Texas Department of State Health Services - Microbiology Lab Tests

Microbiology
Urethritis (Culture – Isolation) (For clinical culture studies see Gonorrhea Culture (Isolation) For probe testing, see Gonorrhea (Culture – Genetic Probe)
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Test Includes: Culture, Conventional biochemicals
Reporting
Results Available: 3-10 days	Contact #s: (512) 458-7582
Reference
Method: Culture, Conventional biochemicals
Turnaround Time: 3-10 days	Reference Range: Negative for N. gonorrhoeae
Limitations: organism must be viable	Interpretation:
Specimen Requirements
Specimen Collection: urethral	Sample Type: urethral swab, endocervical swab
Volume/Amount Required:	Preferred Specimen: urethral swab, endocervical swab
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: For clinical culture studies see Gonorrhea Culture (Isolation) For probe testing, see Gonorrhea (Culture – Genetic Probe).
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature:	Shipping Requirements:
Billing
CPT Code: 87070, 87590, 87591	Fees:

Microbiology
Varicella (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 disease. The success of virus isolation depends a great deal on the submission of the proper specimen, collected at the right time, 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 infections 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: Swab in 1-2 mL of viral transport media.	Preferred Specimen: Vesicle fluid, Skin scrapings
Collection/Preservation: Viral transport media	Storage Instructions: Maintain specimens at 2-8°C immediately after collection. Ship with the least possible delay. If storage is necessary, freeze 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: Isolation is done in conventional tube culture and shell vial culture. If characteristic CPE is observed in the tube culture or after a 5-7 day incubation of the shell vial culture, immunofluorescence tests are performed using VZ-specific monoclonal antibody.
Specimen Submission
Required Request Form: G-2A	Specimen Handling:
Transport Temperature: 2-8° C, overnight	Shipping Requirements: Ship specimens in compliance with governmental regulations.
Billing
CPT Code: 87252	Fees:

Microbiology
Varicella (Culture – Identification)
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Test Includes: Immunofluorescence
Reporting
Results Available: 2-14 days	Contact #s: 512-458-7594
Reference
Method: Immunofluorescence
Turnaround Time: 2-14 days	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 mLs.	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: Identification is based on immunofluorescence test using VZV-specific monoclonal antibody.
Specimen Submission
Required Request Form: G-2A	Specimen Handling:
Transport Temperature: Monolayer with CPE: Ambient temperature. Frozen isolate: on dry ice	Shipping Requirements: Ship specimens in compliance with governmental regulations.
Billing
CPT Code: 87253	Fees:

Microbiology
Varicella (Serological – Enzyme Immunoassay)
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Test Includes:
Reporting
Results Available: 5-7 days	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.	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: Serum
Volume/Amount Required: 10 mls whole blood	Preferred Specimen: Paired Sera
Collection/Preservation: Samples that will be delivered to the laboratory within 8 hours of collection may be transported at room temperature in the original blood collection tube. If the samples are going to be shipped and will be delivered to the laboratory within 48 hours of collection, sera must be separated from the blood and shipped on cold packs, between 2° and 8°C. If the serum samples will not be delivered to the laboratory within 48 hours of collection at these temperatures, then the samples must be frozen at -20°C or lower and shipped on dry ice.	Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C, or frozen at -20°C.
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing, specimens received with extended transit time, or received at incorrect temperature.	Sample Container: Red top or tiger top tube
Sample Test Kit:	Availability: Test performed once per week
Diagnostic Information: A single positive IgG indicates a history of past infection with varicella-zoster virus (VZV), and is detectable for life. Serum specimens are to be collected 10-14 days apart. A significant rise in antibody level between acute and convalescent specimens is evidence of current infection. Test is performed once per week.
Specimen Submission
Required Request Form: G-2A	Specimen Handling: Use Universal Precautions
Transport Temperature: 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: 86787	Fees:

Microbiology
Vibrio parahaemolyticus and other Vibrio species (Culture – Identification)
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Test Includes: Conventional biochemicals
Reporting
Results Available: 4-7 days	Contact #s: (512) 458-7582
Reference
Method: conventional biochemical
Turnaround Time: 4-7 Days	Reference Range: By Report
Limitations: Organism must be viable for biochemical studies	Interpretation: By Report
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, never refrigerate or freeze
Causes for Rejection: Name on tube/form do not match, broken in transport	Sample Container: Agar slant in screw cap tube.
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Pure cultures should not be refrigerated. See Vibrio cholerae (Culture-Identification)
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Infectious agent
Transport Temperature: Ambient temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.
Billing
CPT Code: 87077	Fees:

Microbiology
Vibrio cholerae, (Culture – Identification)
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Test Includes: Conventional biochemicals, serological typing
Reporting
Results Available: 4-7 days	Contact #s: (512) 458-7582
Reference
Method: conventional biochemicals, slide agglutination
Turnaround Time: 4-7 days	Reference Range: By report
Limitations:	Interpretation: Identification of Vibrio cholerae 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, do not refrigerate or freeze
Causes for Rejection: Name on tube/form do not match, broken in transport.	Sample Container: Agar slant in screw cap tube
Sample Test Kit:	Availability: Monday-Friday Outbreak investigations with prior notification: Saturday-Sunday
Diagnostic Information: Pure cultures should NOT be refrigerated. Vibrio cholerae will be serotyped for O1 and O139 serotypes. Requests for Toxin testing are forwarded to CDC. Prior approval must be secured before submitting culture. For Molecular analysis, see Molecular typing (PFGE)
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:	Fees:

Microbiology
Vibrio cholerae, (Toxin Studies)
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Test Includes: Test not performed at TDSHS, Specimens submitted to the CDC with prior approval.
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: Dependent on CDC report	Reference Range:
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Pure Culture, safely contained
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Pure cultures should NOT be refrigerated. Requests for Toxin testing are forwarded to CDC. Prior approval must be secured before submitting culture. For Molecular analysis, see Molecular typing (PFGE) Reference Range
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Infectious agent, biosafety level 2
Transport Temperature: Ambient (Room) temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.
Billing
CPT Code: 87077	Fees:

Microbiology
Vibrio cholerae and other Vibrio species (Isolation)
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Test Includes: conventional biochemicals, serological typing
Reporting
Results Available: 3-7 days	Contact #s: (512) 458-7582
Reference
Method: Conventional biochemicals, slide agglutination
Turnaround Time: 3-7 days	Reference Range: No Vibrio species isolated.
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection: stool	Sample Type: stool
Volume/Amount Required: >10 g	Preferred Specimen: stool in Cary-Blair transport medium
Collection/Preservation: Collect stool in clean, dry container. Transfer to a Cary-Blair if in transport > 24 hours.	Storage Instructions: 2-8° C, Do not ship on dry ice.
Causes for Rejection:	Sample Container: Cary-Blair transport tube or leak-proof container.
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: See aerobic bacterial culture, stool. Pure cultures should NOT be refrigerated. Requests for Toxin testing are forwarded to CDC. Prior approval must be secured before submitting culture. For Molecular analysis, see Molecular typing (PFGE)
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle body fluids using universal precautions
Transport Temperature: Wet Ice (Ice packs)	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87046	Fees:

Microbiology
Virulence Factors - (PCR)
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Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: 7-11 days	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Pure Culture, safely contained
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: PCR is performed at TDSHS for the virulence factor genes for detection of pathogenic Escherichia coli including heat stable and labile toxin, shiga toxin, invasion plasmid antigen, attaching and effacing gene and hemolysin. PCR may be performed from pure cultures or from original plating media used in stool screens. For typing see Escherichia coli 0157:H7 or other Shiga toxin E. coli Culture (Typing) For toxin testing see Escherichia coli 0157:H7 or other Shiga toxin E. coli (Toxin Testing).
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature: Ambient (Room) temperature	Shipping Requirements:
Billing
CPT Code:	Fees:

Microbiology
Water Testing, Bacteriological (Culture – Coliform)
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Test Includes: Colilert 18 hour (See Coliform- Total Colilert)
Reporting
Results Available:	Contact #s:
Reference
Method: MUG fluorescent
Turnaround Time: 1 day	Reference Range: Negative for coliforms
Limitations: Water must be received within 30 hours of collection.	Interpretation: Negative test result indicates that there were no detectable coliforms in the sample submitted. The test does not detect an overall bacterial count or rule out other types of bacteria in the sample.
Specimen Requirements
Specimen Collection: In accordance with the package insert with collection bottle.	Sample Type: Water
Volume/Amount Required: 100 ml	Preferred Specimen: Water
Collection/Preservation:	Storage Instructions: ambient temperature, < 30 hours old.
Causes for Rejection: > 30 hours old.	Sample Container: Leak proof container supplied by TDSHS.
Sample Test Kit: Colilert 18 hour	Availability: Monday- Sunday. Specimen must be received by 11 a.m on weekend to be tested that day.
Diagnostic Information: Samples must be from portable water source in approved sample container and submitted within 30 hours. Fee for service is charged. See Coliform.
Specimen Submission
Required Request Form: G-79	Specimen Handling: According to package insert with collection bottle.
Transport Temperature: ambient	Shipping Requirements: Within 30 hours of collection.
Billing
CPT Code:	Fees:

Microbiology
Water Testing, Bacteriological (Culture – Total Coliform)
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Test Includes: See Coliform- Total Colilert
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time:	Reference Range:
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Water
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Samples must be from portable water source in approved sample container and submitted within 30 hours. Fee for service is charged. See Coliform.
Specimen Submission
Required Request Form: G-79	Specimen Handling:
Transport Temperature:	Shipping Requirements:
Billing
CPT Code:	Fees:

Microbiology
Water Testing, Bacteriological (Culture – E. coli – Presence/Absence)
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Test Includes: See Coliform- Total Colilert
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time:	Reference Range:
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Water
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Samples must be from portable water source in approved sample container and submitted within 30 hours. Fee for service is charged. Enumeration no longer done. See Coliform.
Specimen Submission
Required Request Form: G-79	Specimen Handling:
Transport Temperature:	Shipping Requirements:
Billing
CPT Code:	Fees:

Microbiology
Water Testing, Cryptosporidia & Giardia MPA (Micro particulate analysis (Microscopic – Direct Exam IFA)
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Test Includes:
Reporting
Results Available:	Contact #s: (512) 458-7560
Reference
Method:
Turnaround Time: 5 days	Reference Range:
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Water filter
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Specimens accepted only through TCEQ.
Specimen Submission
Required Request Form: G-79	Specimen Handling:
Transport Temperature: On Ice Packs	Shipping Requirements:
Billing
CPT Code:	Fees:

Microbiology
Western Equine Encephalitis (Serological – Enzyme Immunoassay– IgM only)
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Reporting
Results Available: 5-7 days	Contact #s:
Reference
Method: EIA
Turnaround Time: 5-7 days	Reference Range: <2.00 (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: Serum
Volume/Amount Required: 10 mls whole blood	Preferred Specimen: Paired Sera; 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: As requested
Diagnostic Information: The presence of IgM indicates recent infection. Human infections are seasonal, from mid- to late-summer, occurring throughout the western United States. Serological cross-reactions occur with Venezuelan and Eastern Equine Encephalitis. While a single serum may be tested, a second specimen collected 10-14 days apart may be required for best evidence of recent infection.
Specimen Submission
Required Request Form: G-1A	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: 86654	Fees:

Microbiology
West Nile Virus Encephalitis (Serological – Enzyme Immunoassay– IgG and IgM)
Related Agents: Arbovirus
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Test Includes:
Reporting
Results Available: 1-3 days	Contact #s:
Reference
Method:
Turnaround Time: 1-3 days	Reference Range: <2.00 (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: Paired Sera; 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: Test performed daily
Diagnostic Information: West Nile Virus is a flavivirus recently associated with an outbreak of encephalitis in the Eastern United States. West Nile Virus IgM is usually detectable by the time symptoms appear, but IgG may not be detectable until day 4 or day 5 of illness. Antibodies induced by West Nile Virus infection show extensive crossreactivity with other flaviviruses, including Dengue Fever Virus and St. Louis Encephalitis Virus.
Specimen Submission
Required Request Form: G-1A	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:

Microbiology
Worm, Miscellaneous Identification (Microscopic – Direct Concentration)|
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Test Includes: Microscopic Examination
Reporting
Results Available: 3 days	Contact #s: (512) 458-7560
Reference
Method: Microscopic Examination
Turnaround Time: 3 days	Reference Range: Specimen was not a worm
Limitations:	Interpretation: By Report
Specimen Requirements
Specimen Collection: worm, Feces	Sample Type: Worm
Volume/Amount Required: One Worm	Preferred Specimen: Worm (whole) in alcohol
Collection/Preservation: Place worm in ethyl alcohol	Storage Instructions: Ambient Temperature
Causes for Rejection:	Sample Container: Clean, leak-proof container; formalin transport for parasites.
Sample Test Kit:	Availability: Monday - Friday
Diagnostic Information: Fecal specimens must be sent in fresh (less than five hours) or in formalin. Adult worms should be submitted in ethyl alcohol. Referred material accepted from hospital, private, and reference labs.
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle body fluids using universal precautions.
Transport Temperature: Ambient (Room) temperature	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87015	Fees:

Microbiology
Yellow Fever (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes:
Reporting
Results Available: 3 weeks	Contact #s:
Reference
Method: EIA
Turnaround Time: 3 weeks	Reference Range: <2.00 (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: Serum
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:
Diagnostic Information: Prior notification is requested (512) 458-7760. Serum specimens are to be collected at least 14 days apart, and will be submitted to the CDC when accompanied by immunization, travel, and clinical history. A fourfold titer increase is evidence of current infection. Cross-reactions occur with Dengue Fever and immunization.
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:

Microbiology
Yersinia pestis (Culture – Isolation)
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Test Includes:
Reporting
Results Available:	Contact #s:
Reference
Method:
Turnaround Time: 3-10 days	Reference Range: None isolated
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Blood, bubo aspiration, sputum, throat swabs, CSF; Swabs in Cary-Blair transport at autopsy: blood, tissue specimens from spleen, liver, lungs, buboes.
Collection/Preservation:	Storage Instructions:
Causes for Rejection:	Sample Container:
Sample Test Kit:	Availability:
Diagnostic Information: Telephone Laboratory (512-458-7582) prior to shipping specimen. Cultures must be held for 14 days before reporting as negative. Local and State health authorities must be immediately notified of suspected and presumptive cases of plague. Yersinia pestis is a pathogen in biohazard risk group III and should be handled in a containment laboratory. Blood cultures should be taken (at least 3 in a 24 hour period). Stains of clinical material using Giemsa, Wright, or Wayson stains show small rods with bipolar “safety pin” staining. Yersinia pestis is one of the agents listed on the Bioterrorism agents list. See Bioterrorism agents (Clinical -Isolation) and Bioterrorism agents (Referred Identification - PCR)
Specimen Submission
Required Request Form: G-2B	Specimen Handling:
Transport Temperature: 4ºC , ice packs	Shipping Requirements:
Billing
CPT Code: 87070	Fees:

Microbiology
Yersinia enterocolitica (Culture – Isolation)
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Test Includes: Conventional biochemicals
Reporting
Results Available: 4-14 days	Contact #s: (512) 458-7582
Reference
Method: conventional biochemicals
Turnaround Time: 4-14 days	Reference Range: No Yersinia species isolated.
Limitations:	Interpretation: By report
Specimen Requirements
Specimen Collection: feces	Sample Type: Feces in enteric transport media; Blood
Volume/Amount Required: 10 g stool or 10 ml liquid stool	Preferred Specimen: Feces in enteric transport media; Blood
Collection/Preservation: Collect stool in dry, clean container. Transfer to enteric transport.	Storage Instructions: 2-8° C
Causes for Rejection:	Sample Container: Enteric transport
Sample Test Kit:	Availability: Monday-Friday Outbreak investigations with prior notification: Saturday-Sunday
Diagnostic Information: Intestinal yersiniosis may present in three clinical forms: enteritis, terminal ileitis or mesenteric lymphadenitis causing "pseudoappendicitis", and septicemia.
Specimen Submission
Required Request Form: G-2B	Specimen Handling: Handle body fluids using universal precautions
Transport Temperature: 2-8º C	Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.
Billing
CPT Code: 87046	Fees:

Microbiology
Yersinia enterocolitica (Culture – Identification)
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Test Includes: conventional biochemicals
Reporting
Results Available: 4-10 days	Contact #s: (512) 458-7582
Reference
Method: conventional biochemicals
Turnaround Time: Identification 4-7 days. Serotyping: dependent on CDC report	Reference Range: By report
Limitations:	Interpretation: By report
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:	Sample Container: Agar slant in screw cap tube
Sample Test Kit:	Availability: Monday-Friday
Diagnostic Information: Strains of Y. entercolitica can be characterized by their biotypes but any requests for serotyping of Yersinia enterocolitica are submitted to the CDC with prior approval. Please call the Clinical Bacteriology Section, (512-568-7582) before submitting for serotyping. Complete clinical information must be included with the specimens submitted for serotyping.
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: 87077	Fees:

Microbiology
Zygomycosis (Culture – Isolation)
Names of Related Agents: Rhizopus species, Mucor species, Syncephalastrum species, etc.
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Test Includes: Isolation of fungus and identification by morphological tests
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: 3 ml to 15 ml	Preferred Specimen: Tissue; Sputum; Scrapings
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 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
Zygomycosis (Culture – Identification)
Names of Related Agents: Rhizopus species, Mucor species, Syncepalastrum species, etc.
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Test Includes: Identification of fungus by morphological tests
Reporting
Results Available: 21-28 days	Contact #s: 512-458-7586
Reference
Method: Slide culture
Turnaround Time: 21-28 days	Reference Range: By report
Limitations:	Interpretation:
Specimen Requirements
Specimen Collection:	Sample Type:
Volume/Amount Required:	Preferred Specimen: Pure Culture
Collection/Preservation:	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
Zygomycosis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes:
Reporting
Results Available: 3 weeks	Contact #s:
Reference
Method:
Turnaround Time: 3 weks	Reference Range: Nonreactive
Limitations:	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: 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 for experimental tests.
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: 86671	Fees:

Microbiology Lab Tests - U-Z