Body Fluid Culture and Stain
Test Mnemonic
BFCUL
CPT Codes
- 87070 - QTY (1)
- 87205 - QTY (1)
LOINC ®
611-4
Includes
- Identification and susceptibility performed on postive cultures.
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 5 mL | Fluid, body | Sterile container | Ambient | Ambient | Transfer 5ml (Minimum 2ml) aspirate to a sterile tube or container OR body fluid collected in blood culture bottles, accompanied by orginal specimen, if available. |
Alternate Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 5 mL | Aspirate(s) | Sterile container | Ambient | Ambient | Aspirate of culdocentesis or thoracentesis are acceptable |
| 5 mL | Fluid, vesicle | Sterile container | Ambient | Ambient | |
| 5 mL | Fluid, peritoneal | Sterile container | Ambient | Ambient | |
| 5 mL | Fluid, pericardial | Sterile container | Ambient | Ambient | |
| 5 mL | Fluid, amniotic | Sterile container | Ambient | Ambient |
Minimum Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 2 mL |
Stability
| Environmental Condition | Description |
|---|---|
| Ambient | Ambient = 24 hours |
| Frozen | Unacceptable |
| Refrigerated | Unacceptable |
Days Performed
Sun - Sat
Turnaround Time
7 days
Methodology
| Name | Description |
|---|---|
| Culture, Identification | |
| Stain |
Reference Range
Special Info
Media and incubation conditions are employed for the recovery of aerobic bacteria from normally sterile body fluids (synovial, peritoneal, pericardial, pleural, amniotic). Disinfect overlying skin with iodine or chlorhexidine preparation and obtain specimen with needle and syringe. Push needle through septum of transport container and inject fluid into sterile container (or Port-A-Cul vial if anaerobic culture is also ordered). NEVER submit a swab specimen. Fluid may be inoculated into a blood culture bottle (up to 10 ml) provided a separate 1 ml aliquot is also submitted for preparation of Gram stain and inoculation of solid media. Broth cultures do not reflect bacterial burden and a true pathogen may be obscured by overgrowth of more rapidly growing bacteria. Anaerobic cultures require a separate order. Abscess and drainage from tubes should be submitted with an order for wound culture rather than body fluid culture. Specimens submitted in Red Top Vacutainer evacuated blood collection tubes are unacceptable. The internal walls of these tubes are coated with silica particles, which act as a clot activator and affects the recovery of microorganisms. If culture is positive, identification will be performed at an additional charge for clinically significant organisms. Identification CPT codes that may apply include: 87077, 87106, 87107, 87153, 87158. Antimicrobial susceptibilities are performed when indicated, and the following CPT codes may apply: 87181, 87184, 87185, 87186.
Clinical Info
Provision of specific information regarding the type of body fluid submitted is essential for culture interpretation. Synovial fluid from shoulder joints is inoculated into broth and incubated for 14 days to rule out Propionibacterium acnes. Cultures from other sites are held for 5 days. Spontaneous bacterial peritonitis (SBP) is usually caused by a single aerobic bacterial pathogen (e.g., Enterobacteriaceae, Streptococcus pneumoniae, Enterococcus). Secondary peritonitis (associated with bowel perforation, ruptured diverticuli or ruptured appendix) is typically caused by multiple aerobic and anaerobic gastrointestinal flora organisms.