Clinics and Departments

Laboratory Services

Lab Dept:

Microbiology/Virology

Test Name:

SKIN/SUPERFICIAL WOUND/ LESION CULTURE AND GRAM STAIN

General Information

Lab Order Codes:

SKIC

Synonyms:

Culture, Skin; Culture, Superficial Lesion; Superficial Lesion Culture; Wound, Superficial/skin

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.

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:

Culture of aerobic flora and Gram stain. Useful for the isolation of organisms associated with pyoderma (e.g., Staphylococcus aureus and group A Streptococcus).

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 report available at 1 day, final report within 2 - 5 days.

Special Instructions:

Specimen site and date/time of collection are required for processing.
● If a Mycobacterium species (AFB, TB), fungus or a virus is suspected, refer to AFB Culture, Fungal Culture or Viral Culture.

Specimen

Specimen Type:

Skin, swab or scraping, or lesion

Container:

Swab transport system

Collection:

1. Gently swab affected area or active border of a lesion.
2.
Place swab in transport medium.

Transport/Storage:

Onsite collections: Transport to the Microbiology Laboratory immediately.

Offsite collections: Refrigerate specimen. Specimens must be prompltly transported to the laboratory, with the next available courier, not to exceed 24 hours from the time of collection. However, delayed transport causes a delay of test results.

Sample Rejection:

Improperly labeled specimen; specimens with a prolonged transit time (see Transport/Storage for requirements); 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 skin flora

Critical Value:

If any acid-fast bacilli is isolated, the result will be called to the physician or patient’s nurse.

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.
● Any culture positive for potential agents of Bioterrorism – Bacillus anthracis, Brucella, Bukholderia mallei/pseudomallei, Francisella tularensis, or Yersinia pestis will be called to Infectious Disease or Infection Prevention.

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:

3/22/2010: CPT Update
3/7/2011: CPT Update
4/25/2012: Addition of Critical Value
6/20/2012: Addition of Alert Value
1/20/2014: Updated name to include Superficial Wound
11/20/2014: Addition of offsite collection information



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