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Test ID SPUTS Bacterial Culture, Aerobic, Respiratory with Antimicrobial Susceptibilities


Shipping Instructions


Specimen must arrive within 24 hours of collection.



Necessary Information


Specimen source is required.



Specimen Required


Specimen Type: Respiratory

Patient Preparation: Have patient rinse his/her mouth with water immediately prior to specimen collection. This reduces the number of contaminating oropharyngeal bacteria.

Sources: Sputum, bronchoalveolar lavage, trachea, endotracheal tube, etc.

Container/Tube: Sterile container

Specimen Volume: Entire specimen

Collection Instructions: An early-morning expectorated sputum is preferred.

Specimen Stability Information:  Refrigerated 24 hours (preferred)/Ambient 24 hours


Useful For

Aiding the diagnosis of lower respiratory bacterial infections, including pneumonia

 

Determining the in vitro antimicrobial susceptibility of potentially pathogenic aerobic bacteria, if appropriate

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
RMALD Ident by MALDI-TOF mass spec No, (Bill Only) No
GID Bacteria Identification No, (Bill Only) No
ISAE Aerobe Ident by Sequencing No, (Bill Only) No
REFID Additional Identification Procedure No, (Bill Only) No
SALS Serologic Agglut Method 1 Ident No, (Bill Only) No
EC Serologic Agglut Method 2 Ident No, (Bill Only) No
SHIG Serologic Agglut Method 3 Ident No, (Bill Only) No
STAP Identification Staphylococcus No, (Bill Only) No
STRP Identification Streptococcus No, (Bill Only) No
BLA Beta Lactamase No, (Bill Only) No
MIC Sensitivity, MIC No, (Bill Only) No
SUS Susceptibility No, (Bill Only) No
SIDC Ident Serologic Agglut Method 4 No, (Bill Only) No
PCRID Identification by PCR No, (Bill Only) No
COMM Identification Commercial Kit No, (Bill Only) No

Testing Algorithm

When this test is ordered, the reflex tests may be performed and charged. Antimicrobial agent appropriate to the organism and specimen source will be tested according to Mayo’s practice and the laboratory’s standard operating procedures.

 

See Special Instructions to review tables that provide a listing of the antimicrobials routinely tested in our laboratory as well as antimicrobials that may be tested upon request. These tables are organized by isolate groups and are not all inclusive. Call 800-533-1710 and ask to speak to the Bacteriology Antimicrobial Susceptibility Testing Laboratory if the organism or antimicrobial of interest are not listed in these tables.

Method Name

Conventional Culture Technique with Minimum Inhibitory Concentration (MIC) by Agar Dilution (if appropriate)

Reporting Name

Bacterial Culture, Aerobic + Susc

Specimen Type

Varies

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time
Varies Refrigerated (preferred) 24 hours
  Ambient  24 hours

Reference Values

No growth or usual flora.

 

Identification of probable pathogens.

 

When antimicrobial susceptibilities are performed, results are reported as minimum inhibitory concentration (MIC) in mcg/mL. Breakpoints (also known as "clinical breakpoints") are used to categorize an organism as susceptible, susceptible-dose dependent, intermediate, resistant, or nonsusceptible according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.

In some instances an interpretive category cannot be provided based on available data and the following comment will be included: "There are no established interpretive guidelines for agents reported without interpretations."

 

Susceptible (S):

A category defined by a breakpoint that implies that isolates with an MIC at or below the susceptible breakpoint are inhibited by the usually achievable concentrations of antimicrobial agent when the dosage recommended to treat the site of infection is used, resulting in likely clinical efficacy.

 

Susceptible-Dose Dependent (SDD):

A category defined by a breakpoint that implies that susceptibility of an isolate is dependent on the dosing regimen that is used in the patient. In order to achieve levels that are likely to be clinically effective against isolates for which the susceptibility testing results are in the SDD category, it is necessary to use a dosing regimen (ie, higher doses, more frequent doses, or both) that results in higher drug exposure than the dose that was used to establish the susceptible breakpoint. Consideration should be given to the maximum approved dosage regimen, because higher exposure gives the highest probability of adequate coverage of a SDD isolate. The drug label should be consulted for recommended doses and adjustment for organ function.

 

Intermediate (I):

A category defined by a breakpoint that includes isolates with MICs within the intermediate range that approach usually attainable blood and tissue levels and for which response rates may be lower than for susceptible isolates.

Note: The intermediate category implies clinical efficacy in body sites where the drugs are physiologically concentrated or when a higher than normal dosage of a drug can be used. This category also includes a buffer zone, which should prevent small, uncontrolled, technical factors from causing major discrepancies in interpretations, especially for drugs with narrow pharmacotoxicity margins.

 

Resistant (R):

A category defined by a breakpoint that implies that isolates with an MIC at or above the resistant breakpoint are not inhibited by the usually achievable concentrations of the agent with normal dosage schedules and/or that demonstrate MICs that fall in the range in which specific microbial resistance mechanisms are likely, and clinical efficacy of the agent against the isolate has not been reliably shown in treatment studies.

 

Nonsusceptible (NS):

A category used for isolates for which only a susceptible breakpoint is designated because of the absence or rare occurrence of resistant strains. Isolates for which the antimicrobial agent MICs are above the value indicated for the susceptible breakpoint are reported as nonsusceptible.

Note: An isolate that is interpreted as nonsusceptible does not necessarily mean that the isolate has a resistance mechanism. It is possible that isolates with MICs above the susceptible breakpoint that lack resistance mechanisms may be encountered within the wild-type distribution subsequent to the time the susceptible-only breakpoint was set.

 

Epidemiological Cutoff Value (ECV):

The MIC that separates microbial populations into those with and without acquired resistance (nonwild-type or wild-type, respectively).  The ECV defines the highest MIC for the wild type population of isolates. ECVs are based on in vitro data only, using MIC distributions.  ECVs are not clinical breakpoints, and the clinical relevance of ECVs for a particular patient has not yet been identified or approved by CLSI or any regulatory agency.

 

When an ECV is reported, the following comment will be included: "This MIC is consistent with the Epidemiological Cutoff Value (ECV) observed in isolates (WITH/WITHOUT) acquired resistance; however, correlation with treatment outcome is unknown." (CLSI: Performance Standards for Antimicrobial Susceptibility Testing. 28th edition.  CLSI Supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute; 2018)

Day(s) and Time(s) Performed

Monday through Sunday; Continuously

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test uses a standard method. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

87070-Bacterial, Culture, Aerobic, Respiratory

87186-Antimicrobial Susceptibility, Aerobic Bacteria, MIC-per organism for routine battery (if appropriate)

87181-Susceptibility per drug and per organism for drugs not in routine battery (if appropriate)

87077-Identification Commercial Kit (if appropriate)

87077-Ident by MALDI-TOF mass spec (if appropriate)

87077-Bacteria Identification (if appropriate)

87153-Aerobe Ident by Sequencing (if appropriate)

87077-Additional Identification Procedure (if appropriate)

87147 x 3-Serologic Agglut Method 1 Ident (if appropriate)

87147-Serologic Agglut Method 2 Ident (if appropriate)

87147 x 4-Serologic Agglut Method 3 Ident (if appropriate)

87147 x 2-6-Serologic Agglut Method 4 Ident (if appropriate)

87077-Identification Staphylococcus (if appropriate)

87077-Identification Streptococcus (if appropriate)

87185-Beta Lactamase (if appropriate)

87798-Identification by PCR (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SPUTS Bacterial Culture, Aerobic + Susc 634-6

 

Result ID Test Result Name Result LOINC Value
SPUTS Bacterial Culture, Aerobic + Susc 634-6