Lab Information Manual

Laboratory:

Clinical Microbiology

Test Name:

CYSTIC FIBROSIS, RESPIRATORY, CULTURE, AEROBIC BACTERIA (HSC ONLY)

Test Code: CFR

Clinical Information:

Test Indications:
Identification of bacteria associated with pulmonary disease in CF patients.
Chronic lung infection is responsible for 75 to 85% of deaths in patients with cystic fibrosis (CF). The bacteria most commonly isolated from the lungs of CF patients are Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Burkholderia cepacia complex, Stenotrophomonas maltophilia, and Achromobacter spp. Species of the Burkholderia cepacia complex that are considered to play a role in CF lung disease include B. cenocepacia, B multivorans, and less commonly B. dolosa, and B. vietnamiensis. The role of other Burkholderia species has not been established in CF lung disease. Other non-glucose fermenting bacteria including Inquilinus, Herbaspirillum, Ralstonia, Pandoraea, Cupriavidus, Chryseobacterium, and Sphingobacterium spp. have also been isolated from CF patients but their role as pathogens has not been well established yet. More recent data indicate that mycobacteria, especially M. abscessus and Mycobacterium avium complex, and certain filamentous moulds (Aspergillus fumigatus, Scedosporium apiospermum complex, Trichosporon mycotoxinivorans) may also play a role in pulmonary disease in these patients.

Recommendations:
Indicate current antimicrobic therapy on requisition.
Samples and requisitions must be labeled/completed in accordance with the Shared Health Specimen Acceptance Policy.
Accurate patient identification must be made prior to sample collection. Patient identification should be done in accordance with the site policy.

Patient Preparation Instructions:
If throat swab is collected, place the swab in the back of the throat and induce coughing. Remove the swab when coughed secretions have been collected. Swabs should only be performed in children who are unable to produce sputum.

Collection Devices:

Preferred Device:	1 - Sterile Specimen Container (100 mL) Sterile Specimen Container (100 mL) Manufacturer: Catalogue #:
Alternate Device:	1 - eSwab eSwab Manufacturer: Catalogue #: - for throat swabs

Specimen Required:

Adult: Sputum and lower respiratory tract secretions.
Pediatric: Sputum and lower respiratory tract secretions are preferred. Deep throat swabs are acceptable in children who are unable to produce sputum.

Referral:

Ensure samples that are being sent to a referral laboratory are packaged in accordance with Transport of Dangerous Goods recommendations for diagnostic samples.

Requisition:

_SH Microbiology - Provincial Requisition (R250-10-06)

Reference Values:

No growth.
A final negative report will be sent after 2 days.

Availability:

Daily