Microbiology

SR NO TEST TEST COMPONENTS METHOD SPECIMEN/TRANSPORT TAT CLINICAL APPLICATIONS
1 AFB AFB Conventional microscopic examination after ZN stain All specimens except blood
Miscellaneous specimens ( Urine, Pus, Sputum, Body Fluids like pleural, peritoneal, pericardial, gastric, bronchial, semen etc.) in a sterile, screw capped container OR Tissue in sterile normal saline OR Swabs in sterile normal saline OR Bone marrow in 1 Green Top (Sodium Heparin) tube, OR smeared onto 4 clean glass slides fixed IMMEDIATELY in 95% ethanol for 30 minutes and air dried. For gastric lavage , patient should be fasting for previous 12 hours. Transport the gastric lavage specimens within 4 hrs of collection. Specify type of specimen on container and test request form. Ship refrigerated.
Report Same Day Detection of Mycobacterium spp (AFB) by Microscopy
2 AFB CULTURE AFB stain from concentration material. Differentiation of Mycobacterium between MTB and NTM/MOTT Liquid rapid culture on MGIT. Followed by Differentiation between MTB and NTM/MOTT by TBMPT64Ag Card test. All specimens except blood
Blood/Bone Marrow: Collect 8 mL (5 mL min.) Blood/Bone marrow in Myco F / Lytic bottle available from ADL. Mix by gentle inversion 8–10 times. Ship at 18–22°C.
CSF: Collect 2 mL (1 mL min.) CSF in a Red Top (No Additive) tube or sterile screw capped container. Do not use SST gel barrier tubes. Ship refrigerated. Pus/Body fluids (Pleural/Pericardial/Ascitic/ Synovial/Ocular) Aspirates /Semen/ BAL Bronchial washings: Submit as much as possible (1 mL min.) in sterile screw capped container. Ship refrigerated.
Endometrial curettings/Tissue: Submit in sterile normal saline in a sterile screw capped container. Ship refrigerated.
Swabs: Submit swabs in 1 mL sterile normal saline in sterile screw capped container. Ship refrigerated.
Sputum/Urine: Submit 2 Spot (random) morning samples, 5-10 mL (1 mL min.) sputum/10 mL (5 mL min.) urine in sterile screw capped container. Do not pool the samples. Ship refrigerated. Gastric Lavage: Submit 5-10 mL (2 mL min.) gastric lavage in a sterile screw capped container. Ship refrigerated . Overnight fasting is mandatory.
Priliminary reports at 10 and 20 days and final repot at 42 days or earlier if positive. If smear positive for AFB and culture negative till 42 days then final report at 56 days. Detection of Mycobacterium spp. (MTB or NTM/MOTT) from any clinical specimen
3 AFBIF AFB BY FLUORSCENT STAIN Fluorescent stain and Fluorescent microscopy Miscellaneous specimens ( Urine, Pus, Sputum, Body Fluids like pleural, peritoneal, pericardial, gastric, bronchial, semen etc.) in a sterile, screw capped container OR Tissue in sterile normal saline OR Swabs in sterile normal saline OR Bone marrow in 1 Green Top (Sodium Heparin) tube, OR smeared onto 4 clean glass slides fixed iIMMEDIATELY in 95% ethanol for 30 minutes and air dried. For gastric lavage , patient should be fasting for previous 12 hours. Transport the gastric lavage specimens within 4 hrs of collection. Specify type of specimen on container and test request form. Ship refrigerated. Report Same Day Detection of AFB.
Immunoflourescense increases detection chances by Microscopy (Increased sensitivity of detection as compared to light microscopy)
4 ANAEROBIC CULTURE Gram stain, ZN stain, KOH, Anaerobic growth if any. Identification of anaerobic organism on MALDI TOF Conventional anaerobic culture and automatic identification on MALDI TOF after growth All sample except blood (Blood anaerobic culture is done by BACTEC method under entry Batctec anaerobic)
Collection and transportation under strict anerobic condition. Dry swab not allowed. Anaerobic transport medium is required.
5 days Isolation of Anaerobic organism
5 AUTOI (Identification on Vitek) - Automated identification on Vitek 2 compact system Pure growth of bacteria or yeast on plate or slant
Submit pure isolate on appropriate media. Ship refrigerated. DO NOT FREEZE. Specify collection site and provide brief clinical history.
48 hrs Identification of Bacteria/Yeast by automated system
6 BACTEC AEROBIC - Rapid Automated Aerobic Culture on BACTEC FX 200, Identification and Sensitivity BLOOD/8-10ML/CULTURE BOTTLE. or FLUID/PUS/TISSUE in CULTURE BOTTLE/STERILE CONTAINER
Collect 8-10 mL blood aseptically in special Plus Aerobic bottle available from SMPL. Mix by gentle swirling. Ship at room temperature.
Aerobic culture which includes enrichment, which increases detection chances as compared to platting method in case of fluid/pus/tissue. Also includes aerobic culture of blood
7 BACTEC ANAEROBIC - Rapid Automated Anaerobic Culture on BACTEC FX 200 and Identification BLOOD/8-10ML/CULTURE BOTTLE. or FLUID/PUS/TISSUE in CULTURE BOTTLE/STERILE CONTAINER
Collect 8-10 mL blood aseptically in special Plus Anerobic bottle. Mix by gentle swirling. Ship at room temperature.
Anaerobic culture which includes enrichment, which increases detection chances as compared to platting method in case of fluid/pus/tissue. Also includes anerobic culture of blood
8 BACTEC MYCO - Rapid Automated fungal Culture/NTM culture on BACTEC FX 200 BLOOD/1-5ML/CULTURE BOTTLE. or FLUID/PUS/TISSUE in CULTURE BOTTLE/STERILE CONTAINER
Collect 8-10 mL whole blood / body fluids aseptically in a Myco / F-Lytic bottle available from ADL. Mix by gentle swirling. Ship at room temperature.
Rapid culture system for detection of yeast/fungus/MOTT/NTM from blood and other body fluid.
9 Calcoflour Staininig CALCOFLUOR STAININIG Fluorescent microscopy All specimens except Blood 6 hrs Highly sensitive method for detection of Yeast or Fungus by Florescent staining.
10 FUNGUS CULTURE Gram stain, AFB stain, KOH, Identification of fungus grown, Colony count Conventional Fungus Culture and Rapid Culture for Yeast. CSF: 2 mL (1 mL min.) in a Red Top (No Additive) tube or sterile screw capped vial. Do not use SST gel barrier tubes. Ship refrigerated. Bone Marrow: 2 mL (0. 5 mL min.) Bone marrow in 1 Green Top (Sodium Heparin) tube. Ship refrigerated. Pus/Body fluids (Pleural/ Pericardial/ Ascitic/ Synovial/ Ocular/ Bronchial washings/BAL). Aspirates /Semen/ Stool: Submit as much as possible (1 mL/1g min.) in sterile screw capped container. Ship refrigerated. Endometrial curettings/Tissue: Submit in sterile normal saline in a sterile screw capped container. Ship refrigerated. Swabs: Submit swabs in 1 mL sterile normal saline in sterile screw capped container. Ship refrigerated. Sputum/Urine: Submit 2 Spot (random) morning samples, 5–10 mL (1 mL min.) sputum/10 mL (5 mL min.) urine in sterile screw capped container. Ship refrigerated. Skin: Submit 2–3 mm scrapings from periphery of active skin lesion in sterile container or between 2 sterile glass slides. Wrap slides in black paper. Ship refrigerated. Hair: Submit plucked 10–12 infected, lustreless hair including root in a sterile container. Ship refrigerated. Nail: Submit clippings and powdery material from friable and discolored region of affected nail. Ship refrigerated. 10 days Detection of fungal infection by culture method.
11 FUNGUS MIC Antifungal susceptibility with MIC value and interpretation of Posaconazole, Amphotericin-B, Fluconazole, Itraconazole, Ketoconazole, Flucytosine, Voriconazole, Caspofungin Broth microdilution Pure growth of Yeast from any sample 72 hrs Susceptibility of Antifungal drugs against any Yeast or Aspergillus spp, by MIC method
12 Genexpert-Tb MTB detection, Rifampicin susceptibility RT-PCR by GeneXpert Any specimen except blood/2ml/Sterile container
In case of Bone marrow, sample is to be collected in sterile container containing distilled water in double volume of bone marrow sample
6 hrs. Next day after cut off time Highly sensitive and specific method for rapid detection of MTB infection and Rif susceptibility, directly from clinical specimen.
13 Gram - Stain GRAM STAIN EXAMINATION : Light Microscopy after gram stain Any specimen except blood/1ml/Sterile container 4 hrs Detection of any microorganism and pus cells by microscopic examination. Gram stain from Vaginal swab for diagnosis of Bacterial vaginosis (Nugent score)
14 IDENTIFICATION BY MALDI TOF (Mass Spectrometry) Identification of organism by MALDI TOF Mass spectrometry Upto 48 hrs of culture growth or any bacteria or yeast. Growth on Blood agar or LJ medium or MGIT in case of NTM or MTB. Hyphal growth on plate or slant. 2 hrs Ultra rapid identification of any Bacteria, Yeast, Hyphal fungus, Mycobacteium spp from growth
15 KOH PREPARATION Light Microscopy Submit Skin, Nail scrapings, Hair ( including root), Cerebrospinal fluid, in a sterile screw capped container OR 2 mL whole blood / bone marrow in 1 Green Top (Sodium Heparin) tube. Ship at 18–22°C. Submit Body fluid, Sputum, Bronchial washings / Tissue in a sterile screw capped container OR Oral/Genital/wound swabs in 0. 5 mL sterile normal saline. Ship refrigerated. 4 hrs Detection of Fungal infection in clinical specimen by Microscopy. Also for Detection of Candidial Vaginosis.
16 LPA (Line Probe Assay) MTB-MDR LPAMTBMDR PCR followed by Membrane hybridization Any AFB smear positive sample 4 days Detection of MTB infection by PCR + Hybridization method along with detection of Isonizide and Rifampicin drug susceptibility status directly from specimen.
17 LPA(Line Probe Assay Plus) MTB- XDR LPAMTBXDR PCR followed by Membrane hybridization Any AFB smear positive sample 4 days Detection of MTB infection by PCR + Hybridization method along with detection of Quinolones and Aminoglycosides drug susceptibility status directly from specimen.
18 LPA NT-MAS LPANTMAS PCR followed by Membrane hybridization Pure gorwth of NTM in MGIT tube/LJ slant/Media plate 4 days For Speciation of NTM/MOTT (Additional species)
19 LPA NT-MCM LPANTMCM PCR followed by Membrane hybridization Pure gorwth of NTM in MGIT tube/LJ slant/Media plate 4 days For Speciation of NTM/MOTT (Common Mycobacteria)
20 MODIFIED ZN STAIN - Light Microscopy Stool sample in case of testing for Cryptospora/Isospora/Microspora. Sputum, Pus, Tissue, BAL for Nocardia. Slit skin smears for Lepra bacilli. 4 hrs For detection of Nocardia spp in clinical specimen.
21 NTM / MOTT DRUG Susceptibily results with MIC values of Linezolid, Trimethoprim / Sulphamethaxole, Ciprofloxacin, Imipenem, Moxifloxacin, Cefepime, Cefoxitin, Augmentin, Amikacin, Ceftriaxone, Doxycycline, Minocycline, Tigecycline, Tobramycin, Clarithromycin Broth microdilution Pure gorwth of NTM in MGIT tube/LJ slant/Media plate 5 days Susceptibility of NTM/MOTT with MIC values
22 PRIMARY STAIN Gram stain, AFB stain, KOH, AFB by IF, Calcofluor white Microscopic examination after various stains Any specimen except blood 4 hrs All primary stains for detection of any infectious agent from clinical specimen.
23 PYOGENIC CULTURE AND SENSITIVITY FOR BACTERIA Gram stain, ZN stain, Oragnism isolated, Colony count Aerobic culture and susceptibility repoting of bacteria by Kirby bauer method Any specimen except blood 48-72 hrs Culture of bacteria from specimen along with its identification, colony count and susceptibility by Kirby bauer method.
24 SENSITIVITY ON VITEK (MIC) Antibiotic susceptibilities with MIC values as per tesing organisms MIC reporting by turbidometric monitoring of bacterial or yeast growth Pure growth of bacteria or yeast 24 hrs Susceptibility of bacteria with MIC values
25 Alberts Stain ALBERTS STAIN Alberts stain, Light Microscopy Throat swab 2 hrs Microscopic detection of C. diphtheriae
26 C. diphtheria culture Gram stain, ZN stain, Oragnism isolated, Colony count Special culture Throat swab 72 hrs Selective culture and confirmatory test for detection of C. diphtheriae
27 Cryptococcal Antigen Qualitative and Quantitative detection of Cryptococcal antigen Immunochromatographic dipstick assay CSF/1ml/Sterile container
Serum/1ml/Plain bulb
4 hrs For Detection of Cryptococcal antigen from CSF or Serum.
28 Flu a, Flu B and 2009 H1N1 RNA PCR Influenza A, Influenza B, Influenza A 2009 H1N1 GeneXpert Nasopharyngela swab in Viral transport medium 3 hrs Influenza detection by PCR method
29 India Ink Preparation INDIA INK PREPARATION Light Microscopy CSF/1ml/Leak proof container 3 hrs
30 Legionella Pneumophilia Antigen From Urine - Immunochromatography URINE/5ML/STERILE CONTAINER 4 hrs
31 MIC BY E-TEST MIC BY E-TEST Epsilometer MIC detection Pure growth of Bacteria/Yeast on media plate or slant 24 hrs
32 PNEUMOBACT PANEL Legionella Pneumophilia
Mycoplasma Pneumoniae
Chylamydophilia Pneumoniae
Coxiella Burnetti
Chlamydophila Psittaci
Indirect immunofluorescent assay Serum/1ml/Plain tube 24 hrs
33 PNEUMOCYSTIC JIROVECII ( CARINII ) - Giemsa and Methenamine silver stain Sputum/BAL/ET/Bronchial wash 12 hrs
34 Respiratory Panel by Biofire Adenovirus
Coronavirus HKU1
Coronavirus 229E
Coronavirus NL63
Coronavirus OC43
Human Metapneumovirus
Human Rhinovirus/Enterovirus
Influenza A
Influenza A/H1
Influenza A/H1-2009
Influenza A/H3
Influenza B
Parainfluenza 1
Parainfluenza 2
Parainfluenza 3
Parainfluenza 4
Respiratory Syncytial Virus
Bordetella Pertussis
Chlamydophilia Pneumoniae
Mycoplasma Pneumoniae
Auotmated Nested multiplex PCR Nasopharyngela swab in Viral transport medium 3 hrs
35 SPECIAL CULTURE Selective/ Enriched culture of required organism Specimen in sterile container 10 days
36 TB DRUG SENSITIVITY Susceptibility of drugs MGIT (Liquid medium) and LJ Slant Pure growth of MTB 15 days
37 PNEUMO PANEL Legionella Pneumophilia
Mycoplasma Pneumoniae
Chylamydophilia Pneumoniae
Coxiella Burnetti
Adenovirus
Respiratory Syncytial Virus
Influenza A
Influenza B
Parainfluenza Serotypes 1 2 And 3
Indirect immunofluorescent assay Serum/1ml/Plain tube 24 hrs
38 BIOFIRE MENINGITIS panel Escherichia Coli
Haemophilus Influenzae
Listeria Monocytogenes
Neisseria Meningitidis
Streptococcus Agalactiae
Streptococcus Pneumoniae
Cytomegalovirus (CMV)
Enterovirus
Herpes Simplex Virus I (HSV I)
Herpes Simplex Virus 2 (HSV 2)
Human Herpes Virus 6 (HHV-6)
Human Parechovirus
Varicella Zoster Virus (VZV)
Cryptococcus Neoformans/Gattii
Auotmated Nested multiplex PCR CSF/1-3ML/LEAK PROOF CONTAINER transported with ICE PACKS 3 hrs
39 Streptococcus pneumoniae Ag detection - Immunochromatographic assay Urine and CSF. Both samples - RT - within 24 hrs/ 2-8° C x 14 days. 4 hrs
40 Rotavirus-Adenovirus antigen from stool Immunochromatographic assay Stool in leak proof container. 2-8°C for 2 days 4 hrs
41 Streptococcus A detection from Throat swab Immunochromatographic assay Throat swab in transport medium at RT 4 hrs
42 RSV-Adeno respiratory Immunochromatographic assay Nasal swab, Nasopharyngeal wash or aspirate. Test run ASAP. Or 2-8°C for 8 hrs. 4 hrs
SR NO TEST TEST COMPONENTS METHOD SPECIMEN/TRANSPORT TAT CLINICAL APPLICATIONS