Actinomycete, High Performance Liquid Chromatography

Laboratory Fee Schedule
Procedure: MCD0276A
CPT: 87143

 

Synonym(s): Actino, Nocardia, Actinomadura
Requisition Form G-MYCO
Test Description Test for the identification of aerobic Actinomycete isolates, not Mycobacterium, referred to DSHS Laboratory
Pre-Approval Needed N/A
Supplemental Information Required N/A
Supplemental Form(s) N/A  
Performed on Specimens from (sources) Pure isolate from human sources
Sample/Specimen Type for Testing Aerobic Actinomycete pure isolate in liquid or on solid culture medium
Minimum Volume/Size Required
  • Liquid culture - 2.0 mL
  • Solid culture - Single mature colony
Storage/Preservation Prior to Shipping Ambient
Transport Medium N/A
Specimen Labeling
  • At least two patient identifiers required on specimen (e.g., patient full name, date of birth, medical record number). 
  • Three patient identifiers are preferred. 
  • Patient identifiers on specimen label must exactly match identifiers on submission form. (e.g., abbreviated name on label and full name on form is not acceptable.)
  • Additional DSHS Laboratory specimen labeling guidelines available online here.
Shipping and Specimen Handling Requirements
  • Ship according to Dangerous Goods Regulations, IATA, and/or CFR 49
  • Category B shipping applies for unidentified isolates
Method
  • High performance liquid chromatography (HPLC)
Turn-around Time HPLC is one test in a battery of tests that take 3 to 4 weeks for full identification.
Interferences/Limitations
  • HPLC may only detect the predominant organism in a mixed culture. 
  • HPLC cannot definitively identify an aerobic Actinomycete. 
  • Additional testing methods are needed provide definitive identification.
Common Causes for Rejection
  • Cultures infested with mites
  • Cultures broken in transit
  • Missing identifiers on specimen or submission form
  • Mismatch between specimen and/or submission form identifiers
Additional Information
  • Within one week of isolate receipt, and based on the HPLC analysis, the absence or presence of cell wall mycolic acids can be determined and/or a presumptive identification made based on mycolic acid pattern similarity to a given genus.