Lab Dept:

Microbiology/Virology

Test Name:

GENITAL CULTURE, ROUTINE

General Information

Lab Order Codes:

GENC

Synonyms:

Culture, Genital (Routine); Culture, Cervix; Culture, Urethra; Culture, Vagina

CPT Codes:

87070 – Culture, bacterial; any other source except urine, blood or stool, with isolation and presumptive identification of isolates

The following testing may be added if appropriate based on findings for organism identification (multiple additions are possible if more than one organism is identified).

87077 – Aerobic isolate, additional methods required for definitive identification, each isolate (if appropriate)
87185 – Enzyme detection (eg, beta lactamase), per enzyme (if appropriate)
87206 – Smear, fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types (if appropriate)

Test Includes:

Culture of aerobic flora including N. gonorrhoeae, N. meningitidis, group A and B streptococci, Staphylococcus aureus, Haemophilus influenzae, Gardnerella vaginalis, Listeria monocytogenes, Candida sp., Salmonella sp., Shigella sp., and E. coli in pure culture.

Gram stain is not included with this test. A Gram stain will be performed if specifically requested with an additional charge.

Logistics

Lab Testing Sections:

Microbiology

Phone Numbers:

Minneapolis:

Saint Paul:

612-813-5866

651-220-6555

Test Availability:

Daily, 24 hours

Turnaround Time:

Results are reported within 3 days.

Special Instructions:

Specimen site and date/time of collection are required for processing.

Specimen

Specimen Type:

Swab, aspiration, or drainage

Container:

● Swab transport medium
● Sterile container
● Direct inoculation – Obtain GC kit from Microbiology (JEMBEC system and/or Chocolate agar) plus a swab. See Special Processing.

Collection:

Females:

Cervix

1. Remove mucus and secretions from the cervix with a swab and discard.
2. With a new sterile swab, firmly sample the endocervical canal.
3. Place in swab transport medium or directly inoculate plates.

Vagina

1. Wipe away excessive amount of secretion or discharge.
2. Obtain secretions from mucosal membrane of the vaginal vault with a sterile swab.
3. If smear is also requested, collect a second swab.
4. Place swab in transport medium.

Males:

Urethra

1. Insert a urethrogenital swab 2 to 4 cm into the urethral lumen, rotate swab.
2. Leave in place for at least 2 seconds to facilitate absorption.
3. Place swab in transport medium or directly inoculate plates.

Special Processing:

Direct Inoculation Procedure

1. Warm Chocolate and JEMBEC plate to room temperature before inoculation. Neisseria gonorrhoeae is very susceptible to extreme conditions such as drying and cold temperatures that will decrease the recovery rate.
2. Collect two swabs.
3. With first swab, inoculate the plate(s) by gently rolling the swab to touch all surfaces.
4. Label plate(s) with the proper patient information.
5. Activate CO₂ generating tablet in JEMBEC plate as follows:

6. Submit plates along with second swab.

Transport/Storage:

Transport to the Microbiology Laboratory immediately at room temperature. Do not refrigerate. Refrigeration may prevent the recovery of Neisseria gonorrhoeae.

Sample Rejection:

Specimen with a transit time exceeding 2 hours after collection; refrigerated specimen; specimen not submitted in appropriate transport container; improperly labeled specimen; insufficient volume; external contamination. If an unacceptable specimen is received, the physician or nursing station will be notified and another specimen will be requested before the specimen is discarded.

Interpretive

Reference Range:

Normal vaginal flora (females)

Normal skin flora (males)

See Additional Information for a list of normal flora.

Alert Value:

If Neisseria gonorrhoeae, Listeria, Salmonella or Shigella are isolated, results will be called to the physician or patient’s nurse.

Limitations:

Herpes simplex virus, Chlamydia, and Ureaplasma urealyticum are not recovered by this procedure. Refer to separate listings.

Methodology:

Aerobic culture with selective (Thayer-Martin) and nonselective media.

Additional Information:

Normal vaginal flora includes lactobacilli, corynebacteria, enteric Gram negative rods, enterococci, alpha and gamma streptococci, coagulase-negative staphylococci, and anaerobes.

The male urethra contains organisms found on the skin, such as coagulase-negative staphylococci, micrococci, corynebacteria, alpha and gamma streptococci.

References:

Cook, JH, and M Pezzlo (1992). Specimen receipt and accessioning. Section 1. Aerobic bacteriology, 1.2.1-4. In HD Isenberg (ed) Clinical Microbiology Procedures Handbook. American Society for Microbiology, Washington DC

Miller, J Michael (1999) A Guide To Specimen Management in Clinical Microbiology, American Society for Microbiology, Washington DC

Miller, J Michael, and HT Holmes (1999) Specimen Collection, Transport, and Storage In PR Murray et al, (ed), Manual of Clinical Microbiology, 7^th edition, American Society for Microbiology, Washington DC, pp 33-104

Updates:

3/24/2010: CPT Updates
3/7/2011: CPT Updates
4/25/12: Addition of Alert Value.