Pyrazinamide (PZA) testing is suspended due to issues with the manufacturer’s kit. ARUP will continue testing the other first-line drugs: rifampin, isoniazid, and ethambutol. If PZA susceptibility testing is required during this test delay, contact your local public health laboratory or the CDC for pncA gene testing for PZA resistance mutations.

0060152
print

Acid-Fast Bacillus (AFB) Culture and AFB Stain

MC AFB
Example Reports
Negative
Positive

Icon

Time Sensitive

Ordering Recommendation

Gold standard test for diagnosing the presence of mycobacteria organisms.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Recommended collection: Three sputum specimens at 8-24 hour intervals (24 hours when possible) and at least one first-morning specimen. An individual order must be submitted for each specimen.

Collect

Respiratory specimens. Also acceptable: Body fluid, CSF, gastric aspirate, tissue, or urine.

Specimen Preparation

Place each specimen into 50 ml sterile specimen transport tube (ARUP Supply #29582) and place in an individually sealed bag.
Respiratory Specimens: Transfer (for each collection) 5-10 mL to a sterile container. (Min: 1 mL)
Body Fluids: Transfer 5 mL to a sterile container. (Min: 1 mL culture only)
CSF: Transfer 5 mL to a sterile container. (Min: 1 mL culture only. Min: 5 mL culture and stain)
Gastric Aspirates: Must be neutralized (pH7) with sodium carbonate if transport is delayed for more than four hours. Transfer 5-10 mL to a sterile container. (Min: 1 mL)
Tissue: Transfer to a sterile container. (Min: Visible, for small tissue that cannot be ground, acid fast stain will not be performed.)
Urine: Transfer at least 40 mL to a sterile container. (Min: 10 mL culture only. Min: 40 mL culture and stain)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Dry material or material collected and transported on a swab.
Acid Fast Stain: Stool, blood, bone marrow, grossly bloody specimens.

Remarks

Specimen source required.

Stability

Ambient: 24 hours; Refrigerated: 1 week; Frozen: 2 weeks

Methodology

Stain/Culture/Matrix-Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF) Mass Spectrometry/16SrDNA Sequencing/Polymerase Chain Reaction/Broth Microdilution

Performed

Sun-Sat

Reported

1-62 days
Stain reported within 24 hours. Negative cultures reported at 8 weeks.  Positive cultures are reported as soon as detected.

Reference Interval

Effective May 20, 2013

Culture negative for acid fast bacilli.
Identification performed on positives.
Susceptibility performed on all initial isolates of M. tuberculosis complex.
Susceptibility performed on significant isolates of Mycobacterium other than M. tuberculosis complex isolates.

Interpretive Data



Compliance Category

Standard

Note

Respiratory specimens, body fluids, CSF, gastric aspirates that are under 5 mL and urine specimens under 40 mL will receive a volume suboptimal disclaimer in the report.

Positive cultures are reported as soon as detected. AFB stain, AFB identification of positives, and susceptibility tests are billed separately from culture. Identification of positive culture is billed by matrix-assisted laser desorption ionization (MALDI) and/or sequencing tests performed. Mycobacterium tuberculosis Complex Detection and Rifampin Resistance by PCR (ARUP test code 2010775) is available for respiratory, CSF, or body fluid specimens.

The laboratory should be notified when the presence of Mycobacterium genavense or Mycobacterium haemophilum is suspected, as these organisms will not grow on media routinely used for Mycobacterium isolation.

The laboratory should be notified when M. xenopi is suspected, as this organism requires a different temperature from routine culture setup.

The laboratory should be notified if the specimen is from a cystic fibrosis patient, as these specimens need additional decontamination from routine culture setup.

Susceptibility will be performed on organisms isolated from a sterile source and isolates of Mycobacterium tuberculosis complex, M. chelonae, M. abscesses, M. fortuitum complex, M. immunogenum, M. mucogenicum. Susceptibility testing will be performed by request only on M. kansasii and M. marinum. Susceptibility testing of M. gordonae is inappropriate.

For AFB susceptibility information, refer to Antimicrobial Susceptibility - AFB Mycobacteria (ARUP test code 0060217). 

For AFB culture on blood refer to Culture, Acid-Fast Bacillus, Blood (ARUP test code 0060060).

Hotline History

N/A

CPT Codes

87116; CPT codes for identification and susceptibility vary based on method.

Are you an ARUP Client? Click here for your pricing.

Components

Component Test Code* Component Chart Name LOINC
0060152 Culture, Acid Fast Bacilli 543-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • Acid Fast Stain
  • Acid-fast (Mycobacteria) Smear and Culture With Reflex to Identification and Susceptibility Testing
  • AFS
  • AFS, Auramine-rhodamine stain
  • AO stain
  • AR stain
  • Auramin-rhodamine stain
  • Culture (AFB Culture (Includes AFB Stain 0060151))
  • MTB Culture (AFB Culture (Includes AFB Stain 0060151))
  • Mycobacteria Culture (AFB Culture (Includes AFB Stain 0060151))
  • Mycobacterium
  • Mycobacterium species culture
  • TB Culture (AFB Culture (Includes AFB Stain 0060151))
Acid-Fast Bacillus (AFB) Culture and AFB Stain