Respiratory Culture and Stain
- 87205 - QTY (1)
- 87070 - QTY (1)
- Culture, Aerobic Respiratory
Cleveland Clinic Laboratories
|Volume||Type||Container||Collect Temperature||Transport Temperature||Special Instructions|
|2 mL||Aspirate, tracheal||Sterile container||Ambient||If tracheal aspirate is microscopically deemed unsatisfactory, it will be rejected.|
|2 mL||Washings, bronch||Sterile container||Ambient|
|2 mL||Sputum||Sterile container||Ambient||First morning specimen is preferred. If specimen is microscopically consistent with saliva, it will be rejected.|
Sun - Sat
Gram stain and semi-quantitative culture for the recovery of aerobic bacteria is performed on sputum, tracheal aspirates and bronchial wash specimens. Prior to sputum collection, instruct patient to rinse mouth with water. Scoring of sputum and endotracheal aspirate gram stains is used to screen out improperly collected specimens that are contaminated with oral flora. Bronchoalveolar lavage and protected brush specimens should be ordered as bronchoscopy culture (BALCSM). Separate test orders are required to rule out the presence of mycobacteria, fungi, viruses, and atypical bacterial pathogens in respiratory specimens. Blood cultures are recommended for patients being evaluated for pneumonia. If culture is positive, identification will be performed on clinically significant, fast-growing, nonfastidious aerobic organisms at an additional charge. Identification CPT codes that may apply include: 87077, 87106, 87107, 87153, 87158. Antimicrobial susceptibilities are performed when indicated, and the following CPT codes may apply: 87181, 87184, 87185, 87186.
The most common etiologies of community acquired pneumonia recovered in culture are Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Ventilator-associated pneumonia can be caused by many different pathogens with Staphylococcus aureus and gram negative bacilli the most common etiologies. Distinguishing colonizing organisms from pathogens can be difficult. Susceptibility testing is performed on potential pathogens in amounts considered significant (typically defined as moderate growth in sputum or tracheal aspirate specimens that is greater than normal background respiratory flora, pure culture, or predominance on Gram stain). Correlation of culture results with clinical findings is essential.