Acid Fast Bacilli Smear

Last Modified: 9/16/2022 8:56:44 AM


Medical Necessity Documentation:  
Client Notes: Acid Fast Smear is included in an Acid Fast Culture automatically and should rarely be ordered alone.
Patient Preparation:  Expectorated sputum: Instruct patient to gargle with water and cough deeply.  Three separate early morning collections on at least three consecutive days are recommended.
Specimen Requirements: Preferred Specimen(s):
10 mL of  body fluids, lower respiratory tract specimens, or gastric lavage in sterile container 
or 
2 mL CSF
or
40.0 mL urine in sterile, leak-proof container
or
2 grams fresh (unfixed) tissue in sterile container
or
1 mL exudate, aspirate, lesion material, ocular specimen collected in a sterile, leak-proof container

Minimum Volume:
2 mL of body fluids, lower respiratory tract specimens, or gastric lavage 
or
1 mL CSF
or
1 gram fresh tissue (unfixed)
or
20 mL urine
or
1 mL or 1 swab wound, exudates, aspirates, lesion material, or ocular specimens
Collection Instructions: Tissue and biopsy material: Steile, leak-proof container with small amount of saline, no fixative or preservative.

Gastric lavage fluid: Sterile, leak-proof container.  Must be neutralized with sodium bicarbonate within 4 hours of collection.

Sputums may be collected in sputum collection device per instructions. (First AM, deep cough specimens are best). Transport at room temperature. 

Urine should be first/early AM collection


Transport & Storage: Temperature/Stability: Transport refrigerated

Specimen Stability:
Ambient: unacceptable
Refrigerated: 5 days
Frozen: unacceptable
Rejection Criteria: 24 hour pooled urine or sputum, dry swabs, specimens received in alcohol, formalin, EDTA, lithium heparin or conventional blood culture bottles, throat/oral/sputum swabs from non-cystic fibrosis patients, urine specimens in preservative tubes
Reference Range: See Laboratory Report
Critical Ranges:  
Test Comments: PRMC Microbiology sends specimen to Quest for testing.
Smear results are reported within 24 hours of receipt at Quest.
Methodology: Microscopic Exam with Fluorochrome Stain
Clinical Significance:  There are more than 70 species of mycobacteria of which the primary pathogen is M. tuberculosis.  Tuberculosis is a chronic, granulomatous disease casued by M. tuberculosis.  Identification, and, if appropriate, antibiotic sensitivity, is required to initiate necessary therapy.
Documentation:  
Custom Panel: No

PRODUCTION SCHEDULE

Turn Around Time: 48 hours; 4 days (if received on Friday afternoon)
Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Parkview Regional Medical Center, Quest - Chantilly
PHL Test Code: AFBST
EPIC Test Code: LAB2495
Send Out Test Code: 5202
Alternate Test Names: AFB Smear; Smear for AFB
Included Tests:  Acid-Fast Bacilli Stain
CPT Coding: 87206, 87015

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