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Test Code BRBPS Broad Range Bacterial PCR and Sequencing, Varies

Useful For

Detecting and identifying bacteria (including mycobacteria) from normally sterile sources, including synovial fluid; body fluids such as pleural, peritoneal, and pericardial fluids, cerebrospinal fluid; and both fresh and formalin-fixed paraffin-embedded tissues

 

This test is not recommended as a test of cure because nucleic acids may persist for long periods of time after successful treatment.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ISBA Bacterial Ident by Sequencing No, (Bill Only) No
ISNGS Ident by Next Generation Sequencing No, (Bill Only) No
SPID2 Specimen Identification by PCR No, (Bill Only) No
CSFME Meningitis Encephalitis Panel, PCR Yes No

Method Name

Polymerase Chain Reaction (PCR) followed by Sequencing

Reporting Name

Broad Range Bacteria PCR+Sequencing

Specimen Type

Varies


Necessary Information


Specimen source is required.



Specimen Required


Fresh tissue is preferred over formalin-fixed, paraffin-embedded tissue.

 

Submit only 1 of the following specimens:

 

Preferred Specimen Type:

Specimen Type: Fresh tissue or biopsy

Sources: Normally sterile tissue such as bone, lymph node, joint, heart valve, brain, viscera, organ, lung, prostate

Container/Tube: Sterile container

Specimen Volume: Entire collection or 5 mm(3)-approximately the size of a pencil eraser

Collection Instructions:

1. Collect fresh tissue specimen.

2. Submit tissue only, do not add fluid to tissue.

3. Freeze specimen.

Specimen Stability Information: Frozen <21 days (preferred)/Refrigerated <21 days

 

Alternate Specimen Type:

Preferred: Paraffin-embedded tissue block:

Supplies: Tissue Block Container (T553)

Specimen Type: Formalin-fixed, paraffin-embedded (FFPE) tissue block

Sources: Normally sterile or deep tissues such as bone, lymph node, joint, heart valve, brain, viscera, organ, lung, prostate

Container/Tube: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block to be cut and returned.

Specimen Stability Information: Ambient (preferred)/Refrigerated

 

Acceptable: Paraffin-embedded tissue block:

Specimen Type: Section (scrolls) of FFPE tissue block

Sources: Normally sterile or deep tissues such as bone, lymph node, joint, heart valve, brain, viscera, organ, lung, prostate

Container/Tube: Sterile container for each individual cut section (scroll)

Collection Instructions: Perform microtomy and prepare five separate 10-micron sections. Each section (scroll) must be placed in a separate sterile container for submission.

Specimen Stability Information: Ambient (preferred)/Refrigerated

 

Specimen Type: Fluid

Sources: Normally sterile body fluids such as cerebrospinal, vitreous humor, pleural, abdominal, peritoneal, ascites, pericardial, pelvic, prostatic

Container/Tube: Screw-capped, sterile container

Specimen Volume: 1 mL

Collection Instructions:

1. Collect fresh fluid specimen.

2. Freeze specimen.

Specimen Stability Information: Frozen <21 days(preferred)/Refrigerated <21 days

 

Specimen Type: Synovial fluid

Container/Tube:

Preferred: Red top or sterile container

Acceptable: Lavender top (EDTA), pink top (EDTA), royal blue top (EDTA), or sterile vial containing EDTA-derived aliquot

Specimen Volume: 1 mL

Collection Instructions: Send specimen in original tube (preferred).

Specimen Stability Information: Frozen <21 days (preferred)/ Refrigerated <21 days


Specimen Minimum Volume

Fluid: 0.5 mL
Fresh tissue or biopsy: 5 mm(3)
Paraffin-embedded tissue block: two 10-micron sections

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Varies

Reject Due To

Specimen received in anaerobe vial
Tissue received in any fluid (saline, broth, formalin, formaldehyde, acetone, etc)
Wrapping (gauze, drapes, etc)
Blood Culture bottles (Bactec FX and/or BacT/ALERT bottles)
Bone marrow
Decalcified bone
Slides
Skin biopsy
Colon biopsy
Reject

Clinical Information

Cultures from patients with suspected bacterial infection involving normally sterile sites may fail to provide bacterial (including mycobacterial) growth for identification due to the presence of fastidious or slow-growing bacteria or as a result of antecedent antimicrobial chemotherapy. Polymerase chain reaction amplification of a portion of the 16S ribosomal RNA (rRNA) gene followed by sequencing of the amplified product can be used to detect bacterial (including mycobacterial) nucleic acids in such situations, enabling a diagnosis. Sterile sources accepted for testing may have more than one bacterial species present or the presence of copy variants of the 16S rRNA gene within a single bacterial species, confounding Sanger sequencing analysis. Next-generation sequencing can be useful in such cases. Ideal specimens are those in which bacteria (includes mycobacteria) are visualized by microscopy. Heart valves from patients with endocarditis with positive Gram stains are, for example, especially suitable.

Reference Values

No bacterial DNA detected

Day(s) Performed

Monday through Friday

Report Available

14 to 28 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

87801-Broad Range Bacterial PCR and Sequencing

87798-Bacterial Ident by Sequencing (if appropriate)

87798-Specimen Identification by PCR (if appropriate)

87798-Ident by Next Generation Sequencing (if appropriate)

87483-Meningitis Encephalitis Panel, PCR (if appropriate)

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.