Lab Dept:

Microbiology/Virology

Test Name:

BODY FLUID CULTURE AND GRAM STAIN

General Information

Lab Order Code:

BF

Synonyms:

Culture, Abdominal Fluid; Culture, Ascites fluid; Culture, Joint fluid; Culture, Bile fluid; Culture, Body fluid; Culture, Pericardial fluid; Culture, Pleural fluid; Culture, Synovial fluid; Ascites fluid culture; Abdominal fluid culture; Bile fluid culture; Joint fluid culture; Pericardial fluid culture; Peritoneal fluid culture; Pleural fluid culture; Synovial fluid culture

CPT Codes:

87070 – Culture, bacterial; any other source except urine, blood or stool, aerobic, 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 the specimen submitted, findings for organism identification (multiple additions are possible if more than one organism is identified) and to aid in patient treatment management.

87015 – Concentration (any type), for infectious agents
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)87076 – Anaerobic isolate, additional methods required for definitive identification of isolates

Test Includes:

Gram stain, culture for aerobes and less fastidious anaerobes if appropriate. All aerobic organisms will be identified. Anaerobic organisms will be characterized or identified depending on the nature of the culture. Susceptibilities will be performed if requested.

Logistics

Lab Testing Sections:

Microbiology

Phone Numbers:

Minneapolis:

Saint Paul:

612-813-5866

651-220-6555

Test Availability:

Daily, 24 hours

Turnaround Time:

Preliminary reports are available at 24 hours; final results reported within 7 days.

Special Instructions:

● Specimen site and date/time of collection are required for specimen processing.
● If an anaerobic infection is suspected, i.e., Actinomyces species. Refer to Anaerobic Culture. If a Mycobacterium species (AFB, TB) or fungus is suspected, request AFB Culture or Fungal Culture.

Specimen

Specimen Type:

Aseptically aspirated body fluid (excludes cerebrospinal fluid, blood, and urine) from a normally sterile site. Do not submit swabs.

Container:

Sterile container or anaerobic transport medium (available in Microbiology).

BACTEC® PEDS PLUS/F blood culture bottle (pink cap) may be used for joint fluids.

Volume:

Peritoneal dialysis (PD) fluid: 10 – 15 mL

Other fluids: 1 – 15 mL (Minimum: 0.5 mL)

Collection:

If percutaneous collection, prepare skin as for blood culture.

1. Aspirate fluid with a sterile syringe and needle.
2. Expel air bubbles from syringe.
3. Aseptically transfer specimen into sterile container, anaerobic transport tube or blood culture bottle for joint fluid.

Special Processing:

If a PD fluid is collected, inoculate the aerobic and anaerobic blood culture bottles each with 3 – 5 mL of PD fluid. Refer to Peritoneal Dialysis Fluid Culture and Gram Stain.

Transport/Storage:

Transport to the laboratory immediately at room temperature. Do not refrigerate. Refrigeration inhibits the viability of certain anaerobic organisms. Do not transport through the pneumatic tube.

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:

No growth

Critical Values:

● Significant isolates from a sterile site will be called to the physician or patient’s nurse.

● Infection Prevention will be notified with gram stain results that appear to be gram-negative cocci/diplococci.

Limitations:

Specimens are routinely screened for rapid growing anaerobes (B. fragilis group, Clostridium perfringens, etc.). If an anaerobic infection is suspected, i.e., Actinomyces species, refer to Anaerobic Culture.

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

Updates:

3/23/2010: CPT updates
3/7/2011: CPT updates
6/20/2012: Amended Critical Value