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
Salmonellosis Culture –(Typing)
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Test Includes: serological typing
Reporting
Results Available: 7-14 days	Contact #s: (512) 458-7185
Reference
Method: Slide and tube agglutination
Turnaround Time: 7-14 days	Reference Range: By report
Limitations: Organism must be viable to perform serotyping	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type: Pure culture
Volume/Amount Required: one specimen per patient	Preferred Specimen: Pure culture on agar slant
Collection/Preservation:	Storage Instructions: Ambient temperature
Causes for Rejection:	Sample Container: Agar slant in screw cap tube
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Serotying is performed on all isolates and all referred cultures submitted for identification. Complete serotyping includes both somatic and flagellar antigens. PFGE molecular studies for strain relatedness is performed at TDSHS. For Molecular analysis see Molecular typing (PFGE).
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
Shistosomiasis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes:
Reporting
Results Available: 3 weeks	Contact #s:
Reference
Method:
Turnaround Time: 3 weeks	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: Serum
Volume/Amount Required: 10 mL whole blood	Preferred Specimen: Single Serum
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: Serological testing at the CDC is available if urine and stool specimens have been examined and are Nonreactive and if this remains a possibility. Prior notification is requested (512) 458-7760. A detailed patient history is required.
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: 86849	Fees:

Microbiology
Schistosomiasis (Microscopic – Direct Concentration)
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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: Negative report indicates that there were no visible parasites in the specimen submitted.
Specimen Requirements
Specimen Collection: Feces, Urine	Sample Type: Feces, Urine
Volume/Amount Required: 15 mL liquid stool, 15 g stool; Urine- 15 mL	Preferred Specimen: Feces in formalin– Schistosoma mansoni, Schistosoma japonicum; Urine, unpreserved or in formalin – Schistosoma haematobium
Collection/Preservation: Collect stool in clean, dry container. Transfer to formalin preservative. Collect urine in clean, dry, leak-proof container.	Storage Instructions: Ambient temperature
Causes for Rejection:	Sample Container: Formalin transport for parasites
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Eggs can not be detected in the stool until the worms are mature (may take 4 to 7 weeks from initial infection). In very light or chronic infections, eggs may be very difficult to detect in stool; therefore, multiple stool examinations may be required.
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 diagnostic specimens.
Billing
CPT Code: 87015	Fees:

Microbiology
Schistosomiasis (Microscopic – Urine Filtration)
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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: Negative report indicates that there were no visible parasites in the specimen submitted
Specimen Requirements
Specimen Collection: Urine	Sample Type: Urine
Volume/Amount Required: 15 mL	Preferred Specimen: Urine
Collection/Preservation: Collect urine in a sterile leak-proof container. Transport at ambient temperature. Urine can be transported unpreserved or in formalin.	Storage Instructions: ambient temperature
Causes for Rejection:	Sample Container: Clean, dry, leakproof container.
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: S. haematobian infections are usually detected in the urine, although in heavy infections they may also be found in the stools.Occasionally eggs of S. mansoni are detected in the urine.
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 diagnostic specimens.
Billing
CPT Code: 87015	Fees:

Microbiology
Shigellosis Culture (Isolation)
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Test Includes: Conventional biochemicals, serological typing
Reporting
Results Available: 3-10 days	Contact #s: (512) 458-7582
Reference
Method: Conventional biochemicals, serological typing.
Turnaround Time: 3-10 days	Reference Range: No enteric pathogens isolated
Limitations: Stools should be collected prior to initiation of antibiotic therapy.	Interpretation: Negative report indicates that there were no viable enteric pathogens in the specimen submitted.
Specimen Requirements
Specimen Collection: feces, rectal swab	Sample Type: feces, rectal swab
Volume/Amount Required: 10 mL liquid stool, or 10 g stool	Preferred Specimen: >10 g feces in enteric transport such as Cary-Blair, Aimes, or Stuart’s transport; rectal swab in enteric transport
Collection/Preservation: Collect stool in clean, dry container. Transfer at least 10 grams into the enteric transport medium. Hold at 2-8° C and transport overnight.	Storage Instructions: 2-8° C
Causes for Rejection:	Sample Container: Enteric transport, or clean, leak-proof container.
Sample Test Kit:	Availability: Monday-Friday Outbreak investigations with prior notification: Saturday-Sunday.
Diagnostic Information: Fecal specimens are accepted only from public health officials. All Shigella species isolated are serotyped. See Shigellosis Culture (Typing) See Food Poisoning (Culture - Isolation) For Molecular analysis Molecular typing (PFGE).
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature: 2-8° C	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87045	Fees:

Microbiology
Shigellosis Culture (Identification)
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Test Includes: Conventional Biochemicals, Serological typing.
Reporting
Results Available: 3-10 days	Contact #s: (512) 458-7185
Reference
Method: Conventional biochemicals, slide agglutination,
Turnaround Time: 5-7 days	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type: Pure culture
Volume/Amount Required: One specimen per patient.	Preferred Specimen: Pure culture
Collection/Preservation:	Storage Instructions: Ambient temperature
Causes for Rejection:	Sample Container: Agar slant in screw cap tube
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Food specimens accepted from public health officials, or from physicians as specified in instructions, see Food (Culture –(Identification) For Molecular analysis Molecular typing (PFGE).
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
Shigellosis Culture (Typing)
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Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: 7-10 days	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Pure cultures, safely contained
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Serotying is performed on all Shigella species submitted for identification. PFGE for strain relatedness done at TDSHS. Contact Lab for submission instructions. Molecular analysis at TDSHS upon request. For Molecular analysis Molecular typing (PFGE).
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature: Ambient (Room) temperature	Shipping Requirements:
Billing
CPT Code: 87147	Fees:

Microbiology
Sporotrichosis (Culture – Isolation)
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Test Includes: Isolation of fungus and identification by morphological and physiological tests
Reporting
Results Available: 14-21 days	Contact #s: 512-458-7455 for prior approval Technical questions: 512-458-7586
Reference
Method: Slide culture; conversion at 37º C
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: Exudate; Tissue; Sputum; Aspirate
Collection/Preservation: No preservative	Storage Instructions: Transport specimen as soon as possible. If transport is delayed over one hour, refrigerate specimen.
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.	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 for transport.
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: 87102	Fees:

Microbiology
Sporotrichosis (Culture – Identification)
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Test Includes: Identification of fungus to species level by morphological and physiological tests
Reporting
Results Available: 14-21 days	Contact #s: 512-458-7586
Reference
Method: Slide culture; conversion at 37º C
Turnaround Time: 14-21 days	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Pure Culture
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	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
Sporotrichosis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes:
Reporting
Results Available: 3 weeks	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: Single Serum
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. A titer of 1:16 provides presumptive evidence of infection.
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: 86671	Fees:

Microbiology
St. Louis Encephalitis (Serological – Enzyme Immunoassay (IgM capture and IgG)
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Reporting
Results Available: 1-3 days	Contact #s:
Reference
Method: EIA
Turnaround Time: 1-3 days	Reference Range: <2.00 (Nonreactive)
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. May cross react with other arthropod borne viruses.	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: Red top or tiger top tube	Storage Instructions: 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: Test performed daily
Diagnostic Information: IgG titers of >1:16 are suggestive of exposure, while the presence of IgM indicates recent infection. Human infections are seasonal, from mid- to late-summer, occurring throughout the southern, southwestern and west central states. Serological cross-reactions with Yellow Fever and Dengue Fever disease and immunization. While a single serum may be tested, a second specimen collected 7-14 days later may be required for best evidence of recent infection.
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: 86653	Fees:

Microbiology
Staphylococcus (Culture – Identification )
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Test Includes: Conventional biochemicals, API Staph
Reporting
Results Available: 5-7 days	Contact #s: (512) 458-7582
Reference
Method: Conventional biochemicals, API Staph
Turnaround Time: 5-7 days	Reference Range: By report
Limitations:	Interpretation: By report
Specimen Requirements
Specimen Collection:	Sample Type: Pure culture
Volume/Amount Required: one specimen per patient.	Preferred Specimen: Pure culture on agar slant
Collection/Preservation: ambient temperature	Storage Instructions: ambient temperature
Causes for Rejection: Name on tube/form do not match; Broken in transport	Sample Container: Agar slant in screw cap tube
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Phage typing is no longer performed and has been replaced by molecular analysis. PFGE for strain relatedness is performed at TDSHS. For Molecular analysis see Molecular typing (PFGE) Referred clinical isolates for identification: See Aerobic Bacterial Culture, (Identification), Food (Culture –(Identification).
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle as an infectious agent
Transport Temperature: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.
Billing
CPT Code: 87077	Fees:

Microbiology
Staphylococcus (Culture – TSST-1 testing)
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Test Includes: TSST-1 toxin assay
Reporting
Results Available: 1-2 days	Contact #s: (512) 458-7582
Reference
Method: Reverse passive latex agglutination
Turnaround Time: 1-2 days	Reference Range: No TSST-1 toxin demonstrated
Limitations:	Interpretation: Negative report indicates that there was no detectable TSST-1 toxin in the specimen submitted. This test does not detect any other types of toxins that might be present in the specimen.
Specimen Requirements
Specimen Collection:	Sample Type: Pure culture
Volume/Amount Required: one specimen per patient.	Preferred Specimen: Pure culture on agar slant
Collection/Preservation:	Storage Instructions: ambient temperature
Causes for Rejection: Name on tube/form do not match, Broken in transport.	Sample Container: Agar slant in screw cap tube
Sample Test Kit:	Availability: Monday- Friday
Diagnostic Information: Contact Laboratory for submission instructions a (512) 458-7582 Referred clinical isolates for identification: See Aerobic Bacterial Culture, (Identification).
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Infectious agent
Transport Temperature: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.
Billing
CPT Code: 87999	Fees:

Microbiology
Staphylococcus Culture (Isolation)
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Test Includes: Conventional biochemicals, API Staph
Reporting
Results Available: 3-7 days	Contact #s: (512) 458-7582
Reference
Method: conventional biochemicals, API Staph
Turnaround Time: 3-7 days	Reference Range: None isolated
Limitations: Organism must be viable for culture studies. Specimen must be collected prior to initiation of antimicrobial studies.	Interpretation: No Staphlylococcus aureus isolated indicates that there were no viable organisms in the specimen.
Specimen Requirements
Specimen Collection: stool, wound	Sample Type: stool, wound
Volume/Amount Required: 10 g stool or 10 mL liquid stool;	Preferred Specimen: Stool in aimes or stuart’s transport; wound swab in aimes or stuart’s transport.
Collection/Preservation: Collect stool in clean, dry container. Transfer to aimes or stuart’s transport. Remove Store at 2-8° C.	Storage Instructions: 2-8° C.
Causes for Rejection:	Sample Container: Transport tube
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Food samples are tested for Staphylococcal enterotoxin when requested. See Food Poisoning Culture (Toxin Detection) Culture studies are performed only requested. Food Poisoning (Culture - Isolation).
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature: 2-8 °C	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87077	Fees:

Microbiology
Staphylococcus (Culture – Enterotoxin testing)
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Test Includes: Enterotoxin testing
Reporting
Results Available: 2-4 days	Contact #s: (512) 458-7562
Reference
Method: Mini-Vidas
Turnaround Time: 2-4 days	Reference Range: Toxin not detected
Limitations: This test is approved for food testing only. Human specimens cannot be reported using this technology.	Interpretation: The test used detects Staphylococcus aureus enterotoxin A,B,C,D,E,
Specimen Requirements
Specimen Collection: food	Sample Type: Food
Volume/Amount Required: 25 grams	Preferred Specimen: Food
Collection/Preservation: Food must be collected by a sanitarian or health official.	Storage Instructions: 2-8° C
Causes for Rejection: Insufficient food for testing	Sample Container: Clean, dry leak-proof container.
Sample Test Kit:	Availability: Monday-Friday Outbreak Investigations with prior notification: Saturday-Sunday.
Diagnostic Information: Contact Laboratory for submission instructions. Food specimens accepted from public health officials, or from physicians as specified in instructions for Food Poisoning, see Food (Pathogens –(Isolation).
Specimen Submission
Required Request Form: G-2B	Specimen Handling: In accordance with FDA guidelines for food testing.
Transport Temperature: 2-8° C	Shipping Requirements: Leak-proof container
Billing
CPT Code: 87999	Fees:

Microbiology
Streptococcus, Group A (emm typing)
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Test Includes: Test not performed at TDSHS. Submitted to CDC with prior approval.
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: Dependent on CDC report	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type: Pure culture
Volume/Amount Required: one specimen per patient	Preferred Specimen: Pure culture
Collection/Preservation:	Storage Instructions: Ambient Temperature
Causes for Rejection: Specimens must have prior approval for submission to the CDC. Specimens not approved will be rejected for testing.	Sample Container: Agar slant in screw cap tube
Sample Test Kit:	Availability: Monday - Thursday
Diagnostic Information: Strains from sterile sites resulting in systemic cases and associated with a fatality are sent to the CDC for emm typing. Prior approval from the CDC is required before isolate can be shipped to the CDC. Molecular typing such as PFGE is of little value in determining relatedness of strains and should not be utilized to determine outbreak relatedness.
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Infectious Agent
Transport Temperature: Ambient (Room) temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.
Billing
CPT Code: 87430	Fees:

Microbiology
Strongyloidiasis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes:
Reporting
Results Available: 3 weeks	Contact #s:
Reference
Method:
Turnaround Time: 3 weeks	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: Serum
Volume/Amount Required: 10 mL whole blood	Preferred Specimen: Single Serum
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: Strongyloides stercoralis is a parasitic nematode found in tropical and subtropical regions. Antibody titer decrease in many patients following treatment. Significant cross-reactivity may be observed with filarial and other nematode infections. Prior notification is requested (512) 458-7760. A detailed patient history is required. Serum specimens are sent to the CDC. Referred material accepted from hospital, private, and reference labs.
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: 86849	Fees:

Microbiology
Strongyloidiasis (Microscopic – Direct)
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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 seen
Limitations:	Interpretation: Negative report indicates that there were no visible parasites in the specimen submitted.
Specimen Requirements
Specimen Collection: Feces, sputum	Sample Type: Feces, sputum
Volume/Amount Required: 15 mL liquid stool, 15 g stool, 10-15 mL sputum	Preferred Specimen: Feces in formalin; Sputum
Collection/Preservation: Collect stool in clean, dry container. Transfer immediately to formalin preservative. Collect sputum in clean, dry container. Hold at ambient temperature.	Storage Instructions: ambient temperature; do not refrigerate or freeze.
Causes for Rejection: Unpreserved stool > 5 hours	Sample Container:
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Fecal specimens must be sent in fresh (less that five hours) or in formalin. Sputum specimens can also be sent. 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
Swimming Pool Water
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Test Includes: Coliform testing with prior approval under certain circumstances.
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: Coliform testing is provided under special circumstances only with prior arrangement.
Specimen Submission
Required Request Form: G-79	Specimen Handling:
Transport Temperature:	Shipping Requirements:
Billing
CPT Code:	Fees:

Microbiology
Syphilis (Serological – Rapid Plasma Reagin Card)
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Reporting
Results Available: 1-2 Days	Contact #s:
Reference
Method: RPR Card Test (agglutination)
Turnaround Time: 1-2 days	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: 5 mL serum	Preferred Specimen: Single Serum
Collection/Preservation: Red top or tiger top tube	Storage Instructions: 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, gross hemolysis	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability: Test performed daily
Diagnostic Information: The rapid plasma reagin (RPR) card test is a macroscopic, non-treponemal flocculation test for the qualitative and semi-qualitative serological detection of syphilis. Nontreponemal tests for syphilis become reactive 4-6 weeks after infection with titers peaking during secondary to early latent stage. Treatment in the primary or secondary stages usually results in a rapid decline in titer. Treatment given in latent or late stages has less effect on antibody titers and the test may remain reactive at low titers indefinitely. The reagin-type antibody binds with the antigen that is composed of a complex of cardiolipin, lecithin and cholesterol particles with activated charcoal; the result of this antigen-antibody reaction is a macroscopic flocculation that shows up as black clumps against the white card. The RPR-Card test is a screening test and without some other evidence for the diagnosis of syphilis, a reactive non-treponemal test does not confirm Treponema pallidum infection. The RPR-Card test does not distinguish between syphilis and other treponematoses such as yaws, pinta and bejel. The semi-qualitative RPR-Card Test may be used as a method to follow response to treatment. A four-fold or greater drop in titer between pre- and post-treatment specimens is indicative of response to therapy. Test is performed daily.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Separated serum or SST tube at 2-8°C (refrigerated) or serum -20°C (frozen).	Shipping Requirements: Triple contain. Separated serum, or SST Tubes within 5 days may be shipped overnight on cold packs (2-8°C), or > 5 days, ship serum frozen (-20°C) and mail on dry ice
Billing
CPT Code: 86592	Fees:

Microbiology
Syphilis [Serological – Treponema pallidum - Particle Agglutination (TP-PA)]
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Test Includes:
Reporting
Results Available: 3-4 days	Contact #s:
Reference
Method: Agglutination
Turnaround Time: 3-4 days	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: 5 mL Serum	Preferred Specimen: Single Serum
Collection/Preservation: Red top or tiger top tube	Storage Instructions: 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, gross hemolysis	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability: Test performed three times per week
Diagnostic Information: The Serodia TP-PA is a qualitative gelatin particle agglutination assay for the detection of Treponemal pallidum antibodies in human serum. The test is based on the agglutination of colored gelatin particles sensitized with T. pallidum antigen. Serum containing specific antibodies will react with the antigen sensitized gelatin particles to form a smooth mat of agglutinated particles. A compact button formed by the settling of non-agglutinated particles characterizes negative reactions. Unlike the nontreponemal tests, once the TP-PA test becomes reactive, it remains reactive for many years. Since the reactivity found with the TP-PA does not indicate response to therapy, it is not suitable for monitoring treatment. The TP-PA test does not distinguish between syphilis and other treponematoses such as yaws, pinta and bejel. TP-PA is run only if the RPR Card test results performed at TDSHS are reactive. Otherwise, justification is required for performing TP-PA test. The test is run three times per week.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Separated serum or SST tubes at 2-8°C (refrigerated) or serum -20°C (frozen). -20°C (frozen).	Shipping Requirements: Triple contain. Separated serum, or SST Tubes within 5 days may be shipped overnight on cold packs (2-8°C), or > 5 days, ship serum frozen (-20°C) and mail on dry ice
Billing
CPT Code: 86781	Fees:

Microbiology
Syphilis [Serological – Fluorescent Treponemal Antibody Absorbed (FTA-ABS)]
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Test Includes:
Reporting
Results Available: 5-6 days	Contact #s:
Reference
Method: IFA
Turnaround Time: 5-6 days	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: 5 mL serum	Preferred Specimen: Single Serum
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, gross hemolysis	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability: Test performed twice per week
Diagnostic Information: The FTA-ABS is a specific treponemal assay to detect antibody to T. pallidum. The FTA-ABS becomes reactive 4-6 weeks after infection. Unlike the nontreponemal tests, once the FTA-ABS test becomes reactive, it remains reactive for many years. Since the reactivity found with the FTA-ABS does not indicate response to therapy, it is not suitable for monitoring treatment. The FTA-ABS test does not distinguish between syphilis and other treponematoses such as yaws, pinta and bejel. FTA-ABS is for in-house use only or with justification. The test is run twice per week.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: Separated serum or SST tubes at 2-8°C (refrigerated) or serum -20°C (frozen).	Shipping Requirements: Triple contain. Separated serum, or SST Tubes within 5 days may be shipped overnight on cold packs (2-8°C), or > 5 days, ship serum frozen (-20°C) and mail on dry ice
Billing
CPT Code: 86781	Fees:

Microbiology
Syphilis (Serological – Venereal Disease Research Laboratory)
Names of Related Agents: Neurosyphilis
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Test Includes: Slide agglutination
Reporting
Results Available: 3-5 days	Contact #s: 512-458-7578
Reference
Method: Agglutination
Turnaround Time: 3-5 days	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: Spinal Tap	Sample Type: CSF
Volume/Amount Required: 1 mL CSF minimum	Preferred Specimen: Spinal Fluid
Collection/Preservation: Sterile collection tube	Storage Instructions: CSF may be transported at 2-8°C (ice packs) if the specimen will arrive at the laboratory within 5 days. If not, freeze CSF immediately, store at -20°C .
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of CSF for testing	Sample Container: Sterile collection tube
Sample Test Kit:	Availability: Test performed twice per week
Diagnostic Information: The VDRL is a non-treponemal test to detect lipoidal antigen to T. pallidum. VDRL is run on spinal fluid specimens only, for suspected neurosyphilis. A reactive VDRL test on CSF, free of blood or other contaminants, almost always indicates past or present syphilis infection of the central nervous system. The test is run twice per week.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: 2-8° for 5 days, or -20°C (frozen).	Shipping Requirements: Triple contained, on ice packs at 2-8 °C for five days, or frozen (-20°C) and mailed overnight on dry ice.
Billing
CPT Code: 86592	Fees: $20.00

Microbiology Laboratory Tests: S