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HelpTest ID: CFRCS Bacterial Culture, Cystic Fibrosis with Antimicrobial Susceptibilities, Varies
Shipping Instructions
Specimen must be received in laboratory within 48 hours of collection at refrigerated temperature. Specimens received frozen will be rejected.
Necessary Information
Specimen source is required
Specimen Required
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Sputum, expectorated or induced
Patient Preparation: Have the patient brush their teeth or gargle with water immediately before specimen collection. This reduces the number of contaminating oropharyngeal bacteria.
Container/Tube: Sterile container
Specimen Volume: Entire collection
Acceptable:
Specimen Type: Bronchial aspirate or washing, sinus aspirate, bronchoalveolar lavage, endotracheal, or tracheal
Container/Tube: Sterile container
Specimen Volume: Entire collection
Specimen Type: Throat swab
Supplies:
Culturette (BBL Culture Swab) (T092)
BD E-Swab (T853)
Container/Tube: Culture transport swab (Dacron or rayon swab with aluminum or plastic shaft with either Stuart or Amies liquid medium), or ESwab
Specimen Volume: Entire collection
Useful For
Detecting disease-causing aerobic bacteria in specimens from patients with cystic fibrosis
Determining the in vitro antimicrobial susceptibility of potentially pathogenic aerobic bacteria, if appropriate
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COMM | Identification Commercial Kit | No, (Bill Only) | No |
| 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 |
| MIC | Susceptibility, 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 |
| MECAB | mecA PCR Test, Bill Only | No, (Bill Only) | No |
Testing Algorithm
When this test is ordered, the reflex tests may be performed at an additional charge. Antimicrobial agent appropriate to the organism and specimen source will be tested according to Mayo Clinic's practice.
The following tables provide a listing of the antimicrobials routinely tested in the 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.
-Aerobic Gram-Negative Bacilli Antimicrobials
-Additional Gram-Negative Bacteria Antimicrobials
-Staphylococcus, Enterococcus, Bacillus, and Related Genera Antimicrobials
Special Instructions
Method Name
Conventional Culture Technique with Minimal Inhibitory Concentration (MIC) (Agar Dilution or Broth Microdilution or Gradient Diffusion) or Disk Diffusion (if appropriate)
Reporting Name
Bacterial Culture,Cystic Fib +SuscSpecimen Type
VariesSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Refrigerated | 48 hours |
Clinical Information
Life expectancy of patients with cystic fibrosis (CF) has increased steadily over the past 50 years, in large part due to improvements in the management of lung disease in this patient population. Still, chronic lung infection is responsible for 75% to 85% of deaths in patients with CF. Appropriate treatment for the causative organism can reduce morbidity and mortality.
The number of microbial species associated with CF lung disease is relatively limited. These include Pseudomonas aeruginosa (mucoid and nonmucoid), Staphylococcus aureus, Burkholderia cepacia complex, Stenotrophomonas maltophilia, other non-fermenting gram-negative rods, Haemophilus influenzae, and Streptococcus pneumoniae. Nontuberculous mycobacteria and Aspergillus species may also play a role in CF lung disease, in addition to common respiratory viruses. This culture is specifically designed and utilizes conventional and additional selective media (compared to non-CF respiratory cultures) to isolate bacteria commonly associated with pulmonary disease in patients with CF.
In selected centers, lung transplantation is performed on patients with CF. This test is appropriate for lung transplant patients with underlying CF because they can continue to harbor the same types of organisms as they did pretransplantation. Patients with CF may be colonized or chronically infected by these organisms over a long period of time.
Antimicrobial susceptibility testing determines the minimal inhibitory concentration (MIC) value of selected antimicrobial agents against isolated potentially pathogenic bacteria. The MIC is the lowest antimicrobial concentration (of a series of increasing concentrations) that inhibits growth of the bacterium. Agar dilution MIC testing is performed by testing for growth of bacteria on agar plates containing varying concentrations of antimicrobial agents.
For each organism-antimicrobial agent combination, the Clinical and Laboratory Standards Institute and/or the European Committee on Antimicrobial Susceptibility Testing provide interpretive criteria for determining whether the MIC should be interpreted as susceptible, susceptible-dose dependent, intermediate, nonsusceptible, resistant, or epidemiological cutoff value.
Reference Values
No growth or usual microbiota
Susceptibility results are reported as minimal 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 breakpoint setting organizations, either the Clinical and Laboratory Standards Institute (CLSI) or the European Committee on Antimicrobial Susceptibility Testing (EUCAST), as applicable.
In some instances, an interpretive category cannot be provided based on available data; therefore, the following comment will be included on the report: There are no established interpretive guidelines for agents reported without interpretations.
For information regarding CLSI and EUCAST susceptibility interpretations, see Susceptibility Interpretative Category Definitions.
Interpretation
A negative test result is no growth of bacteria or growth of only usual microbiota. A negative result does not rule out all causes of infectious lung disease. For more information, see Cautions.
Organisms associated with lower respiratory tract infections are reported.
For positive test results, disease-causing bacteria are identified. Patients with cystic fibrosis may be colonized or chronically infected by some organisms over a long period of time, therefore, positive results must be interpreted in conjunction with previous findings and the clinical picture to appropriately evaluate results.
A susceptible category result and a low minimum inhibitory concentration value indicate in vitro susceptibility of the organism to the antimicrobial tested.
For interpretation of various antimicrobial susceptibility interpretive categories (ie, susceptible, susceptible-dose dependent, intermediate, nonsusceptible, resistant, or epidemiological cutoff value), see Reference Values.
Clinical Reference
1. Miller JM, Binnicker MJ, Campbell S, et al. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018;67(6):e1-e94. doi:10.1093/cid/ciy381
2. York MK, Gilligan P, Alby K: Lower respiratory tract cultures. In: Leber AL, ed. Clinical Microbiology Procedures Handbook, Vol 1, 4th ed. ASM Press; 2016:section 3.11.2
3. LiPuma JJ, Currie BJ, Peacock SJ, VanDamme PAR: Burkholderia, Stenotrophomonas, Ralstonia, Cupriavidus, Pandoraea, Brevundimonas, Comamonas, Delftia, and Acidovorax. In: Carroll KC, Pfaller MC, eds. Manual of Clinical Microbiology. 12th ed. ASM Press; 2019:807-828
Day(s) Performed
Report Available
4 to 12 daysTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
87070-Bacterial, Culture, cystic fibrosis, respiratory
87077-Identification commercial kit (if appropriate)
87077-Ident by MALDI-TOF mass spec (if appropriate)
87077-Bacteria Identification (if appropriate)
87077-Additional Identification procedure (if appropriate)
87077-Identification Staphylococcus (if appropriate)
87077-Identification Streptococcus (if appropriate)
87147 x 1-3-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)
87153-Aerobe ident by sequencing (if appropriate)
87150-Identification by PCR (if appropriate)
87185-Beta lactamase (if appropriate)
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)
87150-mec A PCR (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CFRCS | Bacterial Culture,Cystic Fib +Susc | 44798-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CFRCS | Bacterial Culture,Cystic Fib +Susc | 44798-7 |
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
mml-cysticfibrosis