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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: Chromoblastomycosis to Colorado Tick Fever

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Microbiology
Chromoblastomycosis (Culture - Isolation)
Names of Related Agents:  Fonsecaea species, Exophiala species, Cladophialophora species, etc.
< Return to Table of Contents
Test Includes: Isolation of fungus and morphological and/or physiological testing for identification to species level.

Reporting

Results Available: 21-28 days Contact #s: 512-458-7455 for prior approval
Technical questions:  512-458-7586

Reference

Method: Slide culture  
Turnaround Time:  21-28 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: Preferred Specimen:  Crust; Exudate; Tissue
Collection/Preservation: No preservative. Storage Instructions: Transport specimen as soon as possible.  If transport is delayed over one hour, refrigerate specimen.
Causes for Rejection: Specimen frozen, in culture media, in transport media or preserved will be rejected. Sample Container: Prefer sterile, leak-proof 50 mL conical tube.  Add up to 10 mL sterile saline to crust or tissue to maintain moisture during transport.
Sample Test Kit: Availability: Testing available upon approval from 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: 87101, 87102, 87103 Fees:


Microbiology
Chromoblastomycosis (Culture - Identification)
Names of Related Agents:  Fonsecaea species, Exophiala species, Cladophialophora species, etc.
< Return to Table of Contents
Test Includes: Morphological and/or physiological testing for identification to species level.

Reporting

Results Available: 14-21 days Contact #s: 512-458-7586

Reference

Method: Slide Culture  
Turnaround Time:  14-21days   Reference Range:  By report  
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Pure culture
Collection/Preservation: No preservative. Storage Instructions:
Causes for Rejection: Culture infested with mites. Sample Container: Triple-contained.
Sample Test Kit: Availability: Tested 5 days/week: Monday – Friday.
Diagnostic Information:  Fungal isolates (pure culture) submitted to this Laboratory for definitive identification. Drug susceptibility testing on these organisms not available at TDSHS laboratory.

Specimen Submission

Required Request Form: G-2B Specimen Handling:
Transport Temperature:  Room temperature Shipping Requirements: Triple-contained and packaged to meet rigorous performance tests as outlined in the DOT, USPS, PHS, and IATA regulations for shipping of infectious substances.

Billing

CPT Code: 87101, 87102, 87103 Fees:


Microbiology
Clonorchiasis (Microscopic – Direct Concentration)
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Test Includes: Microscopic examination

Reporting

Results Available: 1 day Contact #s: (512) 458-7560

Reference

Method: Microscopic examination  
Turnaround Time:  1 day   Reference Range: No parasites found
Limitations: The specimen must be sent in a fresh (less than 5 hours old) or in formalin. Interpretation: A report of no parasites found is indicative of no visible parasites in the specimen.

Specimen Requirements

Specimen Collection: Fresh feces, flukes, tissue sections, or bile Sample Type: Feces; Bile; Tissue Section; Fluke ID
Volume/Amount Required: > 10 g stool or > 10 mL liquid stool, small amount of tissue or bile. Preferred Specimen:  Feces; Bile; Tissue Section; Fluke ID
Collection/Preservation: the specimen must be sent in a fresh (less than 5 hours old) or in formalin. Adult fluke should be submitted in ethylalcohol. Storage Instructions: ambient temperature
Causes for Rejection: Unpreserved stool> 5 hours old; Sample Container: Clean, dry leak-proof container.
Sample Test Kit: Availability:  Monday-Friday
Diagnostic Information:  For detection of eggs in fecal specimens, the specimen must be sent in a fresh (less than 5 hours old) or in formalin. Adult fluke should be submitted in ethylalcohol. Referred material accepted from hospital, private and reference labs.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Body fluids handled with 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
Clostridium difficile Culture (Identification)
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Test Includes:Rapid ANA II, API anaID; GLC, conventional biochemicals

Reporting

Results Available: 7-10 days Contact #s: (512) 458-7582

Reference

Method: Rapid ANA II, API ana ID GLC Conventional biochemicals.
Turnaround Time:  7-10 days Reference Range:  By report
Limitations: Routine toxin testing for C. difficile is not performed at this laboratory. Transport method must be suitable for anaerobic conditions or organisms may not be viable for testing. Interpretation: Toxigenic culture tests C. difficile isolates for toxin production and has higher sensitivity and equivalent specificity compared to the cytotoxicity assay.

Specimen Requirements

Specimen Collection: Sample Type: Pure culture under anaerobic conditions.
Volume/Amount Required: One culture per patient. Preferred Specimen:  Pure culture under anaerobic conditions.
Collection/Preservation: Must be maintained under anaerobic conditions. Storage Instructions: Store under anaerobic conditions, ambient temperature.
Causes for Rejection: Shipped under aerobic conditions; no identifying marks on sample and/or paperwork. Sample Container: Anaerobic containers required.
Sample Test Kit: Availability: Tested Monday – Friday.
Diagnostic Information:  See Anaerobic Bacterial Culture (Identification).

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handle as infectious agent.
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87076 Fees:


Microbiology
Clostridium perfringens (Culture - Isolation)
< Return to Table of Contents
Test Includes: Rapid ANA II, API anaID; GLC, conventional biochemicals.

Reporting

Results Available: 7-10 days Contact #s: (512) 458-7582

Reference

Method: Rapid ANA II, API ana ID GLC Conventional biochemicals.
Turnaround Time:  7-10 days Reference Range:  No Clostridium perfringens isolated
Limitations: Food samples are tested for outbreaks investigated by the IDEAS department of TDSHS only. All samples must be collected by a sanitarian or appointee. Interpretation: Isolation of C. perfringens from a food source is indicative of food poisoning.

Specimen Requirements

Specimen Collection: Food Sample Type:  Food
Volume/Amount Required: 25 grams of each type of food for each pathogen tested. Preferred Specimen:  Food
Collection/Preservation: Food must be collected by a sanitarian and transported at 2-8° C. Storage Instructions: 2-8° C.
Causes for Rejection: insufficient amount, improperly collected or stored. Sample Container: Clean, dry, leak-proof containers
Sample Test Kit: Availability: Monday-Friday. Outbreak testing available on Saturday with prior arrangements.
Diagnostic Information:  See instructions Food Poisoning (Culture - Isolation). Testing performed for Epidemiological investigations approved by the IDEAS department, only.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Food samples according to FDA protocols for collection and transport. Chain of custody must be used if possibility of legal issues exists.
Transport Temperature:  2-8° C  Shipping Requirements: Leak-proof containers, overnight delivery.

Billing

CPT Code: 87075 Fees:


Microbiology
Clostridium perfringens (Culture Identification)
< Return to Table of Contents
Test Includes: Rapid ANA II, GLC, conventional biochemicals

Reporting

Results Available: 7-10 days Contact #s: (512) 458-7582

Reference

Method: Rapid ANA II, GLC, conventional biochemicals.
Turnaround Time:  7-10 days Reference Range:  By report  
Limitations: Transport method must be suitable for anaerobic conditions or organisms may not be viable for testing.  Interpretation: Growth and results of biochemical tests indicate type of organism.

Specimen Requirements

Specimen Collection: Pure culture Sample Type: Pure culture under anaerobic conditions.
Volume/Amount Required: one specimen per patient. Preferred Specimen: Pure culture under anaerobic conditions.
Collection/Preservation: Must be collected under anaerobic conditions. Storage Instructions: Store under anaerobic conditions at ambient temperature.
Causes for Rejection: Shipped under aerobic conditions; Broken in transport. Sample Container: Anaerobic transport medium.
Sample Test Kit: Availability: Tested Monday – Friday.
Diagnostic Information:    See Anaerobic Bacterial Culture (Identification).

Specimen Submission

Required Request Form: G-2B Specimen Handling: Infectious agents, anaerobic conditions
Transport Temperature:  Ambient  temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87076 Fees:


Microbiology
Clostridium perfringens Culture (Toxin Detection)
< Return to Table of Contents
Test Includes: Toxin detection

Reporting

Results Available: 2 days Contact #s: (512) 458-7562

Reference

Method:  
Turnaround Time:  2 days Reference Range:  No toxin detected
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Food
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  See Food Poisoning Culture (Toxin Detection)

Specimen Submission

Required Request Form:  G-2B Specimen Handling:
Transport Temperature:  2-8° C  Shipping Requirements:

Billing

CPT Code: Fees:


Microbiology
Clostridium perfringens Culture –(Typing)
< Return to Table of Contents
Test Includes: Test is not performed at TDSHS, Test is performed at the CDC.

Reporting

Results Available: Contact #s:

Reference

Method:  
Turnaround Time:  Dependent on CDC report Reference Range:
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: n/a Sample Type: Pure culture under anaerobic conditions.
Volume/Amount Required: one specimen per patient. Preferred Specimen:  Pure Culture under anaerobic conditions.
Collection/Preservation: Pure culture maintained under anaerobic conditions. Storage Instructions: Ambient temperature, anaerobic condition
Causes for Rejection: Culture received under aerobic conditions, incomplete information on submission form, prior approval not secured before shipment. Sample Container: anaerobic transport container.
Sample Test Kit: Availability: Monday-Thursday, unless prior arrangements have been made for Friday ship out.
Diagnostic Information:  Isolates are sent to the CDC for typing with prior approval.  See instructions Food (Culture –(Identification).

Specimen Submission

Required Request Form: G-2A Specimen Handling: Infectious agent
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87147 Fees:


Microbiology
Coccidioidomycosis (Culture – Isolation)
< Return to Table of Contents
Test Includes: Isolation of fungus and identification by Gen-Probe Accuprobe test

Reporting

Results Available: 21-28 days Contact #s: 512-458-7455 for prior approval
Technical questions:  512-458-7586

Reference

Method: Accuprobe culture confirmation test; hybridization of ribosomal RNA to probe detected by chemiluminesence
Turnaround Time:  21-28 days Reference Range:  Negative
Limitations: Delay in transport of specimen could compromise isolation of organism. Interpretation: Positive by DNA Probe Test means that the probe detected ribosomal RNA of Coccidioides immitis from the isolate.

Specimen Requirements

Specimen Collection: Sample Type: Clinical specimen
Volume/Amount Required: 3 mL to 15 mL Preferred Specimen:  Sputum; Exudate; Tissue
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 of 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: 87101, 87102, 87103 Fees:


Microbiology
Coccidioidomycosis (Culture – Genetic Probe - Culture Confirmation)
< Return to Table of Contents
Test Includes: Identification by Gen-Probe Accuprobe Test

Reporting

Results Available: 7-10 days Contact #s: 512-458-7586

Reference

Method: Accuprobe culture confirmation test; hybridization of ribosomal RNA to probe detected by chemiluminesence
Turnaround Time:  7-10 days Reference Range:  By Report
Limitations: Positive DNA Probe Test does not mean the isolate is still viable. Interpretation: Positive by DNA Probe Test means that the probe detected ribosomal RNA of Coccidioides immitis from the isolate.

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Pure Culture
Collection/Preservation: No preservative. Storage Instructions:
Causes for Rejection: Culture infested with mites.  Sample Container: Triple-contained
Sample Test Kit: Availability: Accuprobe test is run once weekly.
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: 87101, 87102, 87103 Fees:


Microbiology
Coccidioidomycosis (Serological – Complement Fixation)
< Return to Table of Contents
Test Includes:

Reporting

Results Available: Contact #s:

Reference

Method:  
Turnaround Time:  5-7 days Reference Range:  <1:1  
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: 2 mL serum/CSF Preferred Specimen:  Single Serum; Spinal Fluid
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  CF titer parallels severity.  A titer of 1:32 indicates disseminating disease. Cerebrospinal fluid titers, when present may indicate coccimeningitis (75% positive).  A Nonreactive CF reaction does not exclude a diagnosis of Coccidioidomycosis. Test is performed once per week.

Specimen Submission

Required Request Form: G-2A Specimen Handling: Use Universal Precautions
Transport Temperature: Cold (2-8º C) on ice packs if received within 48 hours from time of collection. Frozen (=-20°) on dry ice if received more than 48 hours from time of collection. Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8° C), or frozen (-20° C) and mailed on dry ice.

Billing

CPT Code: 86635 Fees:


Microbiology
Coccidioidomycosis (Serological – Immunodiffusion)
< Return to Table of Contents
Test Includes:

Reporting

Results Available: Contact #s:

Reference

Method: Immumodiffusion  
Turnaround Time:  5-7 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:
Volume/Amount Required: 2 mL serum Preferred Specimen:  Single Serum; Spinal Fluid
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: Testing performed on Tuesday
Diagnostic Information:  The immunodiffusion correlates both in sensitivity and clinical utility with the CF test.  It is most useful in confirming the specificity of low CF titers, where line(s) of identity are formed with reference antisera. A precipitin band denotes recent or current infection. Test is performed once per week.

Specimen Submission

Required Request Form: G-2A Specimen Handling: Use Universal Precautions
Transport Temperature: Cold (2-8º C) on ice packs if received within 48 hours from time of collection.  Frozen (≤-20°) on dry ice if received more than 48 hours from time of collection. Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8° C), or frozen (-20° C) and mailed on dry ice.

Billing

CPT Code: 86635 Fees:


Microbiology
Coliform – Fecal (Culture – Quantitation)
< Return to Table of Contents
Test Includes: Membrane filtration or Multitube fermentation

Reporting

Results Available: 3 days Contact #s: (512) 458-7562

Reference

Method: membrane filtration or Multitube fermentation method
Turnaround Time:  3 days Reference Range:   Less than 2.2 MPN/ 100 mL
Limitations: Interpretation:  Values of fecal coliform less than 2.2 MPN/100 mL is considered a negative test. Values are dependent on age of sample and transport temperature.

Specimen Requirements

Specimen Collection: Bottled water Sample Type: Water
Volume/Amount Required: 100 mL Preferred Specimen:  Water
Collection/Preservation:  Sealed bottles of water, ambient temperature Storage Instructions: ambient temperature
Causes for Rejection: Sample too old Sample Container:  Water bottle collectors
Sample Test Kit: Availability: Monday-Sunday
Diagnostic Information:  Test is available only to health officials with 1-day notice.  Sample must be iced and less than 6 hours old.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Specimen collected according to EPA protocol for water testing.
Transport Temperature:  2-8° C Shipping Requirements: On ice within 6 hours of collection.

Billing

CPT Code: 87046 Fees:


Microbiology
Coliform – Total Colilert
< Return to Table of Contents
Test Includes: Colilert 18 hour

Reporting

Results Available: 1 day Contact #s:  (512) 458-7611

Reference

Method: Mug fluoresecent detection  
Turnaround Time:  1 day Reference Range:  Absence of coliform
Limitations: Test results are dependent on fluorescent display. Other substances that fluoresce can give false positive test results. Interpretation: Report is indicative of no detectable levels of fecal coliforms. Test results do not indicate bacterial load of other types of organisms.

Specimen Requirements

Specimen Collection: water Sample Type: water
Volume/Amount Required:  100 mL Preferred Specimen:  water
Collection/Preservation:  Collect 100 mL following instructions provided in collection kit. Store at ambient temperature. Transport to laboratory within 30 hours of collection. Storage Instructions: Ambient temperature
Causes for Rejection:  Sample > 30 hours, incorrect collection bottle. Sample Container:  100 mL sterile bottle with sodium thiosulfate.
Sample Test Kit: Idexx Colilert 18 hour Availability: Monday-Sunday
Diagnostic Information:  Sample must be in container provided by TDSHS.  Water must be from a closed system and less than 30 hours old.  Fee for service is charged.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Specimens must be collected and handled following instructions included in the package.
Transport Temperature:  Ambient  temperature   Shipping Requirements: Within 30 hours of collection.

Billing

CPT Code: 87046 Fees:


Microbiology
Colorado Tick Fever (Serological – Forwarded by TDSHS to CDC for testing.)
< Return to Table of Contents
Test Includes:

Reporting

Results Available: Contact #s:

Reference

Turnaround Time:  3 weeks Reference Range:  <1.00 (Nonreacative)  
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection.

Specimen Requirements

Specimen Collection: Venipuncture Sample Type:
Volume/Amount Required: 10 mL whole blood Preferred Specimen:  Paired Sera
Collection/Preservation: Red top or tiger top tube Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing Sample Container: Red top or tiger top tube
Sample Test Kit: Availability:
Diagnostic Information:  Prior notification is requested (512) 458-7760. A detailed patient history is required. Serum specimens are forwarded to the CDC.  Serum specimens are to be collected at least 14 days apart.  A significant titer increase is evidence of current or recent infection.  Since IgM antibodies appear 14-16 days after onset, PCR test, with prior arrangement with CDC, can be performed on blood specimens collected within 8 days after onset.

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:


Last updated September 15, 2010