Microbiology Laboratory Tests: S

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
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 (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
Strep Screen (Group B only)
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Test Includes: Group B Strep Isolation, Identification

Reporting

Results Available: 4-10 days

Contact #s: (512) 776-7657

Reference

Method: Bacterial culture, routine isolation and identification

 

Turnaround Time: 4-10 days

Reference Range:No group B streptococci isolated.

Limitations: Specimen should be taken prior to antimicrobial therapy. Organisms must be viable for culture studies.

Interpretation: Negative results indicate that the patient does not have detectable amounts group B streptococci.

Specimen Requirements

Specimen Collection: Prepartum patients: Collect specimen at 35-37 weeks gestation. The optimum specimen for this test is a vaginal/rectal swab. Results may be compromised if only a vaginal swab is submitted. A single swab or two separate swabs may be used. Non Pregnant patients: Collect specimen with swab.

Sample Type: Prepartum patients: Vaginal/rectal swab

Other patients: Swab

Volume/Amount Required: One (1) swab

Preferred Specimen:  Pure culture

Collection/Preservation: Amies or Stuart’s media

Note: if two separate swabs are used, submit both in same transport tube.

Storage Instructions: Store at 4°C to 25°C

Causes for Rejection: Swabs > 4 days old, Swabs not on transport media, Expired transport device, received frozen, viral transport device, DNA probe transport device, Urine specimen or swab.

Sample Container: Aimes or Stuart’s transport media

Sample Test Kit: NA

Availability: Tested Monday – Friday

Diagnostic Information:

Specimen Submission

Required Request Form: G-2B

Specimen Handling: Body fluid handled with universal precautions.

Transport Temperature: Ambient temperature (4°-25°C)

Shipping Requirements: In accordance with federal shipping regulations for diagnostic specimens

Billing

CPT Code: 87077

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
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, G-THSTEPS for THSteps Medicaid 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 – 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