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HelpOrder Code LABCFRC Bacterial Culture, Cystic Fibrosis with Antimicrobial Susceptibilities, Varies
Additional Codes
Mayo Test Code: CFRCS
EPIC Test Code: LABCFRC
Shipping Instructions
Specimen must be received in laboratory within 48 hours of collection at refrigerated temperature. Specimens received frozen will be rejected.
Necessary Information
Specimen source is required
Specimen Required
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Sputum, expectorated or induced
Patient Preparation: Have the patient brush their teeth or gargle with water immediately before specimen collection. This reduces the number of contaminating oropharyngeal bacteria.
Container/Tube: Sterile container
Specimen Volume: Entire collection
Acceptable:
Specimen Type: Bronchial aspirate or washing, sinus aspirate, bronchoalveolar lavage, endotracheal, or tracheal
Container/Tube: Sterile container
Specimen Volume: Entire collection
Specimen Type: Throat swab
Supplies:
Culturette (BBL Culture Swab) (T092)
BD E-Swab (T853)
Container/Tube: Culture transport swab (Dacron or rayon swab with aluminum or plastic shaft with either Stuart or Amies liquid medium), or ESwab
Specimen Volume: Entire collection
Useful For
Detecting disease-causing aerobic bacteria in specimens from patients with cystic fibrosis
Determining the in vitro antimicrobial susceptibility of potentially pathogenic aerobic bacteria, if appropriate
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COMM | Identification Commercial Kit | No, (Bill Only) | No |
| RMALD | Ident by MALDI-TOF mass spec | No, (Bill Only) | No |
| GID | Bacteria Identification | No, (Bill Only) | No |
| ISAE | Aerobe Ident by Sequencing | No, (Bill Only) | No |
| REFID | Additional Identification Procedure | No, (Bill Only) | No |
| SALS | Serologic Agglut Method 1 Ident | No, (Bill Only) | No |
| EC | Serologic Agglut Method 2 Ident | No, (Bill Only) | No |
| SHIG | Serologic Agglut Method 3 Ident | No, (Bill Only) | No |
| STAP | Identification Staphylococcus | No, (Bill Only) | No |
| STRP | Identification Streptococcus | No, (Bill Only) | No |
| MIC | Susceptibility, MIC | No, (Bill Only) | No |
| SUS | Susceptibility | No, (Bill Only) | No |
| SIDC | Ident Serologic Agglut Method 4 | No, (Bill Only) | No |
| PCRID | Identification by PCR | No, (Bill Only) | No |
| MECAB | mecA PCR Test, Bill Only | No, (Bill Only) | No |
Testing Algorithm
When this test is ordered, the reflex tests may be performed at an additional charge. Antimicrobial agent appropriate to the organism and specimen source will be tested according to Mayo Clinic's practice.
The following tables provide a listing of the antimicrobials routinely tested in the laboratory as well as antimicrobials that may be tested upon request. These tables are organized by isolate groups and are not all inclusive. Call 800-533-1710 and ask to speak to the Bacteriology Antimicrobial Susceptibility Testing Laboratory if the organism or antimicrobial of interest are not listed in these tables.
-Aerobic Gram-Negative Bacilli Antimicrobials
-Additional Gram-Negative Bacteria Antimicrobials
-Staphylococcus, Enterococcus, Bacillus, and Related Genera Antimicrobials
Special Instructions
Method Name
Conventional Culture Technique with Minimal Inhibitory Concentration (MIC) (Agar Dilution or Broth Microdilution or Gradient Diffusion) or Disk Diffusion (if appropriate)
Reporting Name
Bacterial Culture,Cystic Fib +SuscSpecimen Type
VariesSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Refrigerated | 48 hours |
Reject Due To
| Dry swab | Reject |
Reference Values
No growth or usual microbiota
Susceptibility results are reported as minimal inhibitory concentration (MIC) in mcg/mL. Breakpoints (also known as clinical breakpoints) are used to categorize an organism as susceptible, susceptible-dose dependent, intermediate, resistant, or nonsusceptible according to breakpoint setting organizations, either the Clinical and Laboratory Standards Institute (CLSI) or the European Committee on Antimicrobial Susceptibility Testing (EUCAST), as applicable.
In some instances, an interpretive category cannot be provided based on available data; therefore, the following comment will be included on the report: There are no established interpretive guidelines for agents reported without interpretations.
For information regarding CLSI and EUCAST susceptibility interpretations, see Susceptibility Interpretative Category Definitions.
Method Description
Standard media (5% sheep blood, chocolate, and eosin methylene blue agar plates) used for respiratory cultures are inoculated. In addition, 2 selective agar plates are utilized to enable isolation of slower growing pathogens that may be easily overgrown by usual microbiota and the longstanding colonization by Pseudomonas aeruginosa. Burkholderia cepacia Selective Agar plate is used for the isolation of B cepacia complex, which includes 20 distinct species. Isolates of B cepacia will be forwarded to the University of Michigan's CFF Research Testing and Repository for genotyping. There is no additional charge for this shipping/testing. A chromogenic Staphylococcus aureus agar is used to enhance the isolation of S. aureus. Finally, a second chocolate blood agar plate is incubated in an anaerobic atmosphere. The anaerobic atmosphere allows for detection of Haemophilus species that may otherwise be overgrown by P. aeruginosa. Pathogens or possible pathogens are identified using 1 or a combination of the following techniques: commercial identification strips or panels, matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, conventional biochemical tests, carbon source utilization, real-time polymerase chain reaction, and nucleic acid sequencing of the 16S ribosomal RNA (rRNA) gene.(Gilligan P, Alby K, York MK: Respiratory cultures from cystic fibrosis patients. In: Leber AL, ed. Clinical Microbiology Procedures Handbook, Vol 1, 4th ed. ASM Press; 2016:section 3.11.3)
When antimicrobial susceptibility testing is performed, an agar dilution method is used for routine testing. The agar dilution method employs the use of antimicrobial agents incorporated in agar plates. The antimicrobial is added to agar in various concentrations depending upon levels attainable in serum, urine, or both. A standardized suspension of the organism is applied to the agar plates, which are incubated for a minimum of 16 to 18 hours at 35° C. Complete inhibition of all but one colony or a very fine residual haze represents the end point.(Clinical and Laboratory Standards Institute [CLSI]. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. 11th ed. CLSI standard M07. CLSI; 2018)
Daptomycin and tigecycline are tested by agar gradient diffusion.(Clinical and Laboratory Standards Institute[CLSI]. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. 11th ed. CLSI standard M07. CLSI; 2018; package insert: Etest Biomerieux;15203E-EN-2016/07. 07/2016)
Cefiderocol is tested by disk diffusion.(Clinical and Laboratory Standards Institute [CLSI]. Performance Standards for Antimicrobial Disk Susceptibility Tests. 13th ed. CLSI standard M02.CLSI; 2018)
Day(s) Performed
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
87070-Bacterial, Culture, cystic fibrosis, respiratory
87077-Identification commercial kit (if appropriate)
87077-Ident by MALDI-TOF mass spec (if appropriate)
87077-Bacteria Identification (if appropriate)
87077-Additional Identification procedure (if appropriate)
87077-Identification Staphylococcus (if appropriate)
87077-Identification Streptococcus (if appropriate)
87147 x 1-3-Serologic agglut method 1 ident (if appropriate)
87147-Serologic agglut method 2 ident (if appropriate)
87147 x 4-Serologic agglut method 3 ident (if appropriate)
87147 x 2-6-Serologic Agglut Method 4 Ident (if appropriate)
87153-Aerobe ident by sequencing (if appropriate)
87150-Identification by PCR (if appropriate)
87185-Beta lactamase (if appropriate)
87186-Antimicrobial Susceptibility, Aerobic Bacteria, MIC-per organism for routine battery (if appropriate)
87181-Susceptibility per drug and per organism for drugs not in routine battery (if appropriate)
87150-mec A PCR (if appropriate)
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.