In Patient Microbiology

MICROBIOLOGY INPATIENT CULTURE ORDERS:

The Micro Spec Site-Culture code for a micro culture test describes the general specimen description for the ordered culture. Refer to the HELP screen for appropriate codes available. Only codes may be entered at this prompt.
It may be necessary to describe the specimen in more detail than was possible in Micro Spec Site-Culture. Further description of the specimen may be done in Micro Spec Rmrk-Culture field. This field will appear only on Micro culture orders. Refer to Specimen Description Codes for Cultures list for the appropriate code. The list of specimen description codes includes descriptions such as left, right, upper, lower. More than one code may be entered, separated by hyphens. If the appropriate code is not on the list, type the appropriate test.

A combination of codes and typed text may also be used, separating the code from the free text with a hyphen.

Examples:
1. The specimen is from the upper left leg:
  Micro Spec Site-Culture: LEG
  Micro Spec Rmrk-Culture: UPP-LEFT (2 codes)
2. The specimen is from an abdominal incision:
  Micro Spec Site-Culture: INCI
  Micro Spec Rmrk-Culture: ABD (1 code)
3. The specimen is from the right 3rd finger:
  Micro Spec Site-Culture: FING
  Micro Spec Rmrk-Culture: RT-3rd (1 code and free text)
It is very important for the Microbiology personnel to be notified of any recent or current antimicrobial therapy the patient has received. Type the antibiotic name(s) in the Micro Spec Rmrk Culture field, using hyphens to separate it from any other entries in this field. If the physician has requested that a specific antibiotic be tested, note this in the same field.
After Culture name: Collected, RN enter the collection time and name of person who collected the culture. This field will have different prompts for different types of cultures. Enter data as prompted.
Blood Culture, Blood Culture Acid Fast Organisms and Blood Culture/Fungus must be ordered with a priority of 7 and a specified collection time entered
Questions about entry of specimen descriptions or antibiotic comments may be directed to the Microbiology Department (422-7494).

Microbiology Specimen Site Codes List for Cultures
AAA	Abd Aoric Aneurysm	CST	Cyst Fluid	LGWP	Large Whirl Pool	RIB	Rib
ABO	Abdomen	DECB	Decubitus	LRNX	Larynx	RT	Right
ABSC	Abscess	DIAL	Dialysate	LTRL	Lateral	SAL	Salivary
AMIN	Amniotic Fluid	DSC	Disc	LEFT	Left	SCAL	Scalp
ANAL	Anal	DSTL	Distal	LEG	Leg	SCRP	Scraping
ANKL	Ankle	DRNG	Drainage	LESN	Lesion	SCRT	Scrotum
ANVN	Antecubital Vein	DUOD	Duodenal Fluid	LIP	Lip	SEMN	Semen
ANT	Anterior	ENTR	E.T. (Endotracheal)	LIVER	Liver	SHOL	Shoulder
AORT	Aorta	EAR	Ear	LBOY	Lo Boy	SIN	Sinus
APDX	Appendix	ELBO	Elbow	LOBE	Lobe	SKIN	Skin
ARM	Arm	ENDC	Endocervical	LOCH	Lochia	SWMP	Small Whirl Pool
ARLI	Arterial Line	ENDM	Endometrial	LOW	Low	SPLN	Spleen
ASCT	Ascitic Fluid	EPDD	Epididymis	LUNG	Lung	SPUT	Sputum
ASP	Aspirate	ESPH	Esophagus	LN	Lymph Node	STRN	Sternum
ATR	Atrium	EXNL	External	MAND	Mandible	SMA	Stoma
AUTP	Autopsy	EYE	Eye	M	Mass	STOM	Stomach
AXIL	Axilla	FACL	Facial	MAST	Mastoid	STOL	Stool
BACK	Back	FLTB	Fallopian Tube	MAX	Maxilla	SCLV	Subclavian
Bart	Bartholin	FEM	Femoral	MAXI	Maxillary	SUBM	Submandibular
BILE	Bile	FEMR	Femur	MEDI	Medialstinal	SUPR	Superior
BX	Biopsy	FING	Finger	MDL	Middle	SURN	Suprapubic Urine
BLAD	Bladder	FLUD	Fluid	MURN	Midstream Urine	SWGZ	Swan Gaz
BLUD	Blood	FOOT	Foot	MOUT	Mouth	SYNV	Synovial
BLDY	Bloody	FORE	Foreman	NAIL	Nail	SYN	Synovial Fluid
BONE	Bone	FBOD	Foreign Body	NASL	Nasal	TTUB	T/Tube
BMAR	Bone Marrow	GBLA	Gallbladder	NASO	Nasopharnyx	TST	Testicle
BOWL	Bowel Contents	GAST	Gastric	NECK	Neck	THIG	Thigh
BRN	Brain	GASD	Gastric Drainage	NASP	Needle Aspirate	THOR	Thoracic
BRST	Breast	GEN	Genital	NRNS	Needle Rinse	THRT	Throat Swab
LAV	Bronchial Alv. Lavage	GRAF	Graftsite	NURN	Nephrostomy Urine	THUM	Thumb
BCHB	Bronch Brush	GRT	Great	NOSE	Nose	TIB	Tibia
BPSP	Bronchial (PSB)	GOIN	Groin	OCAV	Oral Cavity	TISU	Tissue
BBSY	Bronchial Biopsy	GROS	Grossing	OMUC	Oral Mucosa	TOE	Toe
BRON	Bronchial Brushings	GRS	Grossly	OTH	Other	TONG	Tongue
RINS	Brush Rinse	HAIR	Hair	OUTR	Outer	TONS	Tonsil
BRH	Brushing	HAND	Hand	PACE	Pacemaker	TOOT	Tooth
BRSA	Bursa	HEAD	Head	PAN	Pancreatic Fluid	TPN	TPN Solution
BUTT	Buttocks	HART	Heart	PRCT	Paracentesis	TCHE	Tracheal
CALF	Calf	HEEL	Heel	PARD	Parotid	TASP	Tracheal Aspirate
CPSL	Capsule	HICK	Hickman Catheter	PELV	Pelvis	TRAC	Tracheostomy Site
CURN	Catheterized Urine	HIP	Hip	PENI	Penis	TTRA	Transtracheal Aspirate
CTIP	Catheter Tip	HTNK	Hubbard Tank	PERI	Pericardial Fluid	TRAP	Trap
CVTY	Cavity	INCI	Incision	PERN	Perineal	TL	Triple Lumen
CELL	Cellulitis	INDX	Index	PERR	Perirectal	TTB	Tube
CENL	Central Line	DUCE	Induced	PRTN	Peritoneal	ULCR	Ulcer
CSF	Cerebrospinal Fluid	INNR	Inner	PERT	Peritoneal Fluid	UMBL	Umbilicus
CERV	Cervix	ISIT	Insertion Site	PETO	Peritonsillar	UPP	Upper
CHEK	Cheek	INTL	Internal	PERM	Perm Catheter	URET	Ureter
CHST	Chest	INOR	Intraocular	PILO	Pilonidal	URTH	Urethra
CTUB	Chest Tube	IU	Intrauterine Device	PLAC	Placenta	UTER	Uterus
COCX	Coccyx	IVST	IV Site	PLAQ	Plaque	VAG	Vagina
COLN	Colon	JP	Jackson Pratt	PLEU	Pleural Fluid	VAD	Vascular Access Device
COLS	Colostomy Site	JONT	Joint	PWP	Portable Whirl Pool	VEIN	Vein
COMD	Common Duct	JUG	Jugular	POSR	Posterior	VERF	Vertebral Fluid
CORS	Corneal Scrapings	KID	Kidney	PRST	Prostate	VCOR	Vocal Cord
CULD	Culdesac	KNEE	Knee	RECT	Rectal	VUL	Vulva
CYT	Cyst	LABA	Labia	RENL	Renal

Other Microbiology Codes for Cultures
BCB	Received in blood culture bottles	NSWB	No swab received in transporter
CTTE	Specimen received in culturette (or on swabs)	NTRN	Not transported anaerobically
DIAP	Specimen obtained from a diaper	POL	Specimen pooled together from:
ENMA	Patient had and enema previous to collection	PSTH	Specimen found in surgery pass through
FEXP	Transporter media expired: (time)	RN1	Run on 1 specimen
FIC	Fluid injected into culturette	SEC	2 nd specimen
FILL	Preservative/container improperly filled	SINC	Specimen inoculated
H2O	Water	SPRG	Specimen refrigerated
ICE	Specimen not received on ice	SROP	Specimen received on plates
INCH	Specimen longer then 2 inches	STLP	Stool preservative not mixed thoroughly
LIT	Too little specimen added to preservative	TRPN	Transported improperly
MUCH	Too much specimen added to preservative	TVOL	Total volume spun:
NCRS	Culturette amplue not crushed	WSWB	Wooden swab may inhibit HSV replication
NOT	Consistency not indicated	WRST	Wrist

POWERCHART NAME	AFB CULTURE OTHER
MERCY TEST NAME	ACID FAST CLT/SMR*	MERCY LAB CODE	AFBCLT

Comment:	Specify collection site when ordering. See pg 1-2 for ordering help and codes.
Specimen:	Submit each specimen in a sterile container with a tight fitting lid. Body fluids: Minimum of 5 ml specimen. Bronchus washings/brushings: Minimum of 5 ml bronchus washings/brushings. Cerebrospinal fluid: 1 ml CSF minimum in a sterile plastic screw cap tube. Gastric washings: 1 ml specimen minimum. Sputum: Minimum of 5 ml specimen. A first morning specimen is recommended. Stool: Submit a pea size sample. No preservative. Tissue: Submit a pea size sample. Can be placed in a small amount of saline to prevent drying out. Urine: Minimum of 50 ml of urine. The first morning specimen is recommended. Bone Marrow: Send using lithium heparin tubes.
Cause for rejection:	Serum is submitted for testing.
Processing:	Send to the laboratory immediately after collection. Specimens are referred to Mayo Medical Laboratories, Rochester, MN for an AFB smear and culture.
Performed:	Smear: Monday through Sunday. Mayo will contact Mercy Lab if positive. Final: 8 weeks. Mayo will notify Mercy Lab if culture is positive prior to 8 weeks. If tissue is submitted for testing, an additional charge will be assessed for processing. If a bacteremia due to mycobacterium is suspected, see BLOOD CULTURE/ACID FAST ORGANISMS
Reference values:	AFB smear: No acid fast organisms seen. If the smear is positive: Mycobacterium tuberculosis, Amplified Direct Test is available at an additional charge. AFB culture: No acid fast organisms isolated. If the culture is positive for Mycobacterium: Antimicrobial Susceptibility testing is available at an additional charge. This testing has to be requested by the ordering location or provider.
Method:	AFB smear: Auramine-Rhodamine Stain AFB culture: Automated Detection plus 7H10-11 agar Identification of AFB isolates by rapid methods: Nucleic Acid Probes, DNA Sequencing and Real-Time PCR, when appropriate.
CPT Code:	87206- Smear 87116- Culture, Mycobacterium 87149- Identification of Mycobacteria by nucleic acid probe (if appropriate) 87158- Identification of Mycobacteria by other methods (if appropriate) 87176- Tissue Processing (if appropriate)

TEST NAME

AEROBIC CULTURE/GRAM STAIN

Cultures are listed according to collection site.
Order according to the source of the specimen.
If there is no culture for the specific source, then order according to the type of culture, i.e.: body fluid, wound, etc.

POWERCHART NAME	ANAEROBIC CULTURE + SMEAR
MERCY TEST NAME	ANAEROBIC CLT/GS	MERCY LAB CODE	ANER

Specimen:	DO NOT USE AEROBIC TRANSPORTER! A Port-A-Cul Cary Blair tube or Port-A-Cul anaerobic transport vial should be used. Both transport systems contain an indicator which will turn purple when oxygen is present. DO NOT USE the transporter if the indicator is purple prior to opening the transporter. Swab specimens: Imbed swab deeply into Port-A-Cul Cary Blair tube and cap tightly. Two swabs from the same specimen site should be submitted in one transport tube. Fluid or pus aspirates: Inject specimen into Port-A-Cul vials. DO NOT inject air into vial.
Listing of acceptable and unacceptable specimens: ACCEPTABLE specimens for anaerobic culture
	Exudates or aspirated pus from deep wounds/abscesses Surgical specimens Normally sterile body fluids Transtracheal aspirates Suprapubic urines from: Percutaneous bladder aspiration Nephrostomy tubes Suprapubic catheter Genital specimens ONLY as follows: Cul de sac aspiration Culdocentesis
UNACCEPTABLE specimens for anaerobic culture:
	Superficial wounds Specimens contaminated with intestinal flora ‑such as intestinal contents, colostomy sites, drainage from a pilonidal sinus, or bowel perforations. Feces/rectal swabs Throat/nasopharyngeal swabs Sputum/bronchoscopic specimens Vaginal/cervical swabs Midstream or catheterized urine specimens
Comments:	Specify collection site when ordering. See pg 1-2 for ordering help and site codes. Specimens will be processed according to site. Only predominant anaerobes will be reported from cultures contaminated with oral, genital, or intestinal flora. Identification to genus and species will only be performed on isolates from blood, CSF and other normally sterile body fluids. Anaerobic susceptibility testing will not be performed. Anaerobic isolates may be referred to Mayo Laboratories, Rochester, MN for susceptibility testing upon special request. Contact the Mercy Microbiology Lab for information.
Performed:	Gram stain: Within 8 hours of receipt. Preliminary report: 2 - 4 days Final report: 7 days
Reference values:	No anaerobes isolated (applies to normally sterile body sites). Varies with site of collection.
Method:	Standard culture techniques.
CPT Code:	87205 Gram Stain+ 87075 Anaerobic Clt+

POWERCHART NAME

BACTERIAL ANTIGENS CSF NEONATAL (< 1 week of age)

SEE: GBSAG

POWERCHART NAME

BACTERIAL ANTIGENS CSF PEDIATRIC (1 week to 17 years)

SEE: BACTAG

POWERCHART NAME

BACTERIAL ANTIGENS CSF ADULT (18 years and older)

SEE: BACTAG

POWERCHART NAME

BACTERIAL ANTIGENS URINE NEONATAL (< 1 week of age)

Test no longer available.

POWERCHART NAME

BACTERIAL ANTIGENS URINE PEDIATRIC (1 week to 17 years)

Test no longer available.

POWERCHART NAME

BACTERIAL ANTIGENS URINE ADULT (18 years and older)

Test no longer available.

TEST NAME

BACTERIAL CULTURE

See: Cultures are listed according to collection site.
Order according to the source of the specimen.
If there is no culture for the specific source, then order according to the type of culture, i.e.: body fluid, wound, etc.

TEST NAME

BACTERIAL MENINGITIS ANTIGENS
(CSF AND URINE):

See: Bacterial Antigens based on common agents of meningitis for certain age groups and the site of the specimen.

POWERCHART NAME

Microbiology Specimen Site Codes List for Cultures

Other Microbiology Codes for Cultures