Modified Acid Fast Stain NocardiaActinomycetes

Single-analyte tests

• Modified Acid Fast Stain Nocardia/Actinomycetes 14511

  Urine · Fasting not stated

  Method and collection

  Method

  Microscopic Examination

  Preparation

  Expectorated sputum: Instruct the patient to rinse his/her mouth and gargle with water prior to collection. Tell the patient not to expectorate saliva or postnasal discharge into the container. 3 separate samples should be collected over an 8-24 hour interval of time. Include at least one first morning specimen. For follow-up patients on therapy, collect at intervals beginning 3 weeks after initiation of therapy. Induced sputum: Use a wet toothbrush and brush the buccal mucosa, tongue, and gums of the patient prior to collection. Rinse the patient's mouth thoroughly with water. Invasive procedures such as transtracheal aspirate, bronchial biopsy and fine needle aspirate yield the highest percentage of positive results. Aerosol-induced sputum: Using an ultrasonic nebulizer, have patient inhale approximately 20-30 mL of sterile hypertonic saline. Avoid sputum contamination with nebulizer reservoir water. Bronchial washings and bronchoalveolar lavage fluids: Generally obtained before brushings or biopsy to avoid excess blood in the specimen. Aspirate or lavage specimens that are collected in traps should be transferred to a sterile, screw cap conical tube to avoid leakage during transport. Tissue and biopsy material: Obtain a sample as large as possible in a small amount of sterile, non-bacteriostatic saline. Urine: Appropriate cleaning of the genitalia must precede collection. Collect entire first morning specimen (> 40 mL) on 3 consecutive days. Organisms may accumulate in the bladder overnight, so first morning void provides the best yield.

  Collection

  Culture recommended in addition to stain

  Reference notes

  See Laboratory Report

  Quest Diagnostics catalog page

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