Culture & Sensitivity, Aerobic bacteria Body Fluids Specify type(Vitek 2 Compact)

Bacterial/ Viral

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No Fasting Required

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Identifies bacteria & antibiotic susceptibility.

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Culture & Sensitivity Aerobic bacteria Body Fluids Specify type(Vitek 2 Compact)

Why is it done?
- Identifies and isolates aerobic bacterial pathogens from various body fluid specimens including cerebrospinal fluid (CSF), synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, and other sterile body compartments
- Determines antibiotic susceptibility patterns of isolated bacteria to guide targeted antimicrobial therapy
- Ordered when patients present with signs of serious infections such as meningitis, septic arthritis, empyema, or peritonitis
- Essential for hospital-acquired infections (nosocomial infections) and cases of sepsis with unclear etiology
- Typically performed urgently or on STAT basis given the serious nature of body fluid infections requiring immediate identification and treatment
Normal Range
- Normal Result: No growth / Negative culture
- Interpretation: Indicates that no aerobic bacterial pathogens were detected in the body fluid sample. This is the expected normal finding for sterile body compartments.
- Units of Measurement: Qualitative result (growth/no growth); organism identification; susceptibility reported as Susceptible (S), Intermediate (I), or Resistant (R) to specific antibiotics
- Abnormal Result: Growth of aerobic bacteria with identification and susceptibility pattern
- Indicates bacterial infection requiring identification of the organism and determination of appropriate antibiotic therapy based on susceptibility results
Interpretation
- Negative Culture (No Growth): Suggests absence of aerobic bacterial infection; however, does not exclude anaerobic, fungal, or viral infections. May indicate adequate antibiotic therapy already in place or sterile specimen collection.
- Positive Culture with Organism Identification: Indicates presence of bacterial infection; organism identification essential for determining infection source and transmission route.
- Susceptibility Results Interpretation:
- Susceptible (S): Organism likely to respond to therapeutic levels of the antibiotic; antibiotic is recommended for treatment.
- Intermediate (I): Antibiotic may be effective at higher doses; considered for infections at sites where drug concentration is naturally high or for serious infections.
- Resistant (R): Organism unlikely to respond to antibiotic therapy; alternative antimicrobial agents should be selected.
- Vitek 2 Compact Methodology: Automated system using biochemical and enzymatic tests for rapid organism identification; susceptibility testing based on automated minimum inhibitory concentration (MIC) determination.
- Factors Affecting Results:
- Prior antibiotic therapy may reduce culture positivity
- Contamination during collection may produce false positive results
- Delayed transport or improper storage conditions may compromise results
- Specimen volume and quality affect recovery of organisms
Associated Organs
- Primary Organ Systems Involved:
- Central Nervous System (CSF analysis): Meningitis, ventriculitis, brain abscess
- Musculoskeletal System (Synovial fluid): Septic arthritis, infectious arthropathy
- Respiratory System (Pleural fluid): Empyema, parapneumonic effusion
- Abdominal/Gastrointestinal System (Peritoneal fluid): Bacterial peritonitis, intra-abdominal infections
- Cardiovascular System (Pericardial fluid): Bacterial pericarditis, infectious pericardial effusion
- Medical Conditions Commonly Associated with Abnormal Results:
- Bacterial meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis, or Listeria monocytogenes
- Septic arthritis from Staphylococcus aureus, Gram-negative organisms, or Streptococcus species
- Empyema and complicated parapneumonic effusions
- Spontaneous bacterial peritonitis (SBP) in cirrhotic patients
- Secondary bacterial peritonitis from perforation or postoperative complications
- Acute bacterial pericarditis and septic pericarditis
- Potential Complications Associated with Abnormal Results:
- Septic shock and multiorgan failure if untreated or inadequately treated
- Permanent neurological damage from meningitis (hearing loss, neurologic sequelae)
- Joint destruction and chronic arthritis from septic arthritis
- Constrictive pericarditis from untreated bacterial pericarditis
- Respiratory compromise and sepsis from empyema
Follow-up Tests
- Tests Recommended Based on Positive Results:
- Blood cultures to assess systemic involvement and bacteremia
- Gram stain and additional culture of body fluid for anaerobes if anaerobic infection suspected
- Fungal and mycobacterial cultures if clinically indicated
- Molecular testing (PCR) for rapid organism identification and antimicrobial resistance genes
- Complete blood count (CBC) to assess inflammatory response
- Comprehensive metabolic panel to evaluate organ function and electrolytes
- Procalcitonin and C-reactive protein (CRP) to assess severity of infection
- Imaging studies (CT, ultrasound, MRI) to identify localized infection or complications
- Further Investigations That Might Be Needed:
- Source control procedures (drainage, debridement) based on organism and clinical presentation
- Repeat lumbar puncture or body fluid sampling to document sterilization with therapy
- Infectious disease consultation for treatment optimization and duration
- Extended susceptibility testing if multiple drug resistance detected
- Monitoring Frequency for Ongoing Conditions:
- Serial body fluid cultures in 24-48 hours to document sterilization during treatment
- Clinical assessment of infection markers at 48-72 hours of therapy initiation
- Repeat cultures if clinical deterioration occurs or inadequate response to therapy
- Related Complementary Tests:
- Blood culture: Critical for assessing bacteremia and systemic infection
- Urine culture: May help identify source if urinary tract involvement
- Respiratory culture: If respiratory involvement suspected
- Toxin studies: For specific organisms like Clostridium difficile if relevant
Fasting Required?
- Fasting Required: No
- Fasting is not required for culture and sensitivity testing of body fluids.
- Special Patient Preparation Requirements:
- Sterile collection technique is essential; body fluid must be obtained via sterile procedure (lumbar puncture, arthrocentesis, thoracentesis, paracentesis, or pericardiocentesis)
- Collect minimum 1-2 mL of body fluid in sterile container; larger volumes (at least 3-5 mL) preferred to optimize organism recovery
- Do NOT use formalin or other fixatives; use sterile collection tube without preservatives for culture
- Transport specimen to laboratory immediately; do not refrigerate unless transport will exceed 1-2 hours
- Clearly label container with patient identifier, specimen source (e.g., 'CSF,' 'synovial fluid,' 'pleural fluid'), collection time, and date
- Medications to Avoid:
- Ideally, culture should be obtained BEFORE initiating antibiotic therapy for optimal organism recovery
- If antibiotics have already been started, continue therapy and notify laboratory; organism may still be recovered but sensitivity may be affected
- No specific medications need to be held before specimen collection as this is an invasive procedure performed by physician
- Additional Preparation Instructions:
- Patient positioning: Specific positioning required based on procedure type (flexion for lumbar puncture, extension for arthrocentesis)
- Procedural consent: Informed consent required before invasive body fluid collection
- Baseline vitals: Monitor blood pressure, heart rate, and temperature before and after procedure
- Post-procedure care: Rest and observation for complications as per institutional protocol

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