Clinics and Departments

Laboratory Services

Lab Dept:

Microbiology/Virology

Test Name:

EYE CULTURE AND GRAM STAIN

General Information

Lab Order Codes:

EYEC

Synonyms:

Culture, Eye; Culture, Conjunctiva; Culture, Cornea

CPT Codes:

87070 – Culture, bacterial; any other source except urine, blood or stool, with isolation and presumptive identification of isolates
87205 – Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi or cell types

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) and to aid in patient treatment management.

87076 – Anaerobic isolate, additional methods required for definitive identification of isolates
87077 – Aerobic isolate, additional methods required for definitive identification, each isolate (if appropriate)
87106 – Culture, fungi, definitive identification, each organism, yeast (if appropriate)
87107 – Culture, mold, definitive identification, each organism, mold (if appropriate)
87206 – Smear, primary source with interpretation, fluorescent and/or acid fast stain for bacteria, fungi or cell types (if appropriate)
87184 – Susceptibility studies, disk method, per plate (if appropriate)
87185 – Enzyme detection (eg, beta lactamase), per enzyme (if appropriate)
87186 – Susceptibility studies, microdilution or agar dilution, each multi-antimicrobial, per plate (if appropriate)

Test Includes:

Aerobic culture and a Gram stain

Logistics

Lab Testing Sections:

Microbiology

Phone Numbers:

MIN Lab: 612-813-5866

STP Lab: 651-220-6555

Test Availability:

Daily, 24 hours

Turnaround Time:

Preliminary reports are available at 24 hours. Cultures from which pathogens are isolated require at least 2 days for completion.

Special Instructions:

Specimen site and date/time of collection are required for processing.
● Specify organism suspected since special isolation procedures may be required.
● This procedure will not detect Chlamydia, fungi, Mycobacterium sp., or viruses, which may cause conjunctivitis and/or keratitis. If these organisms are suspected, refer to separate listings for Chlamydia Culture, AFB Culture, Fungal Culture or Viral Culture.

Specimen

Specimen Type:

Swab or scrapings of the cornea; OD = right eye, OS = left eye

Container:

Swab transport system

Collection:

Conjunctiva:

1. Swab: Pass moistened swab two times over lower conjunctiva. Avoid eyelid border and lashes. Place in swab transport medium.
2.
Contact Microbiology for media for direct inoculation.
3.
Scrapings: Instill one or two drops of topical anesthetic and scrape the lower tarsal conjunctiva. Inoculate plates directly (BAP, CHOC).

Corneal scraping:

1. Procedure performed by ophthalmologist.
2.
Contact Microbiology for media for direct inoculation.
3.
Direct culture inoculation: BHI with 10% sheep blood, Chocolate agar, and SABS.

Transport/Storage:

Transport swabs ≤2 hours at room temperature, plates <15 min, room temperature.

Sample Rejection:

Specimen with a transit time exceeding 2 hours after collection; 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 Flora of the eye may include Corynebacterium sp. (diphtheroids), coagulase negative staphylococci, Neisseria sp., Moraxella catarrhalis, Moraxella sp., streptococci (nonhemolytic), and gram-negative rods (rare).

Abnormal Ocular Flora includes: Haemophilus influenzae, Streptococcus pneumoniae, group A Streptococcus, Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus species, Neisseria gonorrhoeae, some saprophytic fungi, and Mycobacterium chelonei

Alert Value:

● Gram-negative rods identified as ESBL or Carbapenemase producers will be called to the physician or patient’s nurse. Infection Prevention will be notified.
● If MRSA is isolated for the first time, and the patient location is not Emergency department, the result will be called to the physician or patient’s nurse.

Limitations:

Organisms are more readily detected in scrapings than from a swab.

Methodology:

Culture

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, 7th edition, American Society for Microbiology, Washington DC, pp 33-104

Updates:

3/23/2010: CPT Updates
3/7/2011: CPT Updates
6/19/2012: Alert Value added



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