Texas Department of State Health Services

Microbiology Lab Tests - D-E

Microbiology
Dengue Fever (Serological – Enzyme Immunoassay (IgM capture and IgG)
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Test Includes:

Reporting

Results Available: Contact #s:

Reference

Turnaround Time:  5-7 days Reference Range:  <1.00
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. Interpretation:

Specimen Requirements

Specimen Collection: Venipuncture Sample Type:
Volume/Amount Required: 10 mls whole blood Preferred Specimen:  Single Serum; 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
Diagnostic Information:  These assays detect IgM and IgG antibodies against all four Dengue fever types. Except for very early IgM responses, the immune response to Dengue fever is not type specific. While a single serum may be tested, a second serum collected 10-14 days later may be required for best evidence for current infection.  Paired sera are especially important when the acute phase sample is taken within the six days following onset of symptoms. In most patients, Dengue antibodies are detectable after the sixth day. Cross-reactions occur with Yellow Fever immunization and other arboviruses are known to occur, but the extent and degree of cross-reaction varies. This test is performed once per week.

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: 87252, 87253 Fees:

Microbiology
Dermatomycosis (Culture - Isolation)
Names of Related Agents:  Trichophyton species, Microsporum species, etc.
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Test Includes: Isolation of fungus and morphological and physiological tests for identification to species level.

Reporting

Results Available: 14-21 days Contact #s: 512-458-7455 for prior approval
Technical questions:  512-458-7586

Reference

Method: Morphological and physiological testing for identification
Turnaround Time:  14-21 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:  Tissue; Scrapings; Nail; Hair
Collection/Preservation: No preservative Storage Instructions: Transport specimen as soon as possible.  Dermatophytes are sensitive to lower temperatures so skin scrapings, nail, or hair clippings should be held and shipped at room temperature.
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.  Skin scrapings, nail, or hair clipping should be kept and shipped dry.
Sample Test Kit: Availability: Testing available upon approval of 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:  Room temperature Shipping Requirements: Triple-contained and packaged to meet requirements of DOT, USPS, PHS, and IATA for shipping of clinical specimens.

Billing

CPT Code: 87101 Fees:

Microbiology
Dermatomycosis (Culture - Identification)
Names of Related Agents:  Trichophyton species, Microsporum species, etc.
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Test Includes: Morphological and physiological tests for identification to species level.

Reporting

Results Available: 14-21 days Contact #s: 512-458-7586

Reference

Method: Morphological and physiological testing for identification
Turnaround Time:  14-21 days 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 Fees:

Microbiology
Dientamoeba fragilis (Microscopic – Trichrome Stains)
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Test Includes: Microscopic examination

Reporting

Results Available: 3 days Contact #s: (512) 458-7560

Reference

Method: Microscopic examination, Trichrome stain  
Turnaround Time:  3 days Reference Range: No parasites found
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Collect fresh feces and immediately place in PVA preservative. Sample Type: Feces fresh (less than five hours) or in PVA
Volume/Amount Required: 15 ml liquid stool or 15 g stool Preferred Specimen:  Feces fresh (less than five hours) or in PVA
Collection/Preservation: Collect fresh feces and immediately place in PVA preservative. Fresh stools not in PVA must be examined within 5 hours. Storage Instructions: Ambient temperature
Causes for Rejection: Unpreserved stools > 5 hours old Sample Container: PVA transport for Parasites
Sample Test Kit: Availability: Monday-Friday
Diagnostic Information:  Fecal specimens must be sent in PVA.  Referred material accepted from hospital, private, and reference labs

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handle body fluids using universal precautions. PVA is a poison, handle with care.
Transport Temperature:  Ambient  temperature Shipping Requirements: Triple contained, In accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87209 Fees:

Microbiology
Diptheria Culture –(Isolation)
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Test Includes: Conventional biochemicals, toxigencity testing

Reporting

Results Available: 3-7 days Contact #s: (512) 458-7582

Reference

Method: Conventional biochemicals  
Turnaround Time:  3-7 days Reference Range:  No C. diphtheriae isolated.
Limitations: Specimen should be taken prior to antimicrobial therapy. Organisms must be viable for culture studies. Interpretation: No C. diphtheriae isolated indicates that no viable organism was present in the specimen submitted. If clinical symptoms are indicative of diphtheria infection, a specimen should be submitted to the CDC for PCR studies.

Specimen Requirements

Specimen Collection: Throat swab Sample Type: Throat swab
Volume/Amount Required: One throat swab per patient. Preferred Specimen:  Throat Swab submitted on Loeffler’s slant or in Amies or Stuart’s transport media.
Collection/Preservation: Collect by throat swab using a cotton-tipped or polyester-tipped swab. Swabs taken below the membrane are most valuable. A portion of the membrane may be submitted for culture, but these do not always yield C. diphtheriae. Storage Instructions: Stored between 2-25°C.
Causes for Rejection: Incorrect source of specimen. Specimen > 24 hours not in transport medium. Sample Container: Swab transport system.
Sample Test Kit: Availability: Tested Monday – Friday.
Diagnostic Information:  Swabs should be submitted on Loeffler’s Slant or in Amies or Stuart transport medium.  Prior notification of the Clinical Bacteriology Section at 512-458-7582

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature:  2-25° C Shipping Requirements: Triple contained, In accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87070 Fees:

Microbiology
Diptheria Culture –(Identification)
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Test Includes: Conventional biochemicals

Reporting

Results Available: 5-10 days Contact #s: (512) 458-7582

Reference

Method: Conventional biochemicals  
Turnaround Time:  5-10 days Reference Range:  By report
Limitations: Organism must be viable. Interpretation: Identification of C. diphtheriae must be considered significant. Toxin studies must be performed to demonstrate that the strain is toxigenic.

Specimen Requirements

Specimen Collection: Collect by throat swab using a cotton-tipped or polyester-tipped swab. Swabs taken below the membrane are most valuable. A portion of the membrane may be submitted for culture, but these do not always yield C. diphtheriae. Sample Type: Pure culture.
Volume/Amount Required: One culture per patient. Preferred Specimen:  Pure Culture on agar slant.
Collection/Preservation: Agar slant, preferably Loeffler’s media, ambient temperature. Storage Instructions: Ambient temperature
Causes for Rejection: Broken or compromised container. Sample Container: Agar slant in screw cap tube.
Sample Test Kit: Availability: Tested Monday – Friday.
Diagnostic Information:  See Aerobic Bacterial Culture (Isolation).

Specimen Submission

Required Request Form: G-2B Specimen Handling: Infectious agent, biosafety level 2.
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained, In accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87070 Fees:

Microbiology
Diptheria Culture – (Toxigenicity)
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Test Includes: Diphtheria toxin testing by precipitate test.

Reporting

Results Available: 2-7 days Contact #s: (512) 458-7582

Reference

Method: Precipitate test  
Turnaround Time:  2-7 days   Reference Range:  No toxin demonstrated
Limitations: Organism must be viable and grown on media such as Loeffler’s that supports production of toxin. Interpretation: No toxin demonstrated is indicative of a non toxigenic strain of C. diphtheriae or a weakly toxigenic strain. Additional testing may be necessary dependent on the clinical history and symptoms of the patient.

Specimen Requirements

Specimen Collection: Throat swab Sample Type: Pure culture, Throat swab
Volume/Amount Required: One specimen per patient. Preferred Specimen:  Pure Culture safely contained; Throat Swab submitted on Loeffler’s slant or in Amies or Stuart’s transport.  
Collection/Preservation: Swab throat and keep in original container for transport. Storage Instructions: May be stored between 2-25° C.
Causes for Rejection: No identifying marks on sample and/or paperwork, broken container. Sample Container: Transport tube.
Sample Test Kit: Availability: Tested Monday – Friday
Diagnostic Information:  Pure culture submitted on Loeffler’s Slant allows for rapid testing. 

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handle as infectious agent.
Transport Temperature:  2-25° C Shipping Requirements: Triple contained, In accordance with federal shipping regulations for infectious agent.

Billing

CPT Code: 87070 Fees:

Microbiology
Diphyllobothriasis (Microscopic – Direct Concentration)
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Test Includes:

Reporting

Results Available: Contact #s: (512) 458-7560

Reference

Method: Microscopic – Direct Examination  
Turnaround Time:  3 days Reference Range:  No parasites found
Limitations: Fecal Specimens must be sent in Formalin Interpretation:  No parasites found indicates that there were no visibly detectable parasites in the specimen.

Specimen Requirements

Specimen Collection: Fresh feces Sample Type:  Feces; Proglottid Scolex
Volume/Amount Required: 15 ml liquid stool, 15 g stool Preferred Specimen:  Feces; Proglottid Scolex
Collection/Preservation: Fecal specimens must be sent in formalin. Storage Instructions: Ambient temperature
Causes for Rejection:  Unpreserved stool > 5 hours old . Sample Container: Formalin transport for parasites.
Sample Test Kit: Availability: Monday - Friday
Diagnostic Information:  Fecal specimens must be sent in formalin.  Proglottids must be sent in ethyl alcohol or formalin.  Referred material accepted from hospital, private, and reference labs.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handle body fluids using universal precautions. Formalin is a poison, handle with care.
Transport Temperature:  Ambient (Room) temperature Shipping Requirements: Triple contained, In accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87015 Fees:


Microbiology
Eastern Equine Encephalitis (Serological – Enzyme Immunoassay – IgG and IgM)
Related Agents : Arbovirus, EEE
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Reporting

Results Available: Contact #s:

Reference

Method: EIA  
Turnaround Time:  5-7 days Reference Range:  <1.00 (Nonreactive)
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. May be cross reactivity with other arthropod borne viruses. 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 mls whole blood Preferred Specimen:  Single Serum; 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: Testing performed daily
Diagnostic Information:  The presence of IgM indicates recent infection.  A fourfold titer increase on paired sera is required for best evidence of current infection.  Cross-reactions occur with other group A arboviruses, i.e. Western Equine Encephalitis. Human infections are seasonal, from mid- to late summer, occurring from New England to Texas. The test is performed once per week.

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: 86652 Fees:

Microbiology
Echinococcosis (Serological – Forwarded by TDSHS to CDC for testing)
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Test Includes:

Reporting

Results Available: Contact #s:

Reference

Method:  
Turnaround Time:  3 weeks Reference Range:  <1:8
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. Interpretation:

Specimen Requirements

Specimen Collection: Venipuncture Sample Type: Serum
Volume/Amount Required: 10 mls whole blood Preferred Specimen:  Single Serum
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.  Increasing antibody values between acute and convalescent specimens is considered evidence of recent or current infection. Liver cysts yield titers of 1:256 or higher; cysts at other sites stimulate antibody production less.  Titers persist for years even after surgical removal of cysts.  Cross-reactions to cysticercosis do occur.

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: 86682 Fees:

Microbiology
Echinococcosis (Microscopic - Direct)
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Test Includes:

Reporting

Results Available: Contact #s:

Reference

Method:  
Turnaround Time:  24 hours Reference Range: 
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Hydatid Cyst Aspirate
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  Microscopic examination of hydatid cyst fluid may reveal the hydatid sand or, under certain circumstances, just the hooklets.

Specimen Submission

Required Request Form: G-2B Specimen Handling:
Transport Temperature:  Ambient (Room) temperature Shipping Requirements:

Billing

CPT Code: 87177 Fees:

Microbiology
Ehrlichiosis (Serological - Immunofluorscence)
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Reporting

Results Available: Contact #s:

Reference

Turnaround Time:  3-5 days Reference Range:  <1:64 (Nonreactive)
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 mls 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: Test performed every Tuesday and Thursday
Diagnostic Information:  Human ehrlichiosis is a tick-borne disease caused by rickettsial-like agents. Sera are tested for presence of antibodies to Ehrlichia chaffeencis.  Single IgG IFA titers of 1:64 or greater indicate exposure. Ideally, acute and convalescent-phase serum specimens, drawn at least 4 weeks apart, should be submitted. Specimens demonstrating a four-fold rise in IgG titers between acute and convalescent samples suggest recent or current infection. Test is performed twice per week.  

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: 86666 Fees:

Microbiology
Enteric Bacteria (See Aerobic Bacterial Culture, Stool  (Isolation))
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Test Includes:

Reporting

Results Available: Contact #s:

Reference

Method:  
Turnaround Time:  Reference Range: 
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen: 
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  For Salmonella, see SalmonellosisCulture–(Identification) For Shigella, See Shigellosis Culture (Identification) For Escherichia coli, Escherichia coli 0157:H7 Culture (Identification) Escherichia coli 0157:H7 or other Shiga toxin E. coli (Toxin Testing). For Vibrio species Vibrio cholerae, ( Culture – Identification). For Yersinia, see Yersinia enterocolitica (Culture – Identification)

Specimen Submission

Required Request Form: G-2B Specimen Handling:
Transport Temperature:  Shipping Requirements:

Billing

CPT Codes: 87081 (screening), 87040, 87045, 87046, 87070, 87071, 87073 87077, 87143, 87147, 87181, 87205, 87206, 87210, 87278, 87430, 87449 Fees:

Microbiology
Enterobiasis – Pin Worm (Microscopic - Direct)
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Test Includes: Microscopic Examination

Reporting

Results Available: 1 day Contact #s: (512) 458-7560

Reference

Method: Microscopic examination  
Turnaround Time:  24 hours Reference Range:  No pinworm eggs found.
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: taped slide, worms Sample Type:  perianal; worms
Volume/Amount Required: 1 tape slide Preferred Specimen:  Taped Slide of perianal region; worms, pinworm prep kits
Collection/Preservation: using strip of clear cellulose tape sticky side outward on a microscope slide, press firmly against the perianal folds. The tape is then spread back over the slide adhesive side down. Ship in slide carrier. Storage Instructions: Ambient temperature
Causes for Rejection:  Frosted tape used. Sample Container:  Slide carrier
Sample Test Kit: Availability:  Monday-Friday
Diagnostic Information:  Use only clear, cellophane tape or manufactured paddles.  Adult worms should be submitted in EtOH or formalin.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Fecal specimen handled using universal precautions.
Transport Temperature:  Ambient temperature Shipping Requirements:  Slide carrier

Billing

CPT Code: 87172 Fees:

Microbiology
Enterovirus (Culture - Isolation)
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Test Includes: Cell culture

Reporting

Results Available: 2-14 days Contact #s: 512-458-7594

Reference

Method: Cell culture  
Turnaround Time:  2 -14 days Reference Range:  No virus isolated  
Limitations: Interpretation: A result of “No virus isolated” does not necessarily mean absence of a viral agent.  The success of virus isolation depends a great deal on the submission of the proper specimen, collected at the right time, adequately maintained, and shipped with the least possible delay.

Specimen Requirements

Specimen Collection: Specimens should be collected at an appropriate anatomic site and at the proper time after infection because viruses are generally shed for only a short period of time.  Refer to Specimen Collection by Type table for additional instructions.  Sample Type: See preferred specimen
Volume/Amount Required:
2-5 mL of CSF, 2-4g of stool, swabs in 2-4 mL of viral transport media, or tissue in enough viral transport media to prevent drying.
Preferred Specimen:  CSF; Stool; NP Swab; Vesicular Fluid; Conjunctival Fluid; Tissue
Collection/Preservation: Viral transport media. Storage Instructions: Arriving < 3-4 days after collection, store and send at 2-8° C. Arriving > 3-4 days after collection, store and send at -70° C.
Causes for Rejection: Specimens submitted on a preservative such as formalin. Sample Container: Sterile container
Sample Test Kit: Availability: Monday - Friday
Diagnostic Information:  A variety of cell monlayers are inoculated which support the growth of enteroviruses.  If characteristic CPE is observed, confirmation of identification will be performed.

Specimen Submission

Required Request Form: G-2A Specimen Handling:
Transport Temperature:  
Arriving < 3-4 days:  2-8° C 
Arriving >3-4 days:  send on dry ice
Shipping Requirements: Ship specimens in compliance with governmental regulations.

Billing

CPT Code: 87252 Fees:

Microbiology
Enterovirus (Culture – Typing)
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Test Includes: Immunofluorescence, serum neutralization

Reporting

Results Available: 1-4 weeks Contact #s: 512-458-7594

Reference

Method: Immunofluorescence, serum neutralization  
Turnaround Time:  1-4 weeks  Reference Range:  By report
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Fill monolayer tube with media if transporting at ambient temperature.  If transporting on dry ice, send 1-2 mL. Preferred Specimen:  Cell culture isolate with CPE.
Collection/Preservation: Storage Instructions: If shipment of isolate will be delayed, store isolate at -70° C.
Causes for Rejection: Sample Container: Cell culture tube or sterile cryovial.
Sample Test Kit: Availability: Monday - Friday
Diagnostic Information:  Serotyping of clinical isolates is based on immunofluorescence tests using monoclonal antibodies or serum neutralization tests using polyclonal antibodies.  

Specimen Submission

Required Request Form: G-2A Specimen Handling:
Transport Temperature:
Cell culture tube with CPE:  ambient temperature.
Frozen isolate:  on dry ice
Shipping Requirements: Ship specimens in compliance with governmental regulations.

Billing

CPT Code: 87253 Fees:

Microbiology
Erysipeloid (Culture – Isolation)
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Test Includes: Conventional biochemicals

Reporting

Results Available: 7-21 days Contact #s: (512) 458-7582

Reference

Method:  Conventional biochemicals  
Turnaround Time: 7-21 days Reference Range: No bacteria isolated. 
Limitations: Specimen should be collected before initiating antibiotic therapy. Interpretation: No bacteria isolated indicates that there were no viable organisms in the specimen submitted.

Specimen Requirements

Specimen Collection:  venipuncture, biopsy Sample Type:  blood, biopsy
Volume/Amount Required:  20 ml whole blood, Preferred Specimen:  blood, biopsy
Collection/Preservation: If suspecting endocardidis or septicemia, collect blood by venipuncture and hold at ambient temperature. If skin lesion, collect by biopsy through the full thickness of skin at the advancing edge of the infected area. Storage Instructions: Blood: ambient temperature
Biopsy material: 2-8° C
Causes for Rejection: Insufficient specimen, demographic information does not match specimen; Sample Container: tiger top or red top vacutainer,
Sample Test Kit: Availability: Monday-Friday
Diagnostic Information:  Since there is apparently little serologic response to infection with E. rhusiopathiae, serological tests are not useful for diagnosis. Veterinarians, abattoir workers, fish handlers, and butchers are at particular risk for this infection.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature: 2-25°C Shipping Requirements:  Triple contained, In accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87070 Fees:

Microbiology
Erysipeloid (Culture – Identification)
< Return to Table of Contents
Test Includes: Conventional biochemicals

Reporting

Results Available: 7-21 days Contact #s: (512) 458-7582

Reference

Method: Conventional biochemicals  
Turnaround Time: 7-21 days Reference Range:  Genus and species reported
Limitations:  Culture must be viable for studies. Interpretation: Identification of Erysipelothrix should always be considered significant.

Specimen Requirements

Specimen Collection: Sample Type: Pure culture
Volume/Amount Required: One specimen per patient Preferred Specimen:  Pure culture on agar slant
Collection/Preservation: Storage Instructions: Ambient temperature
Causes for Rejection: Broken in transport, Name on tube/submission form do not match. Sample Container:  Agar slant in screw cap tube
Sample Test Kit: Availability:  Monday-Friday
Diagnostic Information:   

Specimen Submission

Required Request Form: G-2B Specimen Handling: Infectious agent, biosafety level 2
Transport Temperature: 2-25° C Shipping Requirements: Triple contained, In accordance with federal shipping regulations for infectious agent.

Billing

CPT Code: 87077 Fees:

Microbiology
Escherichia coli 0157:H7 Culture (Isolation)
< Return to Table of Contents
Test Includes: Conventional biochemicals, EHEC toxin testing, PCR.

Reporting

Results Available: 5-10 days. Contact #s: (512) 458-7582

Reference

Method: Conventional biochemicals, EHEC toxin testing, PCR.
Turnaround Time:  5-10 days Reference Range:  No E. coli O157:H7 isolated. No Shiga Toxin demonstrated.
Limitations: Isolation of E. coli O157:H7 is dependent on viable organisms. Stool specimens should be collected prior to the initiation of antimicrobial therapy.

Premier EHEC will generate a positive signal when Shiga toxin is present in the specimen at detectable quantities. A positive test does not preclude the presence of other infectious organisms. Toxin expression may be lost upon serial passage.

Interpretation:  No E. coli O157:H7 means that there are no detectable (viable) organisms in the specimen submitted.

Absence of toxin means that there is no detectable shiga toxin in the specimen.

Specimen Requirements

Specimen Collection: fresh stool. Sample Type: Stool, Rectal swab
Volume/Amount Required: > 10 mL liquid stool; > 20 g solid or semi-solid stool. Preferred Specimen:  Fresh stool < 24 hours old; Rectal swab submitted in Cary-Blair, Stuart’s or Amies transport.
Collection/Preservation: Collect in dry, clean Leak proof container and store at 2-8° C. Storage Instructions: Store stool at 2-8° C.
Causes for Rejection: Unpreserved stool > 24 hours old for culture. > 7 days for toxin assay. Sample Container: Clean, dry leak-proof container; Enteric transport.
Sample Test Kit: Availability:  Tested Monday – Friday. 
Outbreak testing: Saturday-Sunday with prior notification.
Diagnostic Information:  Stool specimens should be collected in the acute phase of the illness and submitted on ice packs within 24 hours of collection. See Aerobic Bacterial Culture, Stool (Isolation).

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handle Body fluids using universal precautions. Stool and broth storage prior to premier EHEC testing: Stool specimens and broths may be held up to 7 days at 2-8° C before testing in the EIA. If testing is not performed within this time period, the specimens should be frozen at -70° C. Repeated freeze-thaws should be avoided.
Transport Temperature:  2-8° C  Shipping Requirements: Triple contained, In accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87046 Fees:

Microbiology
Escherichia coli 0157:H7 Culture (Identification)
< Return to Table of Contents
Test Includes: Conventional biochemicals, EHEC toxin testing, PCR.

Reporting

Results Available: 5-7 days Contact #s: (512) 458-7582 

Reference

Method: Conventional biochemicals, EHEC toxin testing, PCR.
Turnaround Time:  5-7 days Reference Range: By report: Genus, species, and serotype (if shiga toxin positive)
Limitations: Organism must be viable. Interpretation: Identification of E. coli O157:H7 should be considered significant.

Specimen Requirements

Specimen Collection: Sample Type: Pure culture
Volume/Amount Required: one specimen per patient. Preferred Specimen:  Pure culture on agar slant
Collection/Preservation: May be kept at ambient temperature. Storage Instructions: Ambient temperature.
Causes for Rejection: Broken in transport, expired transport media used. Sample Container: Agar slant in screw cap tube
Sample Test Kit: Availability: Tested Monday – Friday.
Diagnostic Information:  See Aerobic Bacterial Culture (Identification).

Specimen Submission

Required Request Form: G-2B Specimen Handling: Infectious agent biosafety level 2
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained, In accordance with federal shipping regulations for Infectious agent.

Billing

CPT Code: 87077 Fees:

Microbiology
Escherichia coli 0157:H7 or other Shiga toxin E. coli (Toxin Testing)
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Test Includes: Premier EHEC EIA toxin test.

Reporting

Results Available: 2-5 days. Contact #s: (512) 458-7582

Reference

Method: EIA toxin test  
Turnaround Time:  2-5 days Reference Range:  No Shiga toxin demonstrated
Limitations: Premier EHEC will generate a positive signal when Shiga toxin is present in the specimen at detectable quantities. A positive test does not preclude the presence of other infectious organisms. Toxin expression may be lost upon serial passage. Interpretation: Negative results indicate lack of detectable amounts of Shiga toxin present in sample.

Specimen Requirements

Specimen Collection: Stool, Pure culture. Sample Type: Fresh stool; Pure culture.
Volume/Amount Required: 10 g or 10 mL of fresh stool, Preferred Specimen:  Fresh stool; Pure Culture.
Collection/Preservation: Keep stools between 2-8°C; Pure cultures may be kept at ambient temperature. Storage Instructions: Store stools between 2-8° C or freeze at -70° C; Pure cultures may be stored at ambient temperature.
Causes for Rejection: Insufficient amount of sample to perform test; Specimens > 7 days unless frozen. Sample Container: Leak-proof container
Sample Test Kit: Premier EHEC EIA toxin test Availability: Tested Monday – Friday.
Outbreak situations –Saturday-Sunday- with prior notification.
Diagnostic Information:  Stools are accepted for testing with prior notification of the Clinical Bacteriology Section laboratory at 458-7582. Stools should be shipped on wet ice packs. Pure cultures for toxin testing should be shipped safely contained.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handle body fluids using universal precautions. Stool and broth storage prior to premier EHEC testing: Stool specimens and broths may be held up to 7 days at 2-8° C before testing in the EIA. If testing is not performed within this time period, the specimens should be frozen at 
-70° C. Repeated freeze-thaws should be avoided.
Transport Temperature:  2-8° C  Shipping Requirements: Triple contained, In accordance with federal shipping regulations for infectious agent.

Billing

CPT Code: 87427 Fees:

Microbiology
Escherichia coli 0157:H7 or other Shiga toxin E. coli Culture (Typing)
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Test Includes: Pulse Field Gel Electrophoresis (PFGE)

Reporting

Results Available: 4-7 days Contact #s: (512) 458-7582

Reference

Method: Pulse Field Gel Electrophoresis (PFGE)  
Turnaround Time:  4-7 days Reference Range:  By report
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type: Pure culture
Volume/Amount Required: Preferred Specimen:  Pure Culture on agar slants
Collection/Preservation: Storage Instructions: ambient temperature
Causes for Rejection: Specimen broken in transport Sample Container:
Sample Test Kit: Availability: Monday-Friday
Diagnostic Information:  Molecular typing performed at TDSHS as part of the PulseNet program.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Infectious agent, biosafety level 2.
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained; infectious agent

Billing

CPT Code: 87077 Fees: