Clinics and Departments

Laboratory Services

Lab Dept:

Microbiology/Virology

Test Name:

VIRAL RESPIRATORY CULTURE

General Information

Lab Order Codes:

VRSP

Synonyms:

Viral Isolation; Respiratory Virus Isolation; Respiratory Viral Culture

CPT Codes:

87252 – Tissue culture inoculation, observation, and presumptive identification by cytopathic effect

87254 x7 – Centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus

Test Includes:

A rapid culture system to detect RSV, influenza types A and B, parainfluenza virus 1-3, and adenovirus. Traditional tube cultures for isolation of cytomegalovirus, coxsackievirus, echovirus, enterovirus, herpes simplex virus, measles, mumps, parainfluenza virus type 4, poliovirus, and rhinovirus.

Logistics

Lab Testing Sections:

Virology

Phone Numbers:

Minneapolis:

Saint Paul:

 

612-813-5806

651-220-6555

Test Availability:

Daily, 24 hours

Turnaround Time:

1 – 21 days

Special Instructions:

Indicate the virus suspected. Requisition must state specific site of specimen and date/time of collection. Collect specimens early in the course of illness to yield highest viral titers. Do not use calcium alginate swabs.

Specimen

Specimen Type:

Respiratory specimens including nasal washes, nasopharyngeal swabs, throat swabs, bronchial washes and aspirates, endotracheal aspirates.

Container:

Swab transport system, sterile container, viral transport media (M4 VTM)

Volume:

1.0 – 2.0 mL washing/aspirate; 2 nasopharyngeal swabs; 1 throat swab

Collection:

Throat Swab:

1. Depress the tongue with a tongue depressor so the swab does not touch the tongue.
2.
Sample the posterior pharynx, tonsils, and inflamed areas with a sterile swab.
3.
Maintain sterility and forward promptly at ambient temperature.
4.
If there is a delay in transport of 1 hour or more, place specimen in viral transport media and refrigerate.

Tissue:

1. Submit specimen in a screw-capped, sterile container.
2.
Maintain sterility and forward promptly.
3.
If there is a delay in transport of 1 hour or more, place specimen in viral transport media and refrigerate.

Nasopharyngeal:

1. Obtain 2 specimens using 2 NP swabs (i.e., MiniTip Culturette).
2.
Gently insert swab through nose into posterior naspopharynx.
3.
Gently rotate swab slowly for 5 seconds to absorb secretions.
4.
Collect a second specimen in the same manner.

Nasopharynx Aspirates:

1. Prepare suction set up on low to medium suction.
2.
Wash hands.
3.
Put on protective barriers (e.g., gloves, gowns, mask).
4.
Place child supine and obtain assistant to hold child during procedures.
5.
Attach luki tube to suction tubing and #6 french suction catheter.
6.
Insert catheter into nostril and pharynx without applying suction.
7.
Apply suction as catheter is withdrawn.
8.
If there is a delay in transport of 1 hour or more, place specimen in viral transport media.

Brochoscopy:

1. 1.0 – 2.0 mL of specimen obtained by physician through the biopsy channel of the bronchoscope.
2.
Transfer specimen into a luki tube.
3.
Transport to the Microbiology lab immediately.

Special Processing:

● NP swabs; place into VTM. Swabs should remain in the VTM by cutting the wire shafts. Vortex, refrigerate.

● Swabs: place into viral transport media (VTM). Vortex. Extract into VTM by swirling and pressing swab against the inside of the vial, then discard swab. Refrigerate.

● Washings/aspirates: place into VTM, vortex and refrigerate.

● Tissue: place into VTM. Refrigerate.

Transport/Storage:

Transport to the Microbiology Lab immediately at room temperature. Store at refrigerated temperature

Sample Rejection:

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

Interpretive

Reference Range:

No virus isolated.

Limitations:

● Failure to isolate virus in culture does not rule out viral infection.

● Isolation of a virus may not be related to the patient’s disease.

Methodology:

Centrifugation enhanced and conventional cell culture with immunofluorescent detection and identification of viral agents.

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, pg 33-104

Updates:

3/24/2010: CPT Updates



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