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Test Code VRESP Viral Culture, Respiratory

Reporting Name

Viral Culture, Respiratory

Useful For

Diagnosing viral infections in respiratory specimens

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Varies


Advisory Information


Source-based recommendation for testing:

Esophogeal specimens: Tissue, swabs, or brushings

Order VIRNR / Viral Culture, Non Respiratory

 

Infectious agent-based recommendations for testing:

If herpes simplex visus (HSV) is suspected in a neonatal patient (<1 month), order VHSV / Herpes Simplex Virus (HSV), Culture From Neonates

 

State Health Department testing only: specimens will not be accepted at Mayo Medical Laboratories for the following diseases (submit directly to your state health department).

-Measles

-Mumps

-High-risk infectious agents (examples of high-risk infections agents include: Ebola and other causative agents of viral hemorrhagic fever, avian influenza, severe acute respiratory syndrome (SARS), and Middle Eastern respiratory syndrome coronavirus (MERS-CoV)



Shipping Instructions


Specimen must be transported at refrigerate temperature and swab specimens should be sent in viral transport media.

 

Specimens must be received and cultured in the laboratory within 7 days postcollection. 

 

Specimens for viral culture should be transported to the laboratory as soon as possible for optimal recovery.



Necessary Information


Specimen source is required.



Specimen Required


Specimen Type: Lower respiratory tract specimens such as bronchoalveolar lavage, bronchial washings or aspirates, tracheal aspirates or secretions, pleural fluid, nasal swab or washing or sputum

Container/Tube: Sterile container

Specimen Volume: 1 mL

 

Supplies:

Nasopharyngeal Swab (Rayon Mini-Tip swab) (T515)

M5 Media (T484)

Specimen Type: Nasopharynx 

Specimen Volume: Entire collection

Collection Instructions:

1. Collect specimen by swabbing back and forth over mucosa surface to maximize recovery of cells.

2. Place swab into M5 media (T484) or other transport media.

 

Supplies:

Culturette (BBL Culture Swab) (T092)

M5 Media (T484)

Swab, Sterile Polyester (T507)

Specimen Type: Throat

Container/Tube:

Preferred: BBL CultureSwab (T092)

Acceptable: Dacron-tipped swab with plastic handle (T507)

Specimen Volume: Swab

Collection Instructions: Place swab into M5 media (T484) or other transport media.

 

Supplies: M5 Media (T484)

Specimen Type: Tissue

Sources: Lung and others
Container/Tube:
Sterile container with 1 to 2 mL of sterile saline or M5 transport media (T484)

Specimen Volume: Entire collection

 

Supplies:

Swab, Sterile Polyester (T507)

M5 Media (T484)

Specimen Type: Oral

Container/Tube: Dacron-tipped swab with plastic handle (T507)

Specimen Volume: Swab

Collection Instructions: Place swab into M5 media (T484) or other transport media.


Specimen Minimum Volume

NA

Specimen Stability Information

Specimen Type Temperature Time
Varies Refrigerated 7 days

Reference Values

Negative

If positive, virus is identified.

Day(s) and Time(s) Performed

Monday through Sunday; Varies

Test Classification

This test uses a standard method. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

87252-Tissue culture inoculation

87176-Tissue processing (if appropriate)

87253-Additional testing virus, identification (if appropriate)

87254-Viral smear, shell vial (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
VRESP Viral Culture, Respiratory 6584-7

 

Result ID Test Result Name Result LOINC Value
VRESP Viral Culture, Respiratory 6584-7

Clinical Information

Viruses are responsible for a broad spectrum of clinical symptoms and diseases. The most commonly isolated viruses are adenovirus, cytomegalovirus (CMV), enteroviruses, herpes simplex virus (HSV), influenza virus, parainfluenza virus (types 1-3), respiratory syncytial virus (RSV), and varicella-zoster virus (VZV).

 

Many viral infections can now be treated with antiviral drugs. Early laboratory diagnosis by isolation is very helpful in the medical management of these patients.

 

Viruses that are detected in cell culture: adenovirus, CMV, enterovirus, HSV, VZV, RSV, influenza virus, and parainfluenza virus.

 

Viruses that are not detected in cell culture: Epstein-Barr virus, rubella virus (must order serology), and human papillomavirus, Norwalk or norovirus.

Interpretation

A positive result indicates that virus was present in the specimen submitted. Clinical correlation is necessary to determine the significance of this finding.

 

Influenza virus infection is a state-mandated reportable disease.

 

Negative results may be seen in a number of situations including absence of viral disease, inability of the virus to grow in culture (examples of organisms not detected by culture include Epstein-Barr virus, rubella virus, and papilloma virus), and nonviable organisms submitted. Parainfluenza virus type 4 also may not be detected by viral culture.

Clinical Reference

1. Clinical and Laboratory Standards Institute 2005. Viral Culture. Proposed Guideline. CLSI document M41-P. Clinical and Laboratory Standards Institute, Wayne, PA

2. Ginocchio CC, Harris PC: Chapter 17: Reagents, stains, and cell culture: virology. In Manual of Clinical Microbiology. 10th edition. Edited by J Versalovic, KC Carroll, et al. Washington, DC, ASM Press, 2011, pp 1289-1296

3. Smith TF: Antibody-enhanced detection of viruses in cell cultures. In Manual of Clinical Laboratory Immunology. Fifth edition. Edited by NR Rose, EC de Marcio, JD Folds, et al. Washington, DC, ASM Press, 1997, pp 618-624

Analytic Time

14 days

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

Gel swab, E-swab, swab with wooden handle

Testing Algorithm

All routine viral cultures are inoculated into cell culture tubes for viral detection. The most common specimens received for routine testing include bronchoalveolar lavage, sputum, and throat. A rapid (16-hour incubation) shell vial cell culture assay will be inoculated when specimens are designated for herpes simplex virus or cytomegalovirus detection or as appropriate for source indicated.

 

If enterovirus or hand, foot, and mouth disease is suspected, clearly indicate "enterovirus" on request.

Method Name

Cell Culture

Shell Vial Assay for Herpes Simplex Virus or Cytomegalovirus

Disease States

  • Influenza A
  • Influenza B

Secondary ID

88926

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
TISSR Tissue Processing No, (Bill Only) No
VID2 Additional Testing Virus Ident No, (Bill Only) No
SVIR Viral Smear, Shell Vial No, (Bill Only) No

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request Form (T244) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/microbiology_test_request_form.pdf).