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Test ID: Respiratory Lower culture
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Respiratory Lower culture
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Culture of Lower respiratory samples by Conventional culture
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Useful For
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The diagnosis of lower respiratory bacterial and fungal infections including pneumonia.
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Method name and description
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Conventional Culture Technique
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Reporting name
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Respiratory Lower culture
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Clinical information
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Common bacterial agents of acute pneumonia include: Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Pseudomonas aeruginosa, and members of the Enterobacteriaceae (Escherichia coli, Klebsiella species, and Enterobacter species). Clinical history, physical examination, and chest X-ray are usually adequate for the diagnosis of pneumonia, and antimicrobial treatment is typically based on these findings.
Culture of expectorated sputum is used by some for the evaluation of pneumonia, although controversy exists regarding this practice; both sensitivity and specificity of sputum cultures are generally regarded as poor (<50%). Specificity is improved by collecting expectorated purulent matter from the lower respiratory tract and avoiding mouth and oropharyngeal matter, thereby reducing contamination. Prior to culture, the specimen should be examined for the presence of white blood cells (evidence of purulent matter) and a paucity of squamous cells (evidence of minimal contamination by oral matter).
Blood cultures should be performed to establish the definitive etiology of an associated pneumonia. However, only 20% to 30% of patients with bacterial pneumonia are bacteremic.
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Aliases
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- C lower respiratory
- Brochoalveolar lavage Culture
- BAL Culture
- Bronchial wash collection
- Bronchial brush collection
- ETT Culture
- Lung Aspirate Culture
- Tracheal Aspirate Culture
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Specimen type / Specimen volume / Specimen container
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Specimen type:
- Brochoalveolar lavage (BAL)
- Bronchial wash collection
- Bronchial brush collection
- Endotracheal tube (ETT) secretions
- Lung aspirate
- Trans-tracheal aspirate
Specimen volume: 2 mL minimum, For BAL specimens, please send as large a volume as possible
Specimen container: Sterile leak proof container
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Collection instructions / Special Precautions / Timing of collection
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Collection instructions:
Please follow relevant organizational documented procedures
Special Precautions:
As per relevant organizational documented procedures
Timing of collection:
- Where possible all specimens should be fresh and taken before antimicrobial treatment is started
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Relevant clinical information to be provided
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- Patient clinical condition
- Antimicrobial therapy
- Collection site
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Storage and transport instructions
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- ≤ 2 hrs. at room temperature
- > 2 hrs. store at 2-8 °C
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Specimen Rejection Criteria
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- Duplicate specimen within 72 hrs.
- Leaking specimen
- Unlabeled/Mislabeled specimen
- Wrong container
- Specimen received as a swab e.g. endotracheal or tracheal secretion swab
- Endotracheal tube tips
- No relevant clinical details provided with the request. (Please note that where applicable, the relevant clinical details should reflect those on the patient’s electronic record at the time the order was placed).
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Biological reference intervals and clinical decision values
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Microscopy:
- Semi quantitative report of WBC’s, epithelial cells, type of bacteria, Yeast, and fungal hyphae
Culture Negative:
- No growth or normal upper respiratory flora
Culture Positive:
- Significant isolates reported along with antimicrobial susceptibility results when appropriate.
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Factors affecting test performance and result interpretation
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- Improper collection technique
- Improper container
- Improper transportation
- Improper processing
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Turnaround time / Days and times test performed / Specimen retention time
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Turnaround time:
- Microscopy :24 hrs.
- Culture: 48-72 hrs.
Days and times test performed:
- Daily 24/7. Note: In HGH microbiology laboratory, test timings are from Sun to Fri 7am to 3pm.
Specimen retention time:
- 48 hrs. after final report
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