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    Laboratory Services Section
    MC 1947
    PO Box 149347 Austin, TX 78714-9347
    1100 W. 49th Street
    Austin, TX 78756-3199

    Phone: (512) 776-7318
    Fax: (512) 776-7294

    Phone Us Toll Free at:
    (888) 963-7111, ext. 7318

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Microbiology Laboratory Tests: Acanthamoeba to Amebiasis Entamoeba histolytica

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Test Includes:

Reporting

Results Available: Contact #s: 512-458-7560

Reference

Method:
Turnaround Time:  Culture 10 days or until positive Reference Range:
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Eye Wash; Cornial Biopsy; Contact Lens/Fluid
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  Eye washing and/or eye scraping will be examined as a direct wet smear and also set up for culture. A trichrome stained slide may be made to confirm positive specimens.

Specimen Submission

Required Request Form: G-2B Specimen Handling:
Transport Temperature:  Ambient (Room) temperature Shipping Requirements:

Billing

CPT Code: 87081 Fees:


Microbiology
Acanthamoeba (Microscopic-Direct Exam; Trichrome Stained Slide)
< Return to Table of Contents 
Test Includes:

Reporting

Results Available: Contact #s: 512-458-7560

Reference

Method:  
Turnaround Time:  Direct exam 24 hours Reference Range:
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Eye Wash; Cornial Biopsy; Contact Lens/Fluid
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  Eye washing and/or eye scraping will be examined as a direct wet smear and also set up for culture. A trichrome stained slide may be made to confirm positive specimens.

Specimen Submission

Required Request Form: G-2B Specimen Handling:
Transport Temperature:  Ambient (Room) temperature Shipping Requirements:

Billing

CPT Code: 87209 Fees:


Microbiology
Acquired Immune Deficiency Syndrome

Related Agents: AIDS, HIV-1, HIV-2
< Return to Table of Contents 
Test Includes:  Enzyme Assay Screen for HIV-1, automatic reflex to the Western blot Confirmatory Assay if EIA is reactive

Reporting

Results Available: 2 days from receipt at lab Contact #s: 512-458-7657

Reference

Method: Enzyme Assay / Western Blot
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: Whole blood, serum, plasma
Volume/Amount Required: 2 mL serum Preferred Specimen:  Serum
Collection/Preservation:Collect blood by venipuncture, specimen held at Ambient (Room) temperature. Specimen may be submitted on the blood clot or the serum may be separated and placed in a sterile screw cap tube for shipment. 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 or tiger top vacutainer tube
Sample Test Kit: Availability: Test run Monday - Friday
Diagnostic Information:  Test for infections by opportunistic organisms are offered.  See specific diseases.  For antibody detection see under HIV-1.

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: 86701, 86689 Fees: $8.00 screen, $31.00 confirmation


Microbiology
Actinomycosis (Aerobic Culture - Isolation)
Names of Related Agents:  Nocardia species, Actinomadura species, etc
< Return to Table of Contents 
Test Includes:Isolation of actinomycete and identification by biochemical and physiological tests

Reporting

Results Available: 30-50 days Contact #s:
512-458-7455 for prior approval
Technical questions:  512-458-7586 

Reference

Method: Biochemical and physiological tests  
Turnaround Time:  30 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, Spinal Fluid
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 during 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: 87106 Fees:


Microbiology
Actinomycosis (Aerobic Culture - Identification)
Names of Related Agents:  Nocardia species, Actinomadura species, etc
< Return to Table of Contents 
Test Includes: Various biochemical and physiological tests for identification to species level

Reporting

Results Available: 21-28 days Contact #s: 512-458-7586

Reference

Method: Biochemical testing  
Turnaround Time:  21-28 days Reference Range:  By report
Limitations: Some genera and species can only be differentiated with molecular analysis that is not available at TDSHS. Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Pure Culture
Collection/Preservation: No preservatives Storage Instructions:
Causes for Rejection: Sample Container: Triple-contained
Sample Test Kit: Availability: Tested 5 days/week: Monday - Friday
Diagnostic Information:   Aerobic culture submitted to this Laboratory for definitive identification. Drug susceptibility testing on these organisms not available at TDSHS laboratory.  Isolates may be forwarded by TDSHS laboratory to reference laboratory for susceptibility testing.  A handling fee may be charged.  Testing at other reference laboratories is subject to fees charge by those laboratories.

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
Adenovirus (Culture-Isolation)
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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 virus isolated
Limitations: Interpretation:  A result of "No virus isolated" does not necessarily mean absence of a viral agent. The success of virus isolation depends a great deal on the submission of the proper specimen, collected at the right time, adequately maintained, and shipped with the least possible delay.

Specimen Requirements

Specimen Collection:  Specimens should be collected at an appropriate anatomic site and at the proper time after infection because infectious agents are generally shed for only a short period of time. Refer to the  Specimen Collection by Type table for additional instructions. Sample Type: See preferred specimen
Volume/Amount Required: Swabs in 2-4 mLs of viral transport media, 10-20 mLs of urine, or 2-4 grams of stool. Preferred Specimen:  Throat Swab; NP Swab:  Conjunctival Swab; Urine; Stool
Collection/Preservation: Storage Instructions: Arriving < 48 hours after collection, store and send at 2-8° C. Arriving > 48 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:  A variety of cell monolayers which support the growth of adenoviruses are inoculated and observed for 10 days.  If characteristic CPE is observed, confirmation of identification will be performed.

Specimen Submission

Required Request Form: G-2V Specimen Handling: Universal precautions
Transport Temperature:  Arriving less than 348 hours: send at 2-8°C, Arriving greater than 48 hours: send on dry ice Shipping Requirements: Ship specimens in compliance with governmental regulations.

Billing

CPT Code: 87253 Fees:


Microbiology
Adenovirus (Culture-Identification)
< 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 mL. 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:  Identification is based on immunofluorescence test using adeno-specific monoclonal antibody.

Specimen Submission

Required Request Form: G-2V Specimen Handling:
Transport Temperature:  Frozen isolate: on dry ice Shipping Requirements: Ship specimens in compliance with governmental regulations.

Billing

CPT Code: 87252 Fees:



Microbiology
Aerobic Bacterial Culture (Isolation)
< Return to Table of Contents 
Test Includes: Conventional biochemical methods.

Reporting

Results Available:7-21 days Contact #s: (512) 458-7582

Reference

Method: Conventional biochemical methods.  
Turnaround Time:  7-21 days dependent on organism(s) isolated. Reference Range:  None isolated
Limitations: Quality of specimen collection will affect the ability to isolate pathogenic organisms from clinical specimens. Interpretation: Interpretation of test results is dependent on the organism isolated and the clinical history of the patient.

Specimen Requirements

Specimen Collection: 
Intestinal specimens:
Should be obtained early in course of illness. Freshly passed stools are better than rectal swabs.

Blood: Should be collected by venipuncture in a tiger top or red top vacutainer

Sample Type: Blood; Body fluids; Bone marrow; CSF; Stool; Sputum; Throat swab; Tissue; Wound exudates
Volume/Amount Required: CSF 1-2 mL, Stool- 25 grams, Rectal swabs -visible fecal material on swab, blood -2-5 mL; tissue -small piece; bone marrow- small amount; Preferred Specimen:  Blood, Body fluids, Bone marrow, CSF, Stool, sputum, throat swab, tissue, wound exudates
Collection/Preservation: Collect blood by venipuncture, specimen held at ambient temperature. Storage Instructions: Do not freeze or refrigerate whole blood. Keep stools, tissue, body fluids, bone marrow, wound exudates, and sputum at 2-8°C.
Causes for Rejection: Insufficient amount of sample to test due to leakage or other circumstances; no identifying marks on sample and/or paperwork; name discrepancies, expired transport media. Sample Container: 
Stool -
sterile feces container

Rectal swab - Aimes, Stuart’s or Cary-Blair transport tube

Blood: Tiger top or red top vacutainer

Body fluids: Sterile collection tube

Sample Test Kit: Availability: Tested Monday - Friday
Diagnostic Information:  Please indicate suspected organism(s) when submitting specimen.  Culture includes the isolation and identification of the predominant organism or pathogen(s).   Specimens should be collected in the acute phase of infection.  Transport to the laboratory as soon as possible, usually within 48 hours.    Sterile body fluids such as CSF and blood do not require any transport medium and should not be diluted

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handle as body fluid taking universal precautions.
Transport Temperature:  2-8°C (refrigerated), <24 hours unless in transport medium. Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Codes: 87081 (screening), 87040, 87045, 87046, 87070, 87071, 87073 87077, 87143, 87147, 87181, 87205, 87206, 87210, 87278, 87430, 87449 Fees:


Microbiology
Aerobic Bacterial Culture, Stool (Isolation)
< Return to Table of Contents 
Test Includes: Conventional biochemicals, EHEC Toxin test, PCR

Reporting

Results Available: 3-7 days Contact #s: (512) 458-7582

Reference

Method: Conventional biochemical studies, EHEC Toxin test, PCR for virulence factors.  
Turnaround Time:  3-7 days depedent on organism(s) isolated. Reference Range:  Negative for enteric pathogens.
Limitations: Stools must be collected before antibiotic treatment is initiated for greatest chance of isolation of pathogens. Stool specimens must be in enteric preservative or shipped immediately overnight on ice packs. Preservatives used for parasite examinations are not acceptable for bacteriological examinations. Interpretation: Salmonella species, Shigella species, E. coli O157:H7, Shiga toxin producing E. coli; Campylobacter species, Vibrio species, Yersinia enterocolitica, Aeromonas species should be considered significant findings. Significance of other enteric organisms should be determined based on clinical information.

Specimen Requirements

Specimen Collection: Collection of fresh stool. Sample Type: Stool; rectal swabs.
Volume/Amount Required: >10mL for liquid stools; > 20 g solid or semi-solid stools. Preferred Specimen:  Stool in enteric transport media or on ice packs.
Collection/Preservation: Collect in appropriate container to avoid leakage and keep between 2-8°C. If not transported to the laboratory within 24 hours of collection, transfer specimen to an enteric transport media before transporting to the laboratory. Storage Instructions: Keep stools between 2-8°C.
Causes for Rejection: Submitted for culture studies: Unpreserved specimens not received on ice packs or 
> 24 hours old. Received in transport media not recommended for bacterial isolation or expired transport media.
Submitted for toxin studies: Specimen > 7 days old unless frozen at -70°C.
Sample Container: Sealable container that will avoid leakage; Transport media containers such as Cary-Blair, Aimes, or Stuart’s transport.
Sample Test Kit: Availability: Routinely Tested Monday – Friday.
Outbreak investigations may include testing outside these routine test dates.
Diagnostic Information:  Stool culture for isolation of Salmonella, Shigella, Campylobacter, Yersinia, Enterotoxigenic E. coli, E. coli O157:H7; Vibrio is performed by TDSHS in outbreak situations through TDSHS IDEAS department only.  Toxin Testing for Shiga toxin E. coli is available upon request.  See Escherichia coli 0157:H7 or other Shiga toxin E. coli (Toxin Testing). Please indicate suspected organism(s) when submitting specimen.  Culture includes the isolation and identification.  Specimens should be collected in the acute phase of infection.  Transport to the laboratory as soon as possible, usually within 48 hours.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Body fluids must be handled using universal precautions. Specimens should be collected in the acute phase of infection. Transport to the laboratory as soon as possible, within 24 hours unless in transport media.
Transport Temperature: 2-8° C, 24 hours Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87081 (screening), 87040, 87045, 87046, 87070, 87071, 87073 87077, 87143, 87147, 87181, 87205, 87206, 87210, 87278, 87430, 87449 Fees:


Microbiology
Aerobic Bacterial Culture, (Identification)
< Return to Table of Contents 
Test Includes: Conventional biochemicals for identification.

Reporting

Results Available: 4-21 days Contact #s: (512) 458-7582

Reference

Method: Conventional biochemicals  
Turnaround Time:  4-21 days dependent on organism(s) Reference Range:  By report
Limitations: Specimens must be collected before antibiotic treatment is initiated for greatest chance of isolation of pathogens. Routine susceptibilities are not performed at TDSHS. The only antimicrobial susceptibilities offered are: confirmation of vancomycin resistant Enterococcus and Staphylococcus species and limited testing on Neisseria gonorrhoeae. These test results are for epidemiological purposes only and cannot be used for patient care. Interpretation: By report dependent on organism identified.

Specimen Requirements

Specimen Collection: Dependent upon type of specimen to be tested. Sample Type: Pure culture
Volume/Amount Required: One slant, broth, deep, or plate. Preferred Specimen:  Pure Culture
Collection/Preservation: May be kept at ambient temperature. Storage Instructions: Store at temperature and atmospheric conditions that are suitable for growth dependent on organism.
Causes for Rejection: Insufficient amount of sample to test; no identifying markers on sample and/or paperwork. Sample Container: Agar slant, handled as infectious agent.
Sample Test Kit: Availability: Tested Monday - Friday
Diagnostic Information:  Gram-negative rods, Gram-positive cocci, Gram-positive rods. Identification of the organism includes serological studies if the organism is one of the following microbes: See Salmonellosis Culture –(Typing), see Shigellosis Culture (Typing), see Meningitis, Meningococcal Culture (Grouping) and see Escherichia coli 0157:H7 or other Shiga toxin E. coli Culture (Typing). Serological typing or grouping of additional microbes can be arranged with the CDC in the event of community or nosocomial outbreaks. Routine susceptibilities are not performed at TDSHS.  The only antimicrobial susceptibilities offered are: confirmation of vancomycin resistant Enterococcus and Staphylococcus species and limited testing on Neisseria gonorrhoeae. These test results are for epidemiological purposes only.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handled as infectious agent using universal precautions.
Transport Temperature:  Ambient (Room) temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87081 (screening), 87040, 87045, 87046, 87070, 87071, 87073 87077, 87143, 87147, 87181, 87205, 87206, 87210, 87278, 87430, 87449 Fees:


Microbiology
Amebiasis (Entamoebia historlytica/Entamoeba disbar (Culture -Isolation)
< Return to Table of Contents 
Test Includes: Culture

Reporting

Results Available: 10 days or when positive results is determined. Contact #s: (512) 458-7560

Reference

Method:  
Turnaround Time:  Cultured for up to 10 days Reference Range: No parasites found
Limitations: Parasite must be viable for culture isolation Interpretation: Negative test results indicates there are no detectable parasites in specimen.

Specimen Requirements

Specimen Collection: Stools should be collected and be < 5 hours old. Liver and organ aspirates should be aseptically collected. Sample Type: Feces (fresh, less than five hours), liver or other organ aspirates
Volume/Amount Required: Stool >20 g solid or > 10mL liquid.  Aspirates 1-2 mL. Preferred Specimen:  Feces < 5 hrs, preservative; Liver or organ aspirates
Collection/Preservation: Ambient temperature Storage Instructions: Ambient temperature
Causes for Rejection: Incorrect demographic information; Specimen too old. Sample Container: Sterile leakproof container or transport for parasites.
Sample Test Kit: n/a Availability: Test performed Monday-Friday
Diagnostic Information:  Fecal specimens must be sent in as a fresh unpreserved specimen. PVA and formalin preserved specimens cannot be used for culture. Referred material accepted from hospital, private, and reference laboratories.

Specimen Submission

Required Request Form: G-2B Specimen Handling: 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: 87081 Fees:


Microbiology
Amebiasis Entamoeba histolytical/Entamoeba disbar Staining (Identification)
< Return to Table of Contents 
Test Includes: Concentration and trichrome staining

Reporting

Results Available: 3 days Contact #s: (512) 458-7560

Reference

Method: direct microscopic examination, concentration and trichrome stain,  
Turnaround Time:  3 days Reference Range: No parasites found
Limitations: The ability to detect parasites is limited by the quality of the specimen collection. Interpretation: Negative test results indicates there are no detectable parasites in specimen.

Specimen Requirements

Specimen Collection: Specimens should be collected during acute phase of illness if possible. If cannot be transported to laboratory within 5 hours, specimens should be placed in PVA and formalin immediately Sample Type: Feces (fresh, less than five hours), PVA and formalin preserved feces
Volume/Amount Required: >20 g fresh stool; follow instructions for PVA and formalin transport media. Preferred Specimen:  Feces (fresh, less than five hours), PVA and formalin preserved feces
Collection/Preservation: Collect stool during acute or symptomatic phase of illness if possible. Storage Instructions: ambient temperature
Causes for Rejection: Specimen too old Sample Container: PVA and formalin transport containers; sterile specimen container.
Sample Test Kit: n/a Availability: Test performed Monday-Friday
Diagnostic Information:  Fecal specimens must be sent in fresh (less than five hours from being passed) or PVA and formalin for concentration and trichrome staining. Referred material accepted from hospital, private, and reference laboratories.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Body fluids handled using universal precautions.
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87207 Fees:


Microbiology
Amebiasis Entamoeba histolytica/Entamoeba disbar (Serological - Forwarded by TDSHS to CDC for testing)
< Return to Table of Contents 
Test Includes: Test not performed at TDSHS, specimen forwarded to the CDC for testing.

Reporting

Results Available: Contact #s: (512) 458-7560

Reference

Method:  
Turnaround Time:  3 weeks Reference Range:  Negative
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: venipuncture Sample Type: Serum
Volume/Amount Required: 10 mL whole blood Preferred Specimen:  Single Serum
Collection/Preservation: Collect blood by venipuncture, specimen held at ambient temperature. Separate serum and place in a sterile screw cap tube for shipment. Storage Instructions: Ambient temperature
Causes for Rejection: Clinical symptoms not consistent with amebiasis or detailed patient history not available for the CDC submission. Sample Container: Red or tiger top vacutainer
Sample Test Kit: Availability:  Specimens forwarded to the CDC Monday – Friday.
Diagnostic Information:  Serologic studies may be helpful in the diagnosis of invasive intestinal and extraintestinal amebiasis. Asymptomatic cyst passers usually have negative serologic tests. Eighty-five percent of patients with biopsy proven invasive intestinal amebiasis are antibody positive whereas 95-100% of patients with extra-intestinal amebiasis are positive. Values may remain elevated 6 to 18 months after invasive disease. Prior notification is requested (512) 458-7611.

A detailed patient history is required. Referred material accepted from hospital, private, and reference laboratories. However, since antibodies may persist for years after clinical cure, a reactive test may not indicate active infection.

Specimen Submission

Required Request Form: G-2A Specimen Handling: Body fluids handled using universal precautions
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87336 Fees:


Last updated November 18, 2013