Test Catalog

Test Id : SPUT

Bacterial Culture, Aerobic, Respiratory

Useful For
Suggests clinical disorders or settings where the test may be helpful

Aiding in the diagnosis of lower respiratory bacterial infections including pneumonia

Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial 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
SIDC Ident Serologic Agglut Method 4 No, (Bill Only) No
PCRID Identification by PCR No, (Bill Only) No

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

When this test is ordered, the reflex tests may be performed at an additional charge.

Method Name
A short description of the method used to perform the test

Conventional Culture Technique

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Bacterial Culture, Aerobic, Resp

Aliases
Lists additional common names for a test, as an aid in searching

Culture, General Bacteria, Sputum

General Bacteria Culture, Sputum

50003-SPUT

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

When this test is ordered, the reflex tests may be performed at an additional charge.

Specimen Type
Describes the specimen type validated for testing

Varies

Ordering Guidance

If susceptibilities are also desired,  order SPUTS / Bacterial Culture, Aerobic, Respiratory with Antimicrobial Susceptibilities, Varies.

Shipping Instructions

Specimen must arrive within 24 hours of collection.

Necessary Information

Specimen source is required.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
Q00M0055 Specimen Source

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation: Have patient rinse his/her mouth with water immediately prior to specimen collection. This reduces the number of contaminating oropharyngeal bacteria.

Specimen Type: Respiratory

Sources: Sputum, bronchoalveolar lavage, trachea, endotracheal tube, etc.

Container/Tube: Sterile container

Specimen Volume: Entire specimen

Collection Instructions: An early-morning expectorated sputum is preferred.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

2 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 24 hours
Ambient 24 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Aiding in the diagnosis of lower respiratory bacterial infections including pneumonia

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

When this test is ordered, the reflex tests may be performed at an additional charge.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Common bacterial agents of acute pneumonia include: Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Pseudomonas aeruginosa, and members of the Enterobacteriaceae (Escherichia coli, Klebsiella species, and Enterobacter species). Clinical history, physical examination, and chest X-ray are usually adequate for the diagnosis of pneumonia, and antimicrobial treatment is typically based on these findings.

 

Culture of expectorated sputum is used by some for the evaluation of pneumonia, although controversy exists regarding this practice; both sensitivity and specificity of sputum cultures are generally regarded as poor (<50%). Specificity is improved by collecting expectorated purulent matter from the lower respiratory tract and avoiding mouth and oropharyngeal matter, thereby reducing contamination. Prior to culture, the specimen should be examined for the presence of white blood cells (evidence of purulent matter) and a paucity of squamous cells (evidence of minimal contamination by oral matter).

 

Blood cultures should be performed to establish the definitive etiology of an associated pneumonia. However, only 20% to 30% of patients with bacterial pneumonia are bacteremic.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

No growth or usual flora

Identification of probable pathogens

Interpretation
Provides information to assist in interpretation of the test results

A negative test result is no growth of bacteria or growth of only usual flora. A negative result does not rule out all causes of infectious lung disease (see Cautions).

 

Organisms associated with lower respiratory tract infections are reported.

 

For positive test results, pathogenic bacteria are identified. Cystic fibrosis (CF) patients may be colonized or chronically infected by some organisms over a long period of time, therefore, positive results must be interpreted in conjunction with previous findings and the clinical picture to appropriately evaluate results.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

When culture of sputum is delayed, successful isolation of bacterial pathogens is less likely due to the overgrowth of usual oropharyngeal flora.

 

Some bacterial agents that cause lower respiratory infections (eg, mycobacteria, Legionella species, Mycoplasma pneumoniae) are not detected by this assay and require special procedures. If the bacterial culture is negative, clinicians should consider additional testing to detect other bacterial, viral, or fungal agents.

 

Results must be interpreted in conjunction with clinical findings and previous culture results.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Miller JM, Binnicker MJ, Campbell S, et al: A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018 Aug 31;67(6):e1-e94. doi: 10.1093/cid/ciy381

2. Procop GW, Church DL, Hall GS, et al: Introduction to Microbiology Part II: Guidelines for the collection, transport, processing, analysis, and reporting of cultures from specific specimen sources. In: Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 7th ed. Wolters Kluwer Lippincott Williams and Wilkins; 2017:66-110

Method Description
Describes how the test is performed and provides a method-specific reference

All sputum and induced sputum specimens are screened microscopically by Gram stain to avoid culturing specimens that do not represent lower respiratory secretions; specimens with more than 25 squamous epithelial cells per low-power field will not be cultured.

 

Lower respiratory specimens are inoculated onto sheep blood agar, eosin methylene blue agar, and chocolate agar, and are incubated for 48 hours. 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 (RT-PCR), and nucleic acid sequencing of the 16S ribosomal RNA (rRNA) gene. The following organisms are identified and reported: Streptococcus pneumoniae; Streptococcus pyogenes; other beta-hemolytic Streptococcus species. groups B, C, and G; Haemophilus species; Staphylococcus aureus; Moraxella catarrhalis; Neisseria meningitidis; Gram-negative bacilli; and predominant yeast; or Corynebacterium pseudodiphtheriticum/propinquum. Other organisms are classified as usual oropharyngeal flora.(York MK, Gilligan P, Alby K: Lower respiratory tract cultures. In: Leber AL, ed. Clinical Microbiology Procedures Handbook. Vol 1. 4th ed. ASM Press; 2016:section 3.11.2)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

4 to 6 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

1 day

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

87070-Bacteria, Culture, Aerobic, 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)

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
SPUT Bacterial Culture, Aerobic, Resp 89643-1
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
SPUT Bacterial Culture, Aerobic, Resp 89643-1

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports