Test Code AFBN Acid Fast Bacillus, Smear Only
Performing Laboratory
YRMC, Microbiology
Day(s) Test Set Up
Monday through Sunday
Available STAT on Weekends
AFB Smear, ONLY is not acceptable as a stand-alone test order. Must be accompanied by an Acid Fast Culture and Stain (AFSD) or an Cerebrospinal Fluid Acid Fast Culture (CSAF)
Specimen Requirements
All specimens must be submitted in a leak-proof container and sealed in a biohazard bag. Specimens that are received leaking or spilled will be rejected for testing.
Submit only 1 of the following specimens - specimen source is required.
Abscess
Container/Tube: Sterile, screw capped container or syringe with needle removed. Needle may be replaced with sterile syringe cap or sterile capped blunt cannula. Specimens submitted on swabs are sub-opitmal for Mycobacterial culture and do not typically yield productive growth of Mycobacteria.
Specimen Volume: 1-2 ml. aspirate material or abscess drainage.
Collection Instructions:
1. For most open lesions and abscesses, remove the superficial flora by decontaminating the skin before collecting a specimen from the advancing margin or base.
2. A closed abscess is the specimen site of choice. Aspirate the abscess contents with a syringe and submit the specimen in a the syringe or expell the contents into a sterile, screw capped container.
3. Please indicate on the request or order if Mycobacterium marinum infection is suspected. This organism requires specialized processing and incubation requirements for optimal recovery.
Note:
1. Label container with patient’s name (first, last, and
middle initial), medical record number (if appropriate), date of
birth, date and time of collection and collector’s initials
and or ID number.
2. Specimen source is required.
______________________________________________________________________________________
Bronchial Wash/Bronchial Lavage
Container/Tube: Aspirate trap. Attach the tubing firmly to the top of the aspirate trap to ensure the specimen does not leak during transport. Do not add cytology preservative(CytoLyt®) to specimens submitted for culture.
Specimen Volume: Minimum volume: 7.5 ml
Collection Instructions: Collect per established bronchoscopy protocol.
Note:
1. Label container with patient’s name (first, last, and middle initial), medical record number (if appropriate), date of birth, date and time of collection and collector’s initials and or ID number.
2. Specimen source is required.
______________________________________________________________________________________
Body Fluid
Container/Tube: Screw-capped, sterile container, evacuated
collection contaimer. Specimens submitted on swabs are not
acceptable.
Specimen Volume: 5 mL of body fluid
Collection Instructions: Collect aseptically.
Disinfect site with alcohol if collecting by needle and
syringe.
Note:
1. Label container with patient’s name (first, last, and
middle initial), medical record number (if appropriate), date of
birth, date and time of collection and collector’s initials
and or ID number.
2. Specimen source is required.
______________________________________________________________________________________
Gastric Aspirate
Container/Tube: Sterile, screw capped container or aspirate trap. Attach the tubing firmly to the top of the aspirate trap to ensure the specimen does not leak during transport.
Specimen Volume: 5 – 10 ml gastric aspirate.
Collection Instructions: Collect per established gastric aspiration protocol.
Note:
1. Gastric aspirates are often the preferred specimen for diagnosing Myocbacterium tuberculosis in pediatric patients.
2. Aspirate specimens for AFB culture should be collected after the patient has had at least 6 hours of un-interrupted sleep and has been fasting for at least 6 hours.
3. Do not use any NG tube lubricant. All lubricants are bacteriostatic.
4. Label container with patient’s name (first, last, and middle initial), medical record number (if appropriate), date of birth, date and time of collection and collector’s initials and or ID number.
5. Transport the specimen to the Microbiology department without delay.
6. Specimen source is required.
______________________________________________________________________________________
Sputum, Expectorated
Container/Tube: Screw-capped, sterile
container.
Specimen Volume: Early-morning expectorated sputum
(minimum volume: 5 mL) on at least 3 consecutive days (24 hours
apart).
Collection Instructions: Collect specimen as
follows:
1. Have patient remove dentures, if applicable.
2. Instruct patient to brush his/her teeth and/or rinse mouth well
with water to minimize contaminating specimen with food particles,
mouthwash, or oral drugs which may inhibit growth of
mycobacteria.
3. Instruct patient to take a deep breath, hold it momentarily,
then cough deeply and vigorously into container. Nasal
secretions or saliva are not acceptable specimens.
Note:
1. Label container with patient’s name (first, last, and middle initial), medical record number (if appropriate), date of birth, date and time of collection and collector’s initials and or ID number.
2. Specimen source is required.
______________________________________________________________________________________
Sputum, Induced
Container/Tube: Screw-capped, sterile container(s)
or aspirate trap. If an aspirate trap specimen is submitted, attach
the tubing firmly to the top of the aspirate trap to ensure
specimen does not leak during transport.
Specimen Volume: Early-morning induced sputum
(minimum volume: 5 mL) on at least 3 consecutive days
Collection Instructions: Induce cough by
inhalation of sterile, hypertonic saline, and collect expectorated
material. Avoid sputum contamination with nebulizer reservoir
water.
Note:
1. Label container with patient’s name (first, last, and
middle initial), medical record number (if appropriate), date of
birth, date and time of collection, and collector’s initials
and or ID number.
2. Specimen source is required.
______________________________________________________________________________________
Tissue
Container/Tube: Screw-capped, sterile container(s) without
fixative or preservative-Specimen in formalin is not
acceptable.
Specimen Volume: 1 g of tissue, if possible
Collection Instructions: Collect aseptically
avoiding indigenous microbiota. Select caseous portion if
available. Do not immerse in saline or other fluid or wrap in
gauze.
Note:
1. Label container with patient’s name (first, last, and
middle initial), medical record number, date of birth, date and
time of collection and collector’s initials and or ID
number.
2. Specimen source is required.
Specimen Transport Temperature
Ambient.
Specimen must be received within 2 hours of collection.
Reference Values
Negative for Acid Fast Bacilli
Test Classification and CPT Coding
87206 - AFB Smear
Collection Instructions
See Individual Specimen Requirements for Collection Instructions
Methodology
Fluorescent Stain or Kinyoun Acid Fast Stain
Loinc Code
11545-1