TEST DIRECTORY

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Laboratory：Akiruno

○Culture identification

CODE：00671 6

  • TEST NAME TESTING MATERIAL CONTAINER CAP COLOR STORE
    TEMPERATURE
    (STABILITY)     METHODOLOGY TURNAROUND
    TIME (DAY)
  • Culture identification
    Specimens from the gastrointestinal tract (feces, bile, gastric juice)
    See below Refrigeration
     Culture identification and MALDI-TOF-MS 3-6

TEST NAME

TESTING MATERIAL

CONTAINER

Culture identification

Specimens from the gastrointestinal tract (feces, bile, gastric juice)

CAP COLOR

STORE
TEMPERATURE
(STABILITY)

METHODOLOGY

Refrigeration

Culture identification and MALDI-TOF-MS

TURNAROUND
TIME (DAY)

3-6

COMMENT


For bacterial culture identification tests, an emergency reporting range (see below) has been set, and if the range is exceeded, we will issue an emergency report.
Note) Depending on the details of the requested inspection, it may take more days.

supplementary information

Result interpretation criteria for common bacteria

Test results for items listed below will be reported in the following manner, according to the following SRL criteria:
(Reference: Clinical Microbiology Procedures Handbook - 4th edition)

TEST NAME Category and
microscope magnification power		 Result displayed Bacterial count/cell count Comment
Microscopic
examination of
smears		 Bacterial count※
(1000×
magnification)		 (－) No bacteria detected
1＋ 1 field < 1
2＋ 1 field 1-5
3＋ 1 field 6-30
4＋ 1 field > 30
Cell count (WBC/epithelial cells)
(100×
magnification)		 (－) No cell detected
1＋ 1 field < 1
2＋ 1 field 1-9
3＋ 1 field 10-25
4＋ 1 field > 25

※ In the case of a culture bottle and a strain, the indication method of the number of bacteria becomes "positive".

TEST NAME Result displayed Growth in medium Comment
Culture and
identification		 (－) No growth The species of bacteria are reported according to the International Code of Nomenclature of Bacteria.
1＋ < 1/3
2＋ ≥ 1/3 to < 2/3
3＋ ≥ 2/3
4＋ Entire surface of the medium
TEST NAME Result displayed Susceptibility Comment
Drug
susceptibility
testing		 S Susceptible Results are reported according to the CLSI criteria.
I Intermediate
R Resistant
CLSI: Clinical and Laboratory Standards Institute (former NCCLS)

Criteria for harvesting bacterial colonies in feces

In the case of a stool sample, bacteria will be collected according to the following SRL criteria:

Category Bacteria to be harvested Comment
Normal harvesting Salmonella, Shigella, Vibrio cholerae, Vibrio, Yersinia, Aeromonas, Plesiomonas, Staphylococcus aureus Always collected after detection.
Harvesting significantly grown colonies Klebsiella oxytoca, Pseudomonas aeruginosa, Bacillus cereus Collected only when a significant growth of colony is detected.
Harvesting requested bacterial colonies Diarrheagenic Escherichia coli Collected only when a request is made for culture and identification of a target bacterium.
Campylobacter Collected only when a request is made for culture and identification of a target bacterium.
Clostridium difficile Collected only when a request is made for anaerobic culture and identification
Clostridium perfringens Collected only when a request is made for anaerobic culture, identification, and a target bacterium

Criteria for harvesting bacterial colonies in major samples

The process of collecting bacteria for the identification of common bacteria by culture will be performed according to the following SRL criteria:

  • Bacteria Sputum,
    throat    		 Urine Vaginal
    secretion    		 Blood,
    cerebrospinal fluid
    Staphylococcus aureus ○ ○ ○ ◎
    Staphylococcus species,
    coagulase-negative    		 ◆
    Note 1
    		 ○ ○ ◎
    β-hemolytic streptococci ◎ ○ ◎ ◎
    Streptococcus pneumoniae ◎ ○ ○ ◎
    Enterococcus ◆
    Note 1
    		 ○ ○ ◎
    Enterobacteria ◆
    Note 2, Note 3
    		 ○ ○ ◎
    Pseudomonas aeruginosa ○ ○ ○ ◎
    Non-fermentative bacteria ◆
    Note 1
    		 ○ ○ ◎
    Haemophilus ◆
    Note 2
    		 － ○ ◎
    Branhamella ◆
    Note 2
    		 － － ◎
  • Symbols and interpretations

    ◎：Collected if 1 colony is detected
    ○：Collected if 1+ colonies are detected
    ◆：Collected if 2+ colonies are detected
    －：Not collected
    Note 1：Not collected unless there is significant growth
    Note 2：Collected if there is significant growth even with 1+ colonies
    Note 3：Collected in the case of Klebsiella pneumoniae even with 1+ colonies

Other bacteria will be collected only when a target is specifically requested for. (Please see below for the list of target bacteria.)
If specifically requested, a target bacteria will be collected even if there is only 1 colony.

Target bacteria

  • CODE Target bacteria
    		Diarrheagenic Escherichia coli
    (including O157)
    		Escherichia coli O157
    		Yersinia enterocolitica
    		Bordetella pertussis
    		Neisseria gonorrhoeae
    Room temperature
    		Neisseria meningitidis
    Room temperature
    		Campylobacter
    		Legionella
    		Corynebacterium diphtheriae
  • CODE Target bacteria
    		Shigella
    		Salmonella
    		Vibrio parahaemolyticus
    		Vibrio cholerae
    		Pseudomonas aeruginosa
    		Haemophilus
    		Staphylococcus
    		MRSA
    		Streptococcus pneumoniae
  • CODE Target bacteria
    		Group A streptococci
    		Group B streptococci (GBS)
    		Clostridium difficile
    		Clostridium perfringens
    		Candida
    		Cryptococcus
    		Aspergillus
    		Trichophyton
    		Filamentous fungi
Comment (common in all target bacteria)
  • A request only for target bacteria is not accepted. Make sure to also place an order of culture and identification of common bacteria as well.
  • When requesting a test of Clostridium difficile and Clostridium perfringens, make sure to also place an order of anaerobic culture as well. If no target bacterium is stated in a request of anaerobic culture of feces, the target bacterium is considered as Clostridium difficile.
  • When requesting a test of diarrheagenic Escherichia coli or Escherichia coli O157, make sure to also place an order of culture and identification (digestive organs) as well.
    (Note) Please note that if no check mark is placed, the test will not be conducted.
  • MRSA is determined based on a result of drug susceptibility. If no request if made for drug susceptibility testing, the determination is made based on a result from screening medium. For a more reliable determination, we recommend you to also request the drug susceptibility testing as well.
  • For Bordetella pertussis, Legionella, and Corynebacterium diphtheriae, a test is performed only when the corresponding field(s) is checked.
  • Up to 10 bacteria can be chosen as the target bacteria. Even if a request is made with more target bacteria, a report cannot include all.

List of dedicated transport containers and transport media

Classification Material Specimen volume (mL) Storage condition Collection container
Cavity, Airway or Respiratory system Sputum 2-3 Refrigeration X00 Sterile sputum collection containers
Throat swab fluid
 Appropriate amount Refrigeration VS1 eSwab105 Regular FLOQ Swab
Gastrointestinal tract Fecal Appropriate amount Refrigeration F01 Cary Blair feces collection tube
Bile 5-10 Refrigeration ARR Sterile plastic tube for 10mL
Gastric fluid 2-3 Refrigeration ARR Sterile plastic tube for 10mL
Urinary and Reproductive Organs Midstream urine 5-10 Refrigeration ARR Sterile plastic tube for 10mL
Catheter urine 5-10 Refrigeration ARR Sterile plastic tube for 10mL
Vaginal secretions Appropriate amount Refrigeration VS1 eSwab105 Regular FLOQ Swab
Pus Appropriate amount Refrigeration VS1 eSwab105 Regular FLOQ Swab
Blood and paracentesis fluid Venous blood Optimal amount
8-10		 Room temperature CBG
CBS		 Blood Culture Bottle
Arterial blood Room temperature CBG
CBS		 Blood Culture Bottle
Cerebrospinal fluid 2-3 Room temperature C10 Seed Tube II
Pleural fluid 5-10 Refrigeration C10 Seed Tube II
Ascites 5-10 Refrigeration C10 Seed Tube II
Synovial fluid 5-10 Refrigeration C10 Seed Tube II
Other sites Otorrhea Appropriate amount Refrigeration VS2 eSwab106 Mini Tip FLOQ Swabs
Eye discharge Appropriate amount Refrigeration VS1 eSwab105 Regular FLOQ Swab
Skin Appropriate amount Refrigeration ARR Sterile plastic tube for 10mL
Nails Appropriate amount Refrigeration ARR Sterile plastic tube for 10mL
Tissue Appropriate amount Refrigeration ARR Sterile plastic tube for 10mL
Pus Appropriate amount Refrigeration C10 Seed Tube II
Others Environmental materials - Room temperature C30 Stamp culture media (for hospital environment test)
- Refrigeration VS1 eSwab105 Regular FLOQ Swab
Gastric biopsy tissue Appropriate amount Refrigeration C20 Seed tube HP (for Helicobacter culture identification)
Fecal 1.0g Refrigeration F00 fecal container
Sterile polyethylene test tube

ARR　Previous container symbol r

Sterile polyethylene test tube

Storage conditions: Room temperature

C10

C10　Previous container symbol n

C20

C20　Previous container symbol n2

C30

C30　Previous container symbol n3

CBG

CBG　Previous container symbol m1

CBS

CBS　Previous container symbol q1

Stool container

F00　Previous container symbol U

Stool container

Storage conditions: Room temperature

F01

F01　Previous container symbol d3

VS1

VS1　Previous container symbol k

VS2

VS2　Previous container symbol k1

Sterile sputum collection container

X00　Previous container symbol l (Small letter L)

Sterile sputum collection container

Storage conditions: Room temperature

Bacteria test collection method

  • Be sure to indicate the name of the material to be tested or the site from which the material was collected.
  • If the target organisms are Neisseria gonorrhoeae or Neisseria meningitides, store at Room temperature.
  • Test material for anaerobic culture should be collected in Seed Tube II.
  • Note that the number of days required will vary depending on the target bacteria and other factors.

Handling Instructions for Seed Tube II

■ Fluid specimens (paracentesis fluid, digestive fluids, etc.)
  1. Sterilize the puncture site (the small circle on the rubber cap) with rubbing alcohol or other sterile cotton.
  2. Puncture the syringe needle vertically into the puncture site and inject the fluid specimen.
  3. Attach the tube label and transport.
  4. Specimens should be tested immediately. If preservation is unavoidable, store at Refrigeration.
図
■ Solid specimens (pus, feces, tissue fragments, etc.)
  1. Sterilize the rubber cap with sterile alcohol cotton, etc.
  2. Remove the rubber cap and insert a solid specimen. Insert the specimen all the way into the agar.
    (Note) Cotton swabs up to 7 cm in length can be inserted.
    Anything more than that should be cut off.
  3. Quickly and securely close the rubber cap.
  4. Attach the tube label and transport.
  5. Specimens should be tested immediately. If preservation is unavoidable, store Refrigeration.
図

Helicobacter culture identification collection method

Handling Instructions for Seed Tube HP

  1. Place the collected “gastric biopsy tissue” immediately into the collection container (C20) and insert it below the black line.
  2. Specimens should be stored within 30 minutes and requested on the same day.

Environmental Inspection Collection Methods

Hospital environment (wipe method)

Wipe a specific area of the specimen (usually 10cm x 10cm) well with the cotton swab (moistened with medium beforehand) provided with the eSwab105 Regular FLOQ Swab, and re-insert the swab into the medium before submitting it.

Hospital environment (stamp method)

Remove the cap of the stamping medium (C30), and gently press the surface of the medium onto the specimen, being careful not to touch the surface with your fingers. After about 5 seconds, put the cap back on and submit the specimen.

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