Lab and culture reports

This page explains how we use culture reports to confirm infections and pathogens.

Inf you wanted to remove stuff from here that's already in Infections in ICD10 instead.

• SMW

• Cargo

• Categories

Additional Information

• This question is tied in to identification of a clinical infection.
  • For disorders believed to be infectious, we have a list of pathogens, and if the pathogen is never identified then you can use Infectious organism, unknown.
• Even if you do identify one or more organisms that are potential pathogens, usually it requires clinical correlation to decide whether it/they are actually pathogenic in this patient
  • There are very few bugs that are always pathogenic (i.e. causing an infectious disease) -- high on this list is M.Tb. and Legionella. Even organisms like Aspergillis can be colonizers.
  • Thus identifying whether a potential pathogen is in fact acting as a pathogen in a given patient requires clinical correlation.
• Having said that:
  • While it is strongest to have a lab sample (fluid or tissue) from which the organism has been cultured, there are circumstances where this isn't necessary, e.g. Infection with implied pathogen
  • Even a lab identification may not be from culturing -- e.g. there are monoclonal antibody and other non-culture methods such as antigen identification (e.g. Legionella urinary antigen) that can identify the presence of a bug
• The question arises of whether when you do NOT have any sort of lab identification of a bug, whether clinical suspicion is enough to "call it":
  • Again, the answer is generally "Yes" with Infection with implied pathogen, and generally "No" elsewise -- deviating from these generalities can be done if you've got an excellent, scientific rationale.

How long to wait for a result

• Follow up all culture reports up to 5 days after discharge from unit.
• For Cadham results, usually wait 2 weeks.
  • Note, Cadham sends initial and final results. Don't use the initial ones, only use the final ones.
• As above, if you don't get a presumptive pathogen and it's not a situation which relates to Infection with implied pathogen, you should then use Infectious organism, unknown.

Does the lab complete checkbox mean this is complete?

It does not. All collectors use them differently. And at this point labs are not even counted in there, so it is most likely used as a "I have finished counting images and blood products"

Cross-checks

See CCDMB Data Integrity Checks on Pathogens page (needs review).