Acid Fast Bacilli (AFB) Smear

Acid Fast Bacilli (AFB) Smear Reflex to PCR and or Culture

Alias	TB Smear, Mycobacteria, Acid-Fast Stain Reflex to PCR and or Culture
Laboratory Section	Microbiology
Methodology	Microscopy, PCR, and or Mycobacterial Culture & Antibiotic Susceptibility
Preferred Specimen	Lower Respiratory Tract Specimen (Expectorated Sputum, Tracheal Aspirate, Bronchial Wash or Lavage)
Transport Container	Sputucol* or any other similar collecting system for respiratory tract samples (sterile container with proper closure)
Alternative Specimen / Container	Body fluids, i.e. pleural fluid, peritoneal fluid, pericardial fluid, synovial fluid
Minimum Volume	3 mL or 1 gram
Preparation & Collection Instructions	Indicate the specimen source. Sputum or lower respiratory tract specimens: 3 collections preferred to increase the sensitivity of the test: 1st on the spot, 2nd on the next morning, and 3rd is followed by another spot sample on any days. Call Microbiology Section at local 637 for Sputucol* containers if needed. Other specimens: Submit in sterile properly closed container immediately.
Handling Instructions	If delay is anticipated, refrigerate at 2 – 6° C as soon as possible. Do not freeze. Add sterile normal saline to bronchial brushings or tissue to prevent drying. Body Fluids: If large volumes of fluid are collected, take a 10 mL of aliquot of the well-mixed specimen. Wound Aspirate: Transfer aspirate to a sterile container. Remove needle and cap syringe. DO NOT send syringes with needles.
Transport Temperature	Ambient (15 – 30 ^oC)
Specimen Stability	Ambient: 2 hours Refrigerated (2 – 8 ^oC): 5 days
Laboratory Receiving Time	In-patient and ER: Monday to Sunday, 24 Hours Out-patient: Monday to Friday, 8AM to 4PM
Days & Time Performed	Monday to Friday, 8 AM to 4 PM
Rejection Criteria	• Specimen older than stability limits • Pooled specimen for sputum • Quantity Not Sufficient (QNS) • Unlabeled or Mislabeled specimen • Preservatives used • Swabs, urine, and stool specimens • Frozen specimen • Syringe or needle attached • Leaking specimen or unsafe exposure condition
Turn Around Time	<Routine> Within 24 hours for direct smear screening microscopy Note: The test performed at LBJLab is for direct smear screening only on the presence of acid-fast bacilli microscopically. Samples are referred further for additional testing at public health laboratory and off-island reference lab. Turn around time for positive report may take several weeks on culture and antibiotic susceptibility. Call Microbiology Section at local 637 for the follow up report.
Reference Range	Negative or Not Detected
Limitations	N/A