Culture - respiratory

Culture, respiratory

For bronchial washing cultures,we set up BA,MAC,CNA,CHOC,BBE/KVA,PEA and BRUC agars, and a THIO broth. We identify only pathogens. Since many specimens grow normal oral flora, is it necessary to include THIO broth in our set up?
(answered 5/16/2007)

As Microbiologists are we required to recognize squamous epi's from other epi's found in gram stains, especially sputums? Some cells in the gram stain could be bronch cells, which mean the specimen is a good one. I believe some techs call all cells epi's. We do not differentiate the different epi's. this concerns me. I appreciate any advice. thanks.
(answered 05/09/2007)

This question is in regard to Cystic fibrosis cultures. We are a small lab and have a few patients with cystic fibosis that have respiratory cultures done on a routine basis. We currently process them the same as the other respiartory cultures. At this point we have not isolated any Pseudo in the cultures. From what I read these type of cultures should have some specialized media and possibly held longer than a routine culture? Would it be appropriate for us to screen at our facility on our routine media or would we be missing an important pathogen. Any protocols or references would be appreciated.
(answered 4/21/2007)

how many colonies needed to call a positive group a strep culture. I have seen some labs use a <10 colonies are considered neg, but some think only one colony is significant.
(answered 4/19/2007)

how soon may a group a beta strep plate be finalized?

(answered 4/17/2007)

I am a microbiologist from apollo hospital Bangalore India,we are reporting H.influenza and also the antibiogram of it in patients <3yrs of age in the abscnce of any symptoms related to phryngites,so tell us what is the crieteria to follow when reporting this organism in throat swab and in sputum,please.
(answered 03/23/2007)

our lab usually identify all the microorganism isolated from bronchial washes and bronchial lavage as well from endotrachial aspirates including viridans strep and neisseria species. is it correct or we have to identify certain specific species
(answered 03/12/2007)

What is currently the most commonly accepted rejection criteria, as it applies to the evaluation of sputum specimen quality for gram stains? We are currently rejecting sputums with >25 squamous epithelial cells/lpf or <10 pmns/lpf. It has been suggested that this is too lenient, and we should be rejecting specimens with >10 squamous epis.
(answered 02/20/2007)

if we see more than three pathogens in sputum culture, is it contamination?
(answered 11/08/2006)

Currently our laboratory does a routine throat culture which looks predominanty for Groups A, C, & G Streps. Should we ever report other pathogenic organisms(such as Staph. aureus, Strep pneumo, Haemophilus, Moraxella, Neis. meningitis, gram negative rods) if they are predominant? Would there be any difference if the patient is a pediatric patient or if the patient is immunocompromised ??
(answered 10/12/2006)

If a sputum gram stain had moderate gram negative rods, few gram positive cocci, and moderate oropharyngeal flora, does that indicate an infection?
(answered 08/25/2006)

We have recently updated our respiratory culture procedure. In one reference it recomends sputum cultures be 24 hours apart (on the same patient) and another reference states 48 hours apart. Which do you recommend and why?
(answered 08/21/2006)

In updating our respiratory culture procedures one reference indicated that sputums should not be collected closer than 48 hours. Another reference indicated 24 hours. What would you recommend and why?
(answered 08/17/2006)

How useful is a quanitative BAL? Our pulmonologists are asking for it, but we know of other larger institutions that are not offering this test.
(answered 08/10/2006)

is Staph important in sputum with low pus cells
(answered 05/30/2006)

Should Neisseria meningitidis be reported if it is isolated in a sputum culture, or should it be considered normal respiratory flora? What if it is the predominant organism?
(answered 05/15/2006)

In the clinical micro procedures manual by Isenberg,it states that a single bap can be plated for throat cultures and incubated in ambient air with stabs.Why is it unacceptable to incubate in CO2 with stabs? We have found all beta streps to grow better in the CO2. Thank you
(answered 04/10/2006)

sputum - This question is in regards to a delay in transport of a sputum specimen. My question is: How long can a sputum specimen be refrigerated before it is processed for culture and sensitivity? I know that specimens that will have a delay of more than 2 hours should be refrigerated, but what is the maximum time the sputum can be refrigerated before it is rejected? Thanks, David Carbone
(answered 04/05/2006)

ear culture procedure for both otitis media and externa: I am updating our specimen procedure manual and am trying to find a procedure for ear cultures. Can you direct me to either a publication on-line or printed that would help?
(answered 03/16/2006)

chrys.indologenes from tracheal aspirate is pathogenic?
(answered 02/21/2006)

Is the evalation of specimen quality (Q Scoring) applicable to other sources besides expectorated sputum specimens? Does scoring apply to trach and endo aspirates, suctioned sputum specimens, induced sputum specimens, or other collection methodologies?
(answered 02/17/2006)

If a sputum is rejected, can that same specimen be used for AFB and fungus? What are the recommendations?
(answered 02/11/2006)

What is the best specimen to collect to aid in the diagnosis of pneumonia in infants and young chlidren unable to expectorate sputum for examination? Is a nasopharyngeal swab ever appropriate for this purpose? What would you recommend telling a physician who requested an np culture be performed for this purpose? Thank you
(answered 01/12/2006)

What is the current criteria for the evaluation of sputum for routine culture and is mucus seen on gram stain of any significance?
(answered 12/19/2005)

I want to know if it is important to report out OR NOT REPORT OUT Haemophilus sp. and H. parainfluenza sp. on respiratory cultures, namely sputums and bronch washes on adults and throat cultures on children age 6 or younger. We have a pediatrician who seems to want these reported. Also, is Strep Group F considered a pathogen or normal flora in a throat culture?
(answered 12/14/2005)

i am doing a research workon pharyngitis, and i have observed in few patients having moraxella catarrhalis and Klebseilla Pneumoniae growth with complain of sore throat. is there any rcommendation which tells that in case of pure growth of these organisms, i may consider them as pathogen. i did get some such reference in http://www.ttuhsc.edu/SOM/FamMed/lectures/sinusitis.html. kindly give your opinion
(answered 11/28/2005)

It was my understanding that throat cultures looking for beta hemolytic colonies is more successful if incubated in non-CO2 incubator vs. 5% CO2. Is this true?
(answered 11/16/2005)

WHAT ARE THE CURRENT GUIDELINES FOR SCREENING SPUTUM BY GRAM STAIN? WE WERE CURRENTLY USING 25 EPITHELIAL CELLS/LPF AND NOW HERE THAT THIS NUMBER HAS BEEN LOWERED TO 10?
(answered 11/14/2005)

I am looking for a procedure for setting up quantitative PSB cultures. Any suggestions? Thanks
(answered 10/27/2005)

I am looking for a procedure for quantitative protected brush specimen cultures. Do you have any suggestions? Thanks
(answered 10/16/2005)

Are there guidelines for working up sputum and ET specimens from patients in the ICU?
(answered 09/21/2005)

Is there a benchmark for what % of expectorated sputum specimens should be rejected for culture due to poor quality?
(answered 07/12/2005)

Our facility offers a throat culture for group A strep. In this culture we report both group A and beta strep not group A. My question is should we also include a screen for Arcanobacterium? I understand it is a cause of pharyngitis, but could find no literature stating that it could cause the sequelae reactions associated with beta strep. I was also worried about compliance in billing for an organism not included in the name of the culture (Throat for Group A strep). Thank you!
(answered 07/08/2005)

We currently receive a number of NP specimens in Regan-Low deeps for pertussis cultures. These are planted on RL plates as well as nonselective media. My question is: Is it appropriate to report pathogens such as H. influenzae, Strep pneumo, Group A Strep, S. aureus if they are the predominate organism?
(answered 07/06/2005)

We have physicians who send us sputum cultures x3 on their outpatients. Each sputum is collected on a separate day one day apart from each other. We receive all 3 specimens at the same time.Our policy states that we process only one sputum collected within a 24h period. Questions: should we accept 3 sputum cultures collected only a day apart from each other? Should we accept a sputum that is 3 days old? They are for routine culture not AFB. Recommendations??
(answered 06/05/2005)

Are there any recommedations for the amount of volume to use when doing a bronchoscopic alveolar lavage (BAL)? How much return volume is expected? What effect do these volumes have on accuracy of diagnosis? I would appreciate references if they are available. Thank you
(answered 05/27/2005)

CAP recommended on our most recent inspection incubating Grp A strep cultures anaerobically for non beta Grp A- what media and other criteria should a laboratory use to identify?
(answered 05/03/2005)

We recently attended an ASCP teleconference that stated that it may not be necessary to do backup throat cultures on strep screens from adults. However, our state health laboratory has told us that we are not CLIA compliant if we do not do back up throat cultures if the strep test kit recommends it for negative cultures. What is the answer to this?
(answered 04/18/2005)

According to the Clinical Microbiology Procedures Handbook 2004, the interpretation of the quantitative culture from bronchoalveolar lavage fluid is significant when the threshold is greater than 10.000 CFU, and individually morphotype count must be performed. If I have determined two different isolates, like S.aureus (CFU>10.000) and Pseudomonas spp. (CFU<10.000) from a BAL specimen, Should I keep on identifying the Pseudomonas species and perform antimicrobial susceptibility testing? Thanks for your collaboration, rogerarce@yahoo.com
(answered 03/07/2005)

In order to diagnose ventilator-associated pneumonia (VAP) in newborns, Should I use the same interpretation criteria described in adults for brochoalveolar lavage (BAL) specimens and protected specimen brush (PSB)? I would appreciate references in this matter. Thanks, maripiri2@yahoo.com
(answered 03/07/2005)

OUR POLICY FOR ADMITS FOR PNEUMONIA IS TO COLLECT A SET OF BLOOD CULTURES AND A SPUTUM CULTURE, HOWEVER THE SPUTUM CULTURE CAN BE COLLECTED UP TO 48 HRS AFTER ADMISSION. IF THE PATIENT IS STARTED ON ANTIBIOTICS OF WHAT VALUE IS THE SPUTUM CULTURE ESPECIALLY IF THERE IS A PROLONG TIME OF COLLECTION?
(answered 02/21/2005)

Where can I get clinical isolates of atypical respiratory pathogens?
(answered 01/28/2005)

Do bronchial aspirates collected during bronchoscopy need to be centrifuged before plating?
(answered 12/29/2004)

I would like a list of current references for work-up of bacterial "potential" and "frank" pathogens in sputum cultures...in what relative numbers should Haemophilus, Staph aureus, Kleb pneumo, etc be lumped in with normal flora, when should they be considered probable pathogens and thus reported?
(answered 11/23/2004)

Is Neisseria meningitidis considered a pathogen (and thus reported) when isolated from a nasopharynx culture? What clinical information (except carrier) should be considered for reporting? Does it predict life threatening disease such as meningitis?
(answered 11/19/2004)

Are there any quality assurance procedures for sputum gram stains?Should we be keeping statistics on how many sputum specimens are mostly epithelial cells?
(answered 11/05/2004)

What is the frequency for quality control testing on the binax Flu A/B, Urinary Legionella, Urinary Strep pneumo, and BD RSV, is it each new lot or qc with pos and neg controls each day of testing? Thanks
(answered 10/28/2004)

Is it necessary to report the presence of Staphylococcus aureus in troat swab cultures?
(answered 09/03/2004)

Is it necessary to report Staphylococcus aureus presence in the throat swab?
(answered 09/02/2004)

Is Neisseria meningitidis considered a pathogen (and thus reported) when isolated from a throat culture on a patient with a sore throat? Does it make a difference if the patient is a child or an adult?
(answered 08/09/2004)

Does the JCAH require sputums to be screened with gram stains before culturing?
(answered 07/30/2004)

Is there a age limit on rejecting sputum specimens based on Gram Stain results? We are a pediatric hospital and the doctors say it is hard to get a good specimen. In fact, the CF doctors do not want us to even perform a Gram Stain on their patients.
(answered 03/23/2004)

We are a merged core micro laboratory where we receive specimens from two other hospitals. We currently have a policy that if sputum cultures cannot be planted within 2 hours they are to be refrigerated and sent to the main micro lab within 24 hours. One of our respiratory physicians insists that this is unacceptable and that all sputums must be planted within 2 hours. He believes that we are not recovering pathogens because of our practice. All the references I have found claim that what we do is OK. I would like any comments on this issue.
(answered 11/17/2003)

Enterococcus ever a cause of a respiratory infection? Should it be worked up and reported (aside from VRE surveillance). Thank you
(answered 11/11/2003)

Except for expectorated sputums, should induced and endotrach specimens also be questioned for quality by Gram stain and rejected if needed?
(answered 08/05/2003)

What is the common microorganisms that can be found in the textile effluent and what is the procedures to isolate microorganisms from textile effluent?
(answered 07/30/2003)

Could you tell me some advice about the best and rapid way to determine microorganism using P.C.R?
(answered 07/18/2003)

We currently offer a throat culture for strep screen with or without rapid antigen testing and a complete throat culture as well. While changing our testing choice screens for coding purposes I would also like to delete the availability of a "complete" throat culture since group a beta strep is the known cause of bacterial pharyngitis. We would continue to offer the capablility to order throat cultures for specific organisms such as neiss. gonorrhoeae or b. pertussis when called for. Do you have any specific references that speak to this issue in case we get negative physician feedback?
(answered 06/26/2003)

How are bronchoalveolar lavage cultures routinely worked up? Are they treated like routine bronchial washing cultures? Can you give me a summary of how you handle your respiratory cultures?
(answered 06/24/2003)

Is any amount of colonies of beta hemolytic strep significant in a throat culture? Should we work up the beta hemolytic strep even if we only see one or two colonies on the plate? If we work it up, should we add a comment on the amount of growth (one colony, or lightgrowth)or is this going to give a misleading message to the physician?
(answered 06/02/2003)

I have been reading that routine throat cultures are really of no use but rather that there should only be a throat culture for strep offered for pharyngitis, (of course we would still offer specialty cultures for things like pertussis). Are there any references to only offering throat cultures for strep and not a "whole" throat culture?
(answered 04/21/2003)

Tissue from left ethmoid grew mixed anaerobic flora including many gram positive bacilli showing filamentous and some branching morphology. We suspect an actinomyces. Is this a possibility in the nasal sinus?
(answered 03/18/2003)

When should Haemophilus parainfluenzae and other non-H. influenzae species of Haemophilus be considered pathogens in sputum cultures? My lab does microbiology testing for clinical trials and we spend a considerable amount of time and effort working up these organisms and performing susceptibility testing on them. What is the utility of collecting this data for clinical trials?
(answered 02/21/2003)

What is the significance of Haemophilus parainfluenza when found in moderate or large numbers in a lower respiratory tract culture?
(answered 02/19/2003)

EBV PCR in CSF: In patients with confirmed Neuroborreliosis (Serum-Liquor-Index positive), and slightly increased cells in the CSF, with a positive EBV PCR; what is your interpretation concerning the positive EBV PCR in CSF?
(answered 02/18/2003)

HSV PCR in CSF: what is the kinetic of the pcr results during clinical course? Are there reasons to assume false negative pcr in the first week, or: positive results only in late phase (after 1 week)? On what studies is your opinion based on?
(answered 02/14/2003)

ON STREP THROAT CULTURES WE ARE SETTING CHOCOLATE PLATES ON PATIENTS 5 AND UNDER AND REPORTING H. FLU IF THERE IS SIGNIFICANT GROWTH. IS THIS OF ANY BENIFET TO THE DR.
(answered 11/05/2002)

What is the best method to recover Campylobacter spp. from swabs?
(answered 08/15/2002)

Is there currently a standard method for the detection and enumeration of Salmonella?
(answered 08/15/2002)

Which agar is best suited to recover campylobacter spp. from enteric swabs... What tests can be used to confirm the presence of campylobacter spp.
(answered 08/05/2002)

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