Microbiology
Chromoblastomycosis (Culture - Isolation)
Names of Related Agents: Fonsecaea species, Exophiala species, Cladophialophora species, etc.
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| Test Includes: Isolation of fungus and morphological and/or physiological testing for identification to species level. |
Reporting
|
| Results Available: 21-28 days |
Contact #s: 512-458-7455 for prior approval
Technical questions: 512-458-7586 |
Reference
|
| Method: Slide culture |
|
| Turnaround Time: 21-28 days |
Reference Range: Negative |
| Limitations: Delay in transport of specimen could compromise isolation of organism. |
Interpretation: |
Specimen Requirements
|
| Specimen Collection: |
Sample Type: Clinical Specimen |
| Volume/Amount Required: |
Preferred Specimen: Crust; Exudate; Tissue |
| Collection/Preservation: No preservative. |
Storage Instructions: Transport specimen as soon as possible. If transport is delayed over one hour, refrigerate specimen. |
| Causes for Rejection: Specimen frozen, in culture media, in transport media or preserved will be rejected. |
Sample Container: Prefer sterile, leak-proof 50 mL conical tube. Add up to 10 mL sterile saline to crust or tissue to maintain moisture during transport. |
| Sample Test Kit: |
Availability: Testing available upon approval from Dr. Penfield. |
| Diagnostic Information: Approval for this testing must be obtained prior to shipping by telephoning Dr. Susan Penfield at 512-458-7455. |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: |
| Transport Temperature: Ambient acceptable but 2-8º C preferred for non-sterile specimens. |
Shipping Requirements: Triple-contained and packaged to meet requirements of DOT, USPS, PHS, and IATA for shipping of clinical specimens. |
Billing
|
| CPT Code: 87101, 87102, 87103 |
Fees: |
Microbiology
Chromoblastomycosis (Culture - Identification)
Names of Related Agents: Fonsecaea species, Exophiala species, Cladophialophora species, etc.
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| Test Includes: Morphological and/or physiological testing for identification to species level. |
Reporting
|
| Results Available: 14-21 days |
Contact #s: 512-458-7586 |
Reference
|
| Method: Slide Culture |
|
| Turnaround Time: 14-21days |
Reference Range: By report |
| Limitations: |
Interpretation: |
Specimen Requirements
|
| Specimen Collection: |
Sample Type: |
| Volume/Amount Required: |
Preferred Specimen: Pure culture |
| Collection/Preservation: No preservative. |
Storage Instructions: |
| Causes for Rejection: Culture infested with mites. |
Sample Container: Triple-contained. |
| Sample Test Kit: |
Availability: Tested 5 days/week: Monday – Friday. |
| Diagnostic Information: Fungal isolates (pure culture) submitted to this Laboratory for definitive identification. Drug susceptibility testing on these organisms not available at TDSHS laboratory. |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: |
| Transport Temperature: Room temperature |
Shipping Requirements: Triple-contained and packaged to meet rigorous performance tests as outlined in the DOT, USPS, PHS, and IATA regulations for shipping of infectious substances. |
Billing
|
| CPT Code: 87101, 87102, 87103 |
Fees: |
Microbiology
Clonorchiasis (Microscopic – Direct Concentration)
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| Test Includes: Microscopic examination |
Reporting
|
| Results Available: 1 day |
Contact #s: (512) 458-7560 |
Reference
|
| Method: Microscopic examination |
|
| Turnaround Time: 1 day |
Reference Range: No parasites found |
| Limitations: The specimen must be sent in a fresh (less than 5 hours old) or in formalin. |
Interpretation: A report of no parasites found is indicative of no visible parasites in the specimen. |
Specimen Requirements
|
| Specimen Collection: Fresh feces, flukes, tissue sections, or bile |
Sample Type: Feces; Bile; Tissue Section; Fluke ID |
| Volume/Amount Required: > 10 g stool or > 10 mL liquid stool, small amount of tissue or bile. |
Preferred Specimen: Feces; Bile; Tissue Section; Fluke ID |
| Collection/Preservation: the specimen must be sent in a fresh (less than 5 hours old) or in formalin. Adult fluke should be submitted in ethylalcohol. |
Storage Instructions: ambient temperature |
| Causes for Rejection: Unpreserved stool> 5 hours old; |
Sample Container: Clean, dry leak-proof container. |
| Sample Test Kit: |
Availability: Monday-Friday |
| Diagnostic Information: For detection of eggs in fecal specimens, the specimen must be sent in a fresh (less than 5 hours old) or in formalin. Adult fluke should be submitted in ethylalcohol. Referred material accepted from hospital, private and reference labs. |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: Body fluids handled with universal precautions. |
| Transport Temperature: Ambient temperature |
Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens. |
Billing
|
| CPT Code: 87015 |
Fees: |
Microbiology
Clostridium difficile Culture (Identification)
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| Test Includes:Rapid ANA II, API anaID; GLC, conventional biochemicals |
Reporting
|
| Results Available: 7-10 days |
Contact #s: (512) 458-7582 |
Reference
|
| Method: Rapid ANA II, API ana ID GLC Conventional biochemicals. |
| Turnaround Time: 7-10 days |
Reference Range: By report |
| Limitations: Routine toxin testing for C. difficile is not performed at this laboratory. Transport method must be suitable for anaerobic conditions or organisms may not be viable for testing. |
Interpretation: Toxigenic culture tests C. difficile isolates for toxin production and has higher sensitivity and equivalent specificity compared to the cytotoxicity assay. |
Specimen Requirements
|
| Specimen Collection: |
Sample Type: Pure culture under anaerobic conditions. |
| Volume/Amount Required: One culture per patient. |
Preferred Specimen: Pure culture under anaerobic conditions. |
| Collection/Preservation: Must be maintained under anaerobic conditions. |
Storage Instructions: Store under anaerobic conditions, ambient temperature. |
| Causes for Rejection: Shipped under aerobic conditions; no identifying marks on sample and/or paperwork. |
Sample Container: Anaerobic containers required. |
| Sample Test Kit: |
Availability: Tested Monday – Friday. |
| Diagnostic Information: See Anaerobic Bacterial Culture (Identification). |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: Handle as infectious agent. |
| Transport Temperature: Ambient temperature |
Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents. |
Billing
|
| CPT Code: 87076 |
Fees: |
Microbiology
Clostridium perfringens (Culture - Isolation)
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| Test Includes: Rapid ANA II, API anaID; GLC, conventional biochemicals. |
Reporting
|
| Results Available: 7-10 days |
Contact #s: (512) 458-7582 |
Reference
|
| Method: Rapid ANA II, API ana ID GLC Conventional biochemicals. |
| Turnaround Time: 7-10 days |
Reference Range: No Clostridium perfringens isolated |
| Limitations: Food samples are tested for outbreaks investigated by the IDEAS department of TDSHS only. All samples must be collected by a sanitarian or appointee. |
Interpretation: Isolation of C. perfringens from a food source is indicative of food poisoning. |
Specimen Requirements
|
| Specimen Collection: Food |
Sample Type: Food |
| Volume/Amount Required: 25 grams of each type of food for each pathogen tested. |
Preferred Specimen: Food |
| Collection/Preservation: Food must be collected by a sanitarian and transported at 2-8° C. |
Storage Instructions: 2-8° C. |
| Causes for Rejection: insufficient amount, improperly collected or stored. |
Sample Container: Clean, dry, leak-proof containers |
| Sample Test Kit: |
Availability: Monday-Friday. Outbreak testing available on Saturday with prior arrangements. |
| Diagnostic Information: See instructions Food Poisoning (Culture - Isolation). Testing performed for Epidemiological investigations approved by the IDEAS department, only. |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: Food samples according to FDA protocols for collection and transport. Chain of custody must be used if possibility of legal issues exists. |
| Transport Temperature: 2-8° C |
Shipping Requirements: Leak-proof containers, overnight delivery. |
Billing
|
| CPT Code: 87075 |
Fees: |
Microbiology
Clostridium perfringens (Culture Identification)
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| Test Includes: Rapid ANA II, GLC, conventional biochemicals |
Reporting
|
| Results Available: 7-10 days |
Contact #s: (512) 458-7582 |
Reference
|
| Method: Rapid ANA II, GLC, conventional biochemicals. |
| Turnaround Time: 7-10 days |
Reference Range: By report |
| Limitations: Transport method must be suitable for anaerobic conditions or organisms may not be viable for testing. |
Interpretation: Growth and results of biochemical tests indicate type of organism. |
Specimen Requirements
|
| Specimen Collection: Pure culture |
Sample Type: Pure culture under anaerobic conditions. |
| Volume/Amount Required: one specimen per patient. |
Preferred Specimen: Pure culture under anaerobic conditions. |
| Collection/Preservation: Must be collected under anaerobic conditions. |
Storage Instructions: Store under anaerobic conditions at ambient temperature. |
| Causes for Rejection: Shipped under aerobic conditions; Broken in transport. |
Sample Container: Anaerobic transport medium. |
| Sample Test Kit: |
Availability: Tested Monday – Friday. |
| Diagnostic Information: See Anaerobic Bacterial Culture (Identification). |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: Infectious agents, anaerobic conditions |
| Transport Temperature: Ambient temperature |
Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents. |
Billing
|
| CPT Code: 87076 |
Fees: |
Microbiology
Clostridium perfringens Culture (Toxin Detection)
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| Test Includes: Toxin detection |
Reporting
|
| Results Available: 2 days |
Contact #s: (512) 458-7562 |
Reference
|
| Method: |
|
| Turnaround Time: 2 days |
Reference Range: No toxin detected |
| Limitations: |
Interpretation: |
Specimen Requirements
|
| Specimen Collection: |
Sample Type: |
| Volume/Amount Required: |
Preferred Specimen: Food |
| Collection/Preservation: |
Storage Instructions: |
| Causes for Rejection: |
Sample Container: |
| Sample Test Kit: |
Availability: |
| Diagnostic Information: See Food Poisoning Culture (Toxin Detection) |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: |
| Transport Temperature: 2-8° C |
Shipping Requirements: |
Billing
|
| CPT Code: |
Fees: |
Microbiology
Clostridium perfringens Culture –(Typing)
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| Test Includes: Test is not performed at TDSHS, Test is performed at the CDC. |
Reporting
|
| Results Available: |
Contact #s: |
Reference
|
| Method: |
|
| Turnaround Time: Dependent on CDC report |
Reference Range: |
| Limitations: |
Interpretation: |
Specimen Requirements
|
| Specimen Collection: n/a |
Sample Type: Pure culture under anaerobic conditions. |
| Volume/Amount Required: one specimen per patient. |
Preferred Specimen: Pure Culture under anaerobic conditions. |
| Collection/Preservation: Pure culture maintained under anaerobic conditions. |
Storage Instructions: Ambient temperature, anaerobic condition |
| Causes for Rejection: Culture received under aerobic conditions, incomplete information on submission form, prior approval not secured before shipment. |
Sample Container: anaerobic transport container. |
| Sample Test Kit: |
Availability: Monday-Thursday, unless prior arrangements have been made for Friday ship out. |
| Diagnostic Information: Isolates are sent to the CDC for typing with prior approval. See instructions Food (Culture –(Identification). |
Specimen Submission
|
| Required Request Form: G-2A |
Specimen Handling: Infectious agent |
| Transport Temperature: Ambient temperature |
Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents. |
Billing
|
| CPT Code: 87147 |
Fees: |
Microbiology
Coccidioidomycosis (Culture – Isolation)
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| Test Includes: Isolation of fungus and identification by Gen-Probe Accuprobe test |
Reporting
|
| Results Available: 21-28 days |
Contact #s: 512-458-7455 for prior approval
Technical questions: 512-458-7586 |
Reference
|
| Method: Accuprobe culture confirmation test; hybridization of ribosomal RNA to probe detected by chemiluminesence |
| Turnaround Time: 21-28 days |
Reference Range: Negative |
| Limitations: Delay in transport of specimen could compromise isolation of organism. |
Interpretation: Positive by DNA Probe Test means that the probe detected ribosomal RNA of Coccidioides immitis from the isolate. |
Specimen Requirements
|
| Specimen Collection: |
Sample Type: Clinical specimen |
| Volume/Amount Required: 3 mL to 15 mL |
Preferred Specimen: Sputum; Exudate; Tissue |
| Collection/Preservation: No preservative |
Storage Instructions: Transport specimen as soon as possible. If transport is delayed over one hour, refrigerate specimen. |
| Causes for Rejection: Specimens received frozen, in formalin, or in culture medium will be rejected. Swabs are discouraged unless the only specimen available; submit swabs in 5 mL sterile saline. |
Sample Container: Triple-contained. Sterile, leak-proof, 50 mL conical tube preferred for primary container. Add up to 10 mL of sterile saline to tissue if needed to maintain moisture during transport. |
| Sample Test Kit: |
Availability: Testing available upon approval by Dr. Penfield. |
| Diagnostic Information: Approval for this testing must be obtained prior to shipping by telephoning Dr. Susan Penfield at 512-458-7455. |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: |
| Transport Temperature: Ambient acceptable but 2-8º C preferred for non-sterile specimens. |
Shipping Requirements: Triple-contained and packaged to meet requirements of DOT, USPS, PHS, and IATA for shipping of clinical specimens. |
Billing
|
| CPT Code: 87101, 87102, 87103 |
Fees: |
Microbiology
Coccidioidomycosis (Culture – Genetic Probe - Culture Confirmation)
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| Test Includes: Identification by Gen-Probe Accuprobe Test |
Reporting
|
| Results Available: 7-10 days |
Contact #s: 512-458-7586 |
Reference
|
| Method: Accuprobe culture confirmation test; hybridization of ribosomal RNA to probe detected by chemiluminesence |
| Turnaround Time: 7-10 days |
Reference Range: By Report |
| Limitations: Positive DNA Probe Test does not mean the isolate is still viable. |
Interpretation: Positive by DNA Probe Test means that the probe detected ribosomal RNA of Coccidioides immitis from the isolate. |
Specimen Requirements
|
| Specimen Collection: |
Sample Type: |
| Volume/Amount Required: |
Preferred Specimen: Pure Culture |
| Collection/Preservation: No preservative. |
Storage Instructions: |
| Causes for Rejection: Culture infested with mites. |
Sample Container: Triple-contained |
| Sample Test Kit: |
Availability: Accuprobe test is run once weekly. |
| Diagnostic Information: Fungal isolates (pure culture) submitted to this Laboratory for definitive identification. Drug susceptibility testing on these organisms not available at TDSHS laboratory. |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: |
| Transport Temperature: Room temperature |
Shipping Requirements: Triple-contained and packaged to meet rigorous performance tests as outlined in the DOT, USPS, PHS, and IATA regulations for shipping of infectious substances. |
Billing
|
| CPT Code: 87101, 87102, 87103 |
Fees: |
| Test Includes: Membrane filtration or Multitube fermentation |
Reporting
|
| Results Available: 3 days |
Contact #s: (512) 458-7562 |
Reference
|
| Method: membrane filtration or Multitube fermentation method |
| Turnaround Time: 3 days |
Reference Range: Less than 2.2 MPN/ 100 mL |
| Limitations: |
Interpretation: Values of fecal coliform less than 2.2 MPN/100 mL is considered a negative test. Values are dependent on age of sample and transport temperature. |
Specimen Requirements
|
| Specimen Collection: Bottled water |
Sample Type: Water |
| Volume/Amount Required: 100 mL |
Preferred Specimen: Water |
| Collection/Preservation: Sealed bottles of water, ambient temperature |
Storage Instructions: ambient temperature |
| Causes for Rejection: Sample too old |
Sample Container: Water bottle collectors |
| Sample Test Kit: |
Availability: Monday-Sunday |
| Diagnostic Information: Test is available only to health officials with 1-day notice. Sample must be iced and less than 6 hours old. |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: Specimen collected according to EPA protocol for water testing. |
| Transport Temperature: 2-8° C |
Shipping Requirements: On ice within 6 hours of collection. |
Billing
|
| CPT Code: 87046 |
Fees: |
Microbiology
Coliform – Total Colilert
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| Test Includes: Colilert 18 hour |
Reporting
|
| Results Available: 1 day |
Contact #s: (512) 458-7611 |
Reference
|
| Method: Mug fluoresecent detection |
|
| Turnaround Time: 1 day |
Reference Range: Absence of coliform |
| Limitations: Test results are dependent on fluorescent display. Other substances that fluoresce can give false positive test results. |
Interpretation: Report is indicative of no detectable levels of fecal coliforms. Test results do not indicate bacterial load of other types of organisms. |
Specimen Requirements
|
| Specimen Collection: water |
Sample Type: water |
| Volume/Amount Required: 100 mL |
Preferred Specimen: water |
| Collection/Preservation: Collect 100 mL following instructions provided in collection kit. Store at ambient temperature. Transport to laboratory within 30 hours of collection. |
Storage Instructions: Ambient temperature |
| Causes for Rejection: Sample > 30 hours, incorrect collection bottle. |
Sample Container: 100 mL sterile bottle with sodium thiosulfate. |
| Sample Test Kit: Idexx Colilert 18 hour |
Availability: Monday-Sunday |
| Diagnostic Information: Sample must be in container provided by TDSHS. Water must be from a closed system and less than 30 hours old. Fee for service is charged. |
Specimen Submission
|
| Required Request Form: G-2B |
Specimen Handling: Specimens must be collected and handled following instructions included in the package. |
| Transport Temperature: Ambient temperature |
Shipping Requirements: Within 30 hours of collection. |
Billing
|
| CPT Code: 87046 |
Fees: |
Microbiology
Colorado Tick Fever (Serological – Forwarded by TDSHS to CDC for testing.)
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| Test Includes: |
Reporting
|
| Results Available: |
Contact #s: |
Reference
|
| Turnaround Time: 3 weeks |
Reference Range: <1.00 (Nonreacative) |
| Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. |
Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection. |
Specimen Requirements
|
| Specimen Collection: Venipuncture |
Sample Type: |
| Volume/Amount Required: 10 mL whole blood |
Preferred Specimen: Paired Sera |
| Collection/Preservation: Red top or tiger top tube |
Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C |
| Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing |
Sample Container: Red top or tiger top tube |
| Sample Test Kit: |
Availability: |
| Diagnostic Information: Prior notification is requested (512) 458-7760. A detailed patient history is required. Serum specimens are forwarded to the CDC. Serum specimens are to be collected at least 14 days apart. A significant titer increase is evidence of current or recent infection. Since IgM antibodies appear 14-16 days after onset, PCR test, with prior arrangement with CDC, can be performed on blood specimens collected within 8 days after onset. |
Specimen Submission
|
| Required Request Form: G-2A |
Specimen Handling: Use Universal Precautions |
| Transport Temperature: Ambient temperature for specimens on the blood clot, separated serum at 2-8° C (refrigerated) or -20° C (frozen). |
Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8° C), or frozen (-20° C) and mailed on dry ice. |
Billing
|
| CPT Code: 86790 |
Fees: |