Aerobic Bacterial Culture, General

Eye: The major modes of transmission of disease to the conjunctiva include the hands, airborne fomites, and spread for adjacent adnexal infections. Eye infections include eyelid infections, blepharitis, dacryocystitis, orbital cellulitis, conjunctivitis, keratitis, endophthalmitis retinitis, and chorioretinitis. Pinkeye is caused by adenovirus. It presents as bilateral conjunctivitis with a sudden onset. Herpes simplex and zoster present as periorbital or corneal infections. Nontuberculous mycobacterial keratitis may occur following trauma or surgery accompanied by the use of local corticosteroids.¹

Wound (See Table Below): Susceptibility testing is usually performed. The majority of bacteria infecting surgical wounds are common airborne microörganisms.² Effective treatment of wound infection usually includes drainage, removal of foreign bodies, infected prosthetic devices, and retained foreign objects such as suture material. Suction irrigation may be helpful in resolving wound infections. Species commonly recovered from wounds include Escherichia coli, Proteus sp, Klebsiella sp, Pseudomonas sp, Enterobacter sp, enterococci, other streptococci, Bacteroides sp, Prevotella sp, Clostridium sp, Staphylococcus aureus, and coagulase-negative Staphylococcus.

Classification of Soft-tissue Infections

Common Surgical Pathogens
Tissue Level	S pyogenes	S aureus	C perfringens	Mixed Bacteria Staph & Strep	Mixed Bacteria Enteric
Adapted from Ahrenholz DH, “Necrotizing Soft Tissue Infections,” Surg Clin North Am, 1988, 68(1):199-214.
Epidermis	Ecthyma contagiosum	Scalded-skin syndrome		Possibly impetigo
Dermis and subdermis	Erysipelas/ Cellulitis	Folliculitis/ Abscess	Abscess/ Cellulitis	Meleny ulcer (synergistic gangrene)	Tropical ulcer
Fascial planes	Strep gangrene	Carbuncle	Fasciitis	Necrotizing fasciitis	Necrotizing fasciitis
Muscle tissue	Strep myositis	Muscular abscess/ pyomyositis	Myonecrosis	Nonclostridial myonecrosis	Nonclostridial myonecrosis

References

• Baker AS. Ocular infections: Clinical and laboratory considerations. Clin Microbiol Newsl. 1989; 11:97-101.
• Cheadle WG. Current perspectives on antibiotic use in the treatment of surgical infections. Am J Surg. 1992 Oct; 164(4A Suppl):44S-47S. PubMed 1443360
• Goldstein EJ. Management of human and animal bite wounds. J Am Acad Dermatol. 1989 Dec; 21(6):1275-1279. PubMed 2685062
• Jones DB, Leisegang TJ, Robinson NM. Cumitech 17. In: Washington JA, ed. Laboratory Diagnosis of Ocular Infections. Washington, DC: ASM Press;1981 (review).
• Kligman EW. Treatment of otitis media. Am Fam Physician. 1992 Jan; 45(1):242-250. PubMed 1728094
• Macknin ML. Respiratory infections in children. What helps and what doesn’t? Postgrad Med. 1992 Jan; 92(2):242-250. PubMed 1495881
• Pollack AV, Evans M. Microbiologic prediction of abdominal surgical wound infection. Arch Surg. 1987 Jan; 122(1):33-37. PubMed 3541852
• Randall DA, Fornadley JA, Kennedy KS. Management of recurrent otitis media. Am Fam Physician. 1992 May; 45(5):2117-2123. PubMed 1575107

87070

Important: Sterile preparation of the aspiration site is required.

Gram-staining is recommended with all anaerobic cultures (additional charge).

The requisition form must state:

• The specific site of the specimen;
• The age of patient;
• The current antibiotic therapy;
• The patient’s clinical diagnosis; and
• The time of collection.

Container/Tube: Sterile screw-cap container or bacterial swab transport

Sample Volume: Swab or 0.5 mL of aseptically aspirated pus or tissue

Storage: Store specimens at room temperature.

Stability (collection to time of analysis/testing):

• Ambient: Unstable
• Refrigerated: Unstable
• Frozen: 14 days

Rejection Criteria:

This test is used to isolate and identify potentially pathogenic aerobic organisms. A susceptibility test will be performed at an additional charge when organisms isolated meet microbiologic criteria for clinical significance.

This test includes isolation and identification (additional CPT codes) of potential aerobic pathogens and drug susceptibility tests (additional charge). Performing a Gram stain (additional test) is recommended. CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed.

Only rapid-growing, nonfastidious aerobic organisms can be recovered and identified by routine methods. Only organisms that predominate will be identified. Unless specifically requested by the physician, fastidious organisms may not be isolated. Anaerobic, fungal, and mycobacterial pathogens should be considered, and appropriate cultures requested if clinically indicated. The procedure will not detect Chlamydia, viruses, fungi or mycobacteria.

Eye: Routine flora of the eye may include Corynebacterium sp (diphtheroids), Staphylococcus epidermidis, saprophytic fungi, Moraxella (Branhamella) catarrhalis, Moraxella sp, Streptococcus sp (nonhemolytic) and Gram-negative rods (rare). Abnormal ocular flora include:

• Haemophilus influenzae;
• Haemophilus aegyptius;
• Streptococcus pneumoniae;
• Staphylococcus aureus;
• Pseudomonas aeruginosa;
• Bacillus subtilis;
• Neisseria gonorrhoeae; and
• Mycobacterium chelonae.

Wound: Routine skin flora may include:

• Coagulase-negative staphylococci;
• Corynebacterium sp (diphtheroids); and
• α-streptococci (Streptococcus viridans or viridans streptococci).