What Is Afb Culture


Acid-Fast Bacillus (AFB) Tests: MedlinePlus Medical Test

An illness caused by acid-fast bacillus (AFB), a kind of bacterium, is TB and some other diseases. Tuberculosis, often known as tuberculosis, is a dangerous bacterial illness that attacks the lungs in particular. It can also have an impact on other sections of the body, such as the brain, spine, and renal system. Coughing and sneezing are the most common ways in which tuberculosis (TB) is disseminated. Tuberculosis can be either latent or active. If you have latent tuberculosis, the bacterium that causes the disease will be present in your body, but you will not be sick and will not be able to transfer the disease to others.

AFB tests are often ordered for persons who are experiencing symptoms of active tuberculosis.

Sputum is a viscous mucus that comes up from the lungs when you cough.

There are two types of AFB tests that are often used:

  • AFB smear campaign. In this test, your material is “smeared” on a glass slide and examined under a microscope to determine its quality. It can provide benefits in as little as 1–2 days. Although these findings may indicate the presence of a probable or likely illness, they do not offer a definitive diagnosis
  • AFBculture. In this test, your sample is sent to a laboratory where it is placed in an environment designed to promote the development of bacteria. If a person has tuberculosis or another illness, an AFB culture can absolutely confirm the diagnosis. However, it takes 6–8 weeks for enough germs to proliferate to the point where an infection can be detected.

Other names for this test include AFB smear and culture, tuberculosis culture and sensitivity, and mycobacteria smear and culture, among others.

What are they used for?

Activated tuberculosis (TB) tests are the most commonly utilized to diagnose an active TB infection. They may also be utilized to assist in the diagnosis of other forms of AFB infections. These are some examples:

  • The AFB test is the most commonly used to determine active tuberculosis (TB) infection in humans and other animals. Other forms of AFB infections may also be detected using same techniques. Examples of such items are:

People who have previously been diagnosed with tuberculosis may potentially benefit from AFB testing. The tests can determine whether or not the therapy is effective, as well as whether or not the virus is still contagious.

Why do I need an AFB test?

If you are experiencing signs of active tuberculosis, you may require an AFB test. These are some examples:

  • Itchy, dry cough that lasts for three weeks or more. blood and/or sputum coming up via one’s nose
  • Chest discomfort, fever, fatigue, and night sweats are all symptoms of menopause. Weight reduction that is unexplained

Active tuberculosis can manifest itself in various regions of the body in addition to the lungs. When it comes to symptoms, they differ depending on which area of the body is afflicted. As a result, if you have any of the following, you may require testing:

  • In addition to causing symptoms in the lungs, active tuberculosis can manifest itself in other places of the body as well. The signs and symptoms differ depending on which portion of the body is being impacted by the condition. Consequently, if you have any of the following:

In addition, if you have specific risk factors, you may require testing. If you do any of the following, you may be at increased risk of contracting tuberculosis:

  • Certain risk factors may necessitate further testing as well. A increased chance of contracting tuberculosis may exist if you do any of the following things:

What happens during AFB testing?

An AFB smear and an AFB culture will be performed by your health care practitioner, and both will require a sample of your sputum. Typically, the two tests are performed at the same time. To get sputum samples, follow these steps:

  • You will be asked to cough vigorously and spit into a sterile container during the procedure. This will need to be done for a minimum of two or three days in a row. This ensures that your sample contains a sufficient number of germs for testing. If you are having difficulty coughing out enough sputum, your healthcare professional may instruct you to breathe in a sterile saline (salt) mist, which can aid in deeper coughing. If you are still unable to cough up enough sputum, your physician may recommend that you undergo a procedure known as a bronchoscopy. During this treatment, you will initially be given pain medication to ensure that you do not experience any discomfort. Afterwards, a small, illuminated tube will be inserted via your mouth or nose and into your respiratory tract. Collection of the sample can be accomplished with a suction device or a tiny brush.

Will I need to do anything to prepare for the test?

An AFB smear or culture does not necessitate any particular preparations on your part.

Are there any risks to the test?

Coughing into a container does not pose any danger in terms of delivering a sputum sample. It is possible that your throat will be painful following a bronchoscopy surgery. An infection or bleeding at the location where the sample is obtained is a modest but real possibility at this time.

What do the results mean?

If the findings of your AFB smear or culture were negative, you are most likely not suffering from active tuberculosis. In certain cases, however, this might indicate that there were not enough germs in the sample for your health care physician to make a diagnosis. If your AFB smear was positive, this indicates that you most likely have tuberculosis or another illness; nonetheless, an AFB culture is required to confirm the diagnosis. Because culture results can take several weeks to come back, your physician may opt to treat your infection while waiting for the findings of the culture.

The culture will be able to tell you what sort of illness you have.

If you have any questions about your results, you should speak with your health-care provider about them. Understand laboratory testing, reference ranges, and how to interpret data in more detail.

Is there anything else I need to know about AFB testing?

If left untreated, tuberculosis can be fatal. However, most instances of tuberculosis may be treated if you follow your doctor’s instructions and take medicines as prescribed. Treatment of tuberculosis takes far longer than treatment of other forms of bacterial diseases. You will no longer be infectious after a few weeks of antibiotic treatment, but you will still have tuberculosis. Antibiotics must be used for six to nine months in order to treat tuberculosis. You will be monitored for a period of time depending on your general health, your age, and other considerations.

It is possible that stopping too soon will cause the illness to reappear.


  1. TB can be fatal if left untreated. Most instances of tuberculosis, on the other hand, may be healed if you follow your doctor’s instructions and take medicines. When compared to other forms of bacterial illnesses, curing tuberculosis takes substantially longer. Even though you will no longer be contagious after a few weeks of antibiotic treatment, tuberculosis will still be present in your bloodstream. Antibiotics must be used for six to nine months in order to completely treat tuberculosis (TB. You will be monitored for an extended period of time depending on your general health, your age, and other considerations. Even if you feel better, it is critical that you continue to take the antibiotics for as long as your specialist instructs. If you stop too soon, the infection may reappear and become more severe.

Acid Fast Bacilli (AFB) Smear and Culture Testing

If left untreated, tuberculosis (TB) can be fatal. However, most instances of tuberculosis may be healed if you follow your doctor’s instructions and take medicines as advised. Treatment of tuberculosis (TB) takes significantly longer than treatment of other forms of bacterial diseases. When treated with medications for a few weeks, you will no longer be infectious, but you will still have tuberculosis (TB). Antibiotics are required for six to nine months in order to treat tuberculosis. The length of time relies on your overall health, your age, and a variety of other factors, among them.

If you stop too soon, the infection may reappear.


In any laboratory test technique, it is a fundamental premise that the validity of the test is strongly dependent on the use of specimens that have been correctly collected, labeled, handled, or kept prior to and during the testing process. Microbiological tests are not as uniform as other types of laboratory testing; the method in which a sample is processed and the findings are interpreted is largely influenced by the information supplied with the specimen during collection. Erroneous findings as a result of specimen mismanagement can have a negative impact on patient care and outcomes, as well as hospital infection control, the amount of time patients spend in the hospital, expenses, and the efficiency of the laboratory.

AFB smear and culture tests for Acid Fast Bacilli (AFB) are the primary subject of this lab best practices blog, which will go over the proper specimen collecting and processing procedures.

AFB smear microscopy is a technique for doing a rapid and affordable microscopic analysis of clinical specimens using a fluorochrome stain (fluorescein is used).

Even when utilizing staining methods unique to mycobacteria, such as Nocardia spp., only a few other species may be stained, which is particularly true for Nocardia spp.

After that, it is incubated at 37 degrees Celsius for up to six weeks. Finally, it is checked to determine whether there has been any growth.


  • AFB smear – fluorescence staining
  • AFB culture – B-D MGIT system and conventional culture medium
  • AFB smear – fluorescence staining

Specimen Collection

  • Health Systems at the University of California, Davis
  • Hospital Based Clinics / HBC
  • Physician Clinics Network / PCN
  • Others


  • Plastic biohazard bags, both small and big in size, as well as biohazard stickers, are also available.

Acceptable Specimen Type(s):

  • The following is the recommended practice for collecting specimens and sputum for the first diagnosis of tuberculosis: Cough specimen collected in the early morning, deep cough specimen collected three (3) consecutive days – If more than one specimen is obtained during the same 24-hour period, a minimum of eight (8) hours must be allowed between each specimen. – The minimum admissible specimen volume is two (2) milliliters (mL). Refrigerate until ready to be transported

Bronchial Washing:

  • Two (2) milliliters (mL) is the preferred minimum permissible volume
  • Keep refrigerated until transported.

Pleural Fluid:

  • The preferred minimum volume is two (2) milliliters
  • Keep refrigerated until transported.

FIGURE 1: *The blue fluid displayed in the photo is used as an example of 2-3 mL, or the quantity of fluid required from the patient. Figure 2:

Unacceptable Conditions:

  1. The specimens that have not been labeled with the patient’s name or identifying information
  2. It is necessary to obtain a clinical specimen within eight hours of collecting the preceding specimen. A clinical specimen that was obtained more than three (3) days after it was collected
  3. Upon arrival, the specimen was leaking
  4. Insufficient specimen volume (less than 2 mL)
  5. Insufficient specimen volume Substances that cause interference
You might be interested:  Which Of The Following Would Best Characterize Traditional Individualistic Political Culture

Result Report Timing

  1. After receiving AFB smears, they are reported within 24 hours of receipt
  2. AFB cultures are reported when growth begins and identification is made, or when no growth occurs at the end of the 7th week of the culture.

Possible Results:

At 100x magnification, the following number of AFBs were observed: 1+ (Rare) = 1-9 out of every 100 fields 2+ (Few) = 1-9 / 10 fields = 2+ (Few) fields Moderate = 1-9 in field 3+ (Moderate). 4+ (Many) = larger than 1-9 / field of four or more AFB Could Not Be Located Smear was not carried out.

AFB Culture:

  • Species identification of Mycobacteria bacteria
  • After 6 weeks, there was no development of Mycobacteria
  • This was unsatisfactory.

Patient instructions:

Please carefully read and follow the procedures outlined below.

  1. Gargle with water just prior to acquiring a sputum specimen to limit the amount of oral bacteria present at the specimen collection site. It is not necessary to use mouthwash or any other gargle. Remove the container’s lid and inspect it. To begin, try coughing as hard as you possibly can while holding a tissue over your nose and mouth
  2. When you’re ready to spit, spit into the cup or vial, swishing any phlegm away with your saliva as you go. You can spit saliva into the cup or vial if you are not successful in producing any phlegm when coughing. To capture all of the expectorated or coughed sputum, place the rim of the specimen container beneath the lower lip and press down. Expel sputum (not saliva) into the cup by coughing deeply and expectorating it
  3. Close the cover tightly and alert your caregiver that your specimen is ready to be sent to the laboratory, if applicable.

Gargle with water just prior to taking a sputum specimen to lower the amount of oral bacteria present in the specimen collection tube. No mouthwash or other gargle should be used. The container’s lid should be removed. To begin, try coughing as hard as you possibly can while holding a tissue over your nose and mouth. When you’re ready to spit, spit into the cup or vial, swishing any phlegm away with your saliva as you do so. You can spit saliva into the cup/vial if you are not successful in producing any phlegm when coughing.

Expel sputum (not saliva) into the cup by coughing deeply and expectorating it.

Cup Instructions

  1. To remove any extra sputum or saliva from the sterile container, rinse it outdoors if at all feasible. Allow enough time for drying to take place. Secure the sample container lid with a strip of Parafilm and check that it is completely sealed. Individual specimens should be placed in the proper individual small or big biohazard bag. Ensure that each specimen is accompanied by a copy of the order slip (order slips should be put in the biohazard order slip pocket).

To remove any extra sputum or saliva from the exterior of the sterile container, as shown in Figure 3. Give yourself plenty of time to dry. In Figure 4, each specimen should be placed in its own small / big biohazard bag, with a copy of the matching order slip included in the bag for each specimen (order slips are to be placed in the biohazard order slip pocket)


  1. Procedures for Collection of Induced Sputum Specimens from Children, by Lindsay R. Grant and colleagues, published in Pediatrics. In “How to Collect and Ship COVID-19 Samples,” published in Clinical Infectious Diseases: an Official Publication of the Infectious Diseases Society of America, Oxford University Press, April 2012, the authors explain how to collect and ship COVID-19 samples. ‘Acid-Fast Bacilli (AFB) Smear and Culture’ published by MicroGen Diagnostics on April 28, 2020. The smear and culture of Acid-Fast Bacilli (AFB) are performed at the State Public Health Laboratory, which is part of the Department of Health and Senior Services. Sputum Collection
  2. ISDH: Sputum Collection

What Is an AFB Stain?

If you have a lung condition such as tuberculosis, your doctor may do an acid-fast bacteria (AFB) stain test to determine whether you have the disease (TB). Another benefit of an AFB stain is that it can detect other mycobacterial infections, such as leprosy or TB-like illness, which can afflict persons who have HIV/AIDS and show up as a positive result. In water and soil, mycobacteria are a kind of bacterium that may be discovered living there. Despite the fact that they are normally harmless, if they get into your body, they can cause a variety of problems, including lung troubles, various infections, and sores on your body’s surface.

It is capable of determining if the bacteria or fungus that is causing your sickness belongs to one of these groups.

How Does an AFB Stain Test Work?

Acid fastness is a distinctive property shared by a group of bacteria that distinguishes them from other bacteria. Because they have been dyed with a particular medical dye, they will retain their color even after being subjected to decolorizing acid, which would ordinarily cause the color to fade.

Under a microscope, this makes them simple to observe and distinguish from one another. Your doctor will obtain a sample of your sputum (mucus in your lungs or airways) using one of four procedures. These are as follows:

  • Coughing. Your doctor will most likely rely on collecting some of the material that you cough up for an AFB stain
  • This is referred to as induction of coughing. If you do not have a productive cough, your doctor may instruct you to inhale aerosolized saline to induce coughing
  • This is known as bronchoscopy. Gastricaspiration is an invasive technique in which your doctor examines your airway or lungs through a scope and collects sputum
  • It is performed by your doctor. In the event that sputum is ingested rather than coughed out, your doctor will be able to recover it from your stomach.

The sputum is sent to a laboratory, where it is spread onto a tiny dish and tested. A fuchsia-colored dye is given to the sample by the use of a procedure known as the Ziehl Neelsen technique. The color penetrates the bacteria’s cell walls and becomes trapped within them. It is possible to remove the color from surrounding material by rinsing with a specific acid solution. Bacteria that cause TB, for example, are not harmed by the acid and retain their pink hue. It is easier to perceive and recognize them as a result of this — and the test is also less costly, more widely available, and more generally trustworthy.

When Your Doctor May Order an AFB Stain

There are a variety of reasons why you could require this examination, including: You are suffering from a lung infection. If you are experiencing signs of a lung infection, your doctor may order an AFB stain to determine the source of the illness. Coughing up blood, considerable weight loss, fever, chills, and exhaustion are some of the most common signs of achronicorrhea. You have tuberculosis and are at high risk. If you have tuberculosis and a skin or blood test indicates that you have the disease, or if you have a weakened immune system as a result of a condition such as the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), your doctor may order this test to determine whether or not the disease is present.

  1. You have tuberculosis (TB) outside of your lungs.
  2. An AFB stain may be used by your doctor to determine whether it is harming your lungs as well as other organs.
  3. Infections with HIV, AIDS, or a comparable illness increase your chances of acquiring tuberculosis (TB).
  4. This test can determine if you have contracted the disease.
  5. Finally, if you have been successfully treated for tuberculosis, your doctor may order this test.

What Do the Results Mean?

It is deemed a negative result if your AFB stain does not include any bacteria that will stay onto the dye after being exposed to it. This indicates that you are not likely to develop tuberculosis or another mycobacterial infection in your lungs at this time. If there is just a small number of bacteria that retain their dye color, the findings may be regarded an early positive or inconclusive, depending on the circumstances. The greater the number of bacteria visible under a microscope, the more strongly positive and infectious you are most likely to be.

If you are diagnosed with tuberculosis, you will be treated with anti-tuberculosis medications.

It is possible to have both false-positive and false-negative findings. Your provider may request additional scans or tests to obtain additional information about your condition if your findings are unclear or if your doctor believes that the test may not have been reliable in its results.

Are There Risks to an AFB Stain Test?

There are no dangers associated with an AFB stain examination. You should be aware that your doctor may need to perform a bronchoscopy or stomach aspiration in order to extract sputum, and there are risks connected with this phase of the operation. The AFB stain test is not uncomfortable, even if you cough, which is a common indicator of a lung infection. However, you may experience some moderate discomfort when coughing, which is normal. There is no need to prepare anything ahead of time.

Acid-Fast Bacillus (AFB) Culture and AFB Stain

When to order the test and when not to order the test are recommended. It is possible to include related or preferred tests. For diagnosing the presence of Mycobacterium organisms, the gold standard test is performed.


A unique identification for the test. Air Force Base in McKinney (MC AFB)


Process(es) that were employed to carry out the test. Stain/Culture/Identification/Susceptibility


The exam is carried out on certain days of the week. Sun-Sat


The anticipated turnaround time for a result, starting from the time that ARUP receives the specimen. 1 to 62 days AFB staining time is 24 hours.

New York DOH Approval Status

ARUP expects to receive the specimen and begin processing it within a specified time frame. 1-62 days are included in this calculation. staining with AFB: 24-hour staining

Specimen Required

Preparation of the Patient The following sputum specimens are recommended: three specimens taken at 8-24 hour intervals (24 hours if possible), as well as at least one first-morning specimen Each specimen must have its own order, which must be filed separately. Obtain specimens of the respiratory system. Also acceptable are the following: Body fluid, cerebrospinal fluid, stomach aspirate, tissue, or urine are all acceptable specimens. Preparation of Specimens Place each specimen in a bag that has been properly sealed.

  1. (Minimum quantity: 1 mL) Transfer 5 mL of bodily fluids to a sterile container and set aside.
  2. (Minimum culture volume is 1 mL only.) 5 mL of culture and stain (minimum).
  3. Transfer 5-10 mL of the solution into a sterile container.
  4. acid fast stain will not be conducted on tiny tissue that cannot be ground because the minimum visibility requirement has not been met.) Transfer at least 40 milliliters of urine into a sterile container.
  5. Conditions that are intolerable Material that is dry or material that has been gathered and transferred on a swab Acid Fast Stain: Stool, blood, bone marrow, and excessively bloody specimens are all good candidates for this stain.

Stability Ambient storage for 24 hours; refrigeration for 1 week; freezing for 1 week

Reference Interval

For a certain illness condition, the normal range/expected value(s) is defined. It is possible to have aberrant ranges as well. As of the 20th of May, 2013 Acid fast bacilli were not detected in the culture. Identification is carried out on the positives. Susceptibility testing was carried out on all of the early isolates of the M. tuberculosiscomplex. Testing for resistance was carried out on important isolates of Mycobacterium that were not M. tuberculosis complex isolates.

Interpretive Data

Preliminary information for the test. Contains illness information, patient result explanations, suggestions and specifics of testing. Also contains information on linked disorders and an explanation of probable patient outcomes Standard ComplianceCategory of Compliance


Additional details about the test will be provided. Respiratory specimens, bodily fluids, CSF, stomach aspirates, and urines that are less than 5 mL in volume and less than 40 mL in volume will be marked as volume unsatisfactory in the report. When positive cultures are identified, they are reported as quickly as possible. The AFB stain, the AFB detection of positives, and the susceptibility tests are all invoiced separately from the culture procedure. Individual DNA probes and assays are used to determine the presence of a positive culture, and they are invoiced separately.

  • When the presence ofM.
  • Susceptibility testing will be carried out on organisms isolated from a sterile source as well as isolates of Mycobacterium TB complex, Mycobacterium chelonae, Mycobacterium abscesses, Mycobacterium fortuitum complex, Mycobacterium immunogenum, and Mycobacterium mucogenicum.
  • kansaii and M.
  • The use of M.
  • For more on AFB susceptibility, see Antimicrobial Susceptibility – AFB Mycobacteria (AFB Mycobacteria) (ARUP test code 0060217).
You might be interested:  What Is Digital Culture

CPT Codes

Details about the exam and any further information Volume suboptimal disclaimers will be included in the report for respiratory specimens, bodily fluids, cerebrospinal fluid, gastric aspirates, and urines that are less than 5 mL and less than 40 mL. As soon as positive cultures are identified, they are submitted to the appropriate authority. The AFB stain, the AFB identification of positives, and the susceptibility tests are all invoiced separately from the culture test. Individual DNA probes and assays are used to determine the presence of a positive culture, which are invoiced separately.

Because M.

Organisms isolated from a sterile source, as well as isolates of Mycobacterium tuberculosiscomplex, Mycobacterium chelonae, Mycobacterium abscesses, Mycobacterium fortuitum complex, Mycobacterium immunogenum, and Mycobacterium mucogenicum, will be tested for susceptibility to the antimicrobial agent.

kansaii and M.

The use of M.

gordonae for susceptibility testing is not recommended. Antimicrobial Susceptibility – AFB Mycobacteria is a good resource for information on AFB susceptibility (ARUP test code 0060217). See Culture, Acid-Fast Bacillus (Blood) for further information on AFB culture on blood (ARUP test code 0060060).


Components of the examination

Component Test Code* Component Chart Name LOINC
0060152 Culture, Acid Fast Bacilli 543-9

* It is not possible to organize tests using component test codes. In order to finish interface builds, the information supplied here is insufficient. To access the Interface Map, please click on the sidebar link in the left-hand navigation bar.


Other titles for the exam that are descriptive. Synonyms.

  • AO stain
  • Auramine-rhodamine stain
  • Auramin-rhodamine stain

Acid-Fast Bacillus (AFB) Culture and Acid-Fast Bacillus (AFB) Stain

AFB Smear and Culture

TB culture and sensitivity testing are two other names for this test. Acid-Fast Bacillus Smear and Culture with Sensitivity is the formal name for this test. Originally published on June 16, 2021. Last updated on June 16, 2021. For the purpose of assisting in the identification of a mycobacterial infection, diagnosing tuberculosis (TB), or monitoring the success of therapy If you are experiencing symptoms such as a persistent cough, weight loss, fever, chills, and weakness that your doctor believes may be caused by tuberculosis or another mycobacterial infection, consult your doctor.

  1. Typically, three independent spit (sputum) samples are obtained in the early morning hours on three successive days in a row.
  2. Stomach washings/aspirates may be obtained from children under the age of one.
  3. Specifically, the test searches for the presence of bacteria known as acid-fast bacilli (AFB), which are rod-shaped bacteria that may be seen and counted under the microscope in a carefully dyed sample applied to a glass slide and referred to as an AFB smear.
  4. The Mycobacterium tuberculosiscomplex is the most prevalent species of mycobacteria, as well as the one that is the most infectious to humans.
  5. Other mycobacteria that have been found are capable of causing infections in people.
  • In certain places of the world, M. africanum is responsible for an illness that is comparable to tuberculosis. Immunosuppressed patients, such as the elderly and those with AIDS, can develop a lung infection caused by the Mycobacterium avium-intracellularecomplex (MAC)
  • Although this illness is not easily disseminated to other people, it can be difficult to treat since it is very resistant to medications. Other mycobacteria, such as M. bovis, M.abscessus, and M. chelonae, can occasionally cause human infection if particular predisposed factors (such as respiratory illness and other diseases) are present. All mycobacteria other than Mycobacterium tuberculosis are classified as non-tuberculous mycobacteria (NTM), which is a larger category that includes M. tuberculosis.

Because the amount of bacilli might fluctuate from day to day, it is recommended to screen several smears from various samples for AFB. If acid-fast bacilli are seen on any of the smears, it is likely that the patient has a mycobacterial infection. Given the fact that Mycobacterium tuberculosis is the most common cause of mycobacterial respiratory infections, a provisional diagnosis of tuberculosis can be made; however, additional testing must be performed in order to positively identify the acid-fast bacilli as either Mycobacterium tuberculosis or another mycobacterial species.

  • AFB is grown in the laboratory using the cultures obtained from the animals.
  • Testing in a short period of time Additional TB testing methods, including those that are based on genetic components of mycobacteria, have been developed to aid in the reduction of the amount of time it takes to identify the disease.
  • These assays have the ability to amplify and copy portions of the bacterial genetic code in less than 24 hours.
  • In addition, if the bacterium is present, several of these tests can offer information on the bacteria’s sensitivity to antibiotics (usually only one or two drugs, not the entire panel), but only if the test is positive.

Please keep in mind that a negative fast test does not rule out a diagnosis, and it does not eliminate the necessity for a culture to be performed on the specimen. It is possible that further samples for treatment monitoring may be necessary.

How is the sample collected for testing?

Because M. TB and M. avium are the most prevalent pathogens that infect the lungs, sputum is the most often analyzed sample. Sputum is phlegm, which is a viscous mucus that is coughed up from the lungs when someone has a cold. Typically, three to five early morning samples are taken in individual sterile cups (on consecutive days) and then analyzed. If you are unable to cough up phlegm, your doctor may perform a bronchoscopy to get respiratory samples to test for the presence of infection. Using a tube inserted through your throat after being given a local anesthetic, your doctor can examine and collect samples from the inside of your lungs, allowing him or her to diagnose and treat you.

This procedure entails inserting a small amount of salt solution (saline) into the stomach through a tube and drawing the fluid back up through the tube.

For example, if it is believed that tuberculosis (TB) has affected your kidneys, one or more urine samples may be taken and tested.

Your doctor may occasionally need to use a needle to collect a sample of cerebral spinal fluid (CSF) or perform a brief surgical operation to acquire a tissue biopsy in order to diagnose your condition.

  • In order to determine whether you have an activeMycobacterium tuberculosis(TB) infection, an infection caused by another member of the Mycobacterium family, or TB-like symptoms caused by another cause, AFB smears and cultures are performed. TB-like symptoms are caused by a variety of different causes. They are used to determine if tuberculosis is contained only inside the lungs or whether it has spread to organs other than the lungs. They are used to detect Mycobacterium TB and to determine the most effective antimicrobial drug to employ in treating the disease. M. tuberculosis has the potential to be resistant to one or more medications widely used to treat tuberculosis (TB). If the bacteria are resistant to more than one of the common drugs used in therapy, the organisms are referred to as’multi-drug resistant’ tuberculosis (MDR TB), and if the bacteria are resistant to multiple first and second lines of therapy, the organisms are referred to as ‘extensively drug-resistant’ tuberculosis (XDR TB). If the bacteria are resistant to multiple first and second lines of therapy, the organisms are referred to as (XDR TB). AFB cultures can be used to assess the efficacy of therapy and to determine whether a patient is no longer contagious. Because tuberculosis is carried via the air by aerosols released by coughing and sneezing, it poses a threat to public health. It has the potential to spread in confined settings, such as prisons, nursing homes, and schools, among other places. Those who are extremely young, very old, or who have illnesses and disorders like as AIDS that might impair their immune systems are more prone than others to get the virus. As a result of AFB testing, it may be possible to track and minimize TB transmission among these groups of vulnerable persons, as well as determine the efficiency of TB therapy. AFB testing may be ordered when the following conditions exist:
  • You have symptoms that are suggestive of pulmonary tuberculosis, such as a persistent cough that produces phlegm or sputum that may contain streaks of blood
  • You have a history of TB in your family
  • You have a positive tuberculosis skin or blood test and distinctive lung involvement (as determined by an X-ray)
  • You are pregnant. Someone you are in intimate touch with, such as a family member or co-worker, has been diagnosed with tuberculosis, and you either have symptoms or have a condition or disease that puts you at a much increased risk of getting the disease, such as HIV/AIDS, as a result of the interaction. For example, persons with AIDS are more likely than other afflicted patients to have tuberculosis outside of the lungs and to have minimal or ambiguous symptoms. You are undergoing treatment for tuberculosis. AFB smears and cultures are then often required at regular intervals, both to determine the efficiency of your therapy and to determine whether or not you are still infectious
  • This is done to ensure that you are not spreading disease.
  • Positive AFB smears suggest the presence of a possible mycobacterial infection. In the case of a positive AFB culture, the mycobacterium that is causing your symptoms is identified, and your doctor receives information about how resistant it may be to therapy. A positive AFB smear or culture obtained many weeks after the initiation of medication therapy may indicate that the treatment is ineffective and that it is necessary to modify it. It also indicates that you are still likely to be contagious and can spread the mycobacteria to others by coughing or sneezing, among other methods. In the case of an AFB smear or culture, a negative result indicates that you do not have an AFB infection or that the mycobacteria were not present in the material tested (which is why multiple samples are often collected). If you have tuberculosis, the infection may be in a different place of your body, and a new sort of body sample may be required to diagnose you. It suggests that your tuberculosis is responding to medication therapy and that you are no longer contagious if your culture comes back negative many weeks following treatment. To effectively treat tuberculosis when it is active, a lengthy course of several medicines is required. Even if they are asymptomatic, people with inactive (latent) infections can be treated with a single medicine in order to limit the chance of developing an active infection in the future
  • And Yes. There is a sort of tuberculosis infection that is concealed (latent). A small number of humans have been exposed to the bacterium, but their bodies’ immune systems have limited it to only a few of their cells, and they are no longer active. People who have latent tuberculosis infections are not unwell, and they are not contagious, yet the germs are still present and living in their bodies. If people with latent infections were examined, the vast majority would test positive for tuberculosis. 90% of patients with latent tuberculosis infection will never develop active tuberculosis illness, according to the Centers for Disease Control and Prevention (CDC). If, on the other hand, the patient’s immune system is impaired, the likelihood of progression to active illness increases significantly. Those who have active tuberculosis may not have any symptoms at first. Early symptoms of tuberculosis may be subtle, and if the infection has spread outside of the lungs to organs such as the kidneys and bones, the disease may already be advanced by the time symptoms become noticeable. Both indicate resistant strains of Mycobacterium tuberculosis that can be difficult to treat, but XDR (eXtremely drug resistant) TB is resistant to a greater number of drug therapies. According to the Centers for Disease Control and Prevention in the United States and the World Health Organization, M. tuberculosis is classified as XDR TB if it is resistant to all three injectable’second-line’ treatments, plus any fluoroquinolone and at least one of three injectable ‘third-line’ medications (amikacin, kanamycin, or capreomycin). International medical experts are closely monitoring the spread of XDR TB, and measures are being implemented in the hope of limiting its spread. Direct observed therapy (DOT) ensures that patients are taking their medications and completing the prescribed treatment regimen for the required amount of time. Instead of being treated with one or two treatments for 7-10 days as is the case with other bacterial illnesses, tuberculosis (TB) must be treated with two or more drugs for several months
  • This is only the marketing term for a quick diagnostic PCR test. Because it is the most often utilized, it is conceivable that your doctor or healthcare provider will refer to it by its proper name rather than using the term “quick test.”
You might be interested:  What Is A Rape Culture

The following tests are available on this site: tuberculosis skin testing, antibiotic susceptibility testing, bacterial wound culture, sputum culture, bacterial body fluid testing, and adenosine deaminase testing. Conditions: Diseases such as tuberculosis, non-tuberculous mycobacteria infections, meningitis and encephalitis, lung diseases such as HIV/AIDS, Septic Arthritis, wound and skin infections are all treated in this clinic. TB-Related Websites Located Elsewhere On The InternetHPA, TB-Related Websites

AFB Smear and Culture: The Test

NOTE: This article is based on research that draws on the sources listed in this page, as well as the combined experience of the Lab Tests OnlineEditorial Review Board, to come up with its conclusions. This article is evaluated by the Editorial Board on a regular basis, and it may be amended as a consequence of the review process. Any new sources that are referenced will be added to the list and differentiated from the original sources that were utilized in the essay. Sources consulted for the current review A.B.

  1. Sahm are co-authors of Scott’s Diagnostic Microbiology, which was published by Mosby Elsevier in St.
  2. Pages 478-508 in Scott’s Diagnostic Microbiology 12th Edition.
  3. Tuberculosis is diagnosed using a series of tests.
  4. The date of access was January 2011.
  5. Guidelines for the Use of Nucleic Acid Amplification Tests in the Diagnosis of Tuberculosis have been updated.
  6. The date of access was January 2011.
  7. Herchline is credited with inventing the phrase (December 17, 2010).

Through the use of the internet, you may access this resource.

(February 29, 2009) Mayo Clinic is a medical center in Rochester, Minnesota.

Through the use of the internet, you may access this resource.

(12th of November, 2010) The National Institute of Allergy and Infectious Diseases is a federally funded research organization.

Through the use of the internet, you may access this resource.

(Updated on November 2010) Organización Mundial de la Salud.

Through the use of the internet, you may access this resource.

A rapid molecular detection method for tuberculosis and rifampin resistance was developed by C.

N Engl J Med 2010; 363:1005-1015.

N Engl J Med 2010; 363:1005-1015.

Minion J, Leung E, Menzies D, Pai M.

The Lancet Infectious Diseases, October 2010, 10(10):688-98.

Through the use of the internet, you may access this resource.

Sources that have been used in previous reviews Clayton L.

Taber’s Cyclopedic Medical Dictionary is a medical dictionary published by Taber’s Cyclopedic Medical Dictionary.

Davis Company is based in Philadelphia, Pennsylvania.

Pagana, Kathleen D.; Pagana, Timothy J.; Pagana, Timothy J.




Available on the internet at the following link: Kirchner, J.

Do AFB-positive sputum smears indicate that treatment has been unsuccessful?

Through the use of the internet, you may access this resource.

Jerant and colleagues (2000 May 1).

Through the use of the internet, you may access this resource.

Sadovsky, R.

(2001 May 15).

Through the use of the internet, you may access this resource.

Frequently Asked Questions, as well as Questions and Answers, regarding tuberculosis.

Through the use of the internet, you may access this resource.

The Merck Manual of Medical Information-Home Edition is a comprehensive resource for medical information.

Tan, L.J., et al (2000 June 28, Updated).

The American Medical Association is a professional organization dedicated to the advancement of medical knowledge and practice.

Mazurek, G.; Villarino, M.; Mazurek, G.; Mazurek, G.

Specifications and Instructions for Using the QuantiFERON®-TB Test for Diagnosis of Latent Mycobacterium tuberculosis Infection CDC stands for the Centers for Disease Control and Prevention.

Through the use of the internet, you may access this resource.

Co-infection with tuberculosis and HIV.

Through the use of the internet, you may access this resource.

Tuberculosis in History.

Through the use of the internet, you may access this resource.

Through the use of the internet, you may access this resource (2002 January).

Available online at through (2002 January).

Available online at through (2002 January).

Available online at through.

Tuberculosis and Its Burden on the World.

Skin test for tuberculosis.


Introduction to the genus Mycobacteria in the field of mycobacteriology.

Mycobacteriology, Acid-Fast Staining Procedures for Mycobacteria.

Available online at Hall, G.


Medscape from Infect Med 18(1):28-30, 2001.

Tuberculin Purified Protein Derivative (Mantoux) Tubersol.

(Swiftwater, PA) (Swiftwater, PA).

AccuProbe, Mycobacterium Tuberculosis Complex Culture Identification Test.

Through the use of the internet, you may access this resource.

Notice to Readers: Revised Definition of Extensively Drug-Resistant Tuberculosis.

Through the use of the internet, you may access this resource.

(2006 April).

National Center for HIV, STD, and TB Prevention, Division of Tuberculosis Elimination Fact Sheet.

Accessed December 10, 2006.


Through the use of the internet, you may access this resource.

(2006 March).

Accessed December 10, 2006.

Available FTP:(2006 April) (2006 April).

National Center for HIV, STD, and TB Prevention, Division of Tuberculosis Elimination Fact Sheet.

Accessed December 10, 2006.

Pagana, Kathleen D.Pagana, Timothy J. (© 2007). Mosby’s Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 955-957. Moore, DAJ et al. Microscopic-Observation Drug-Susceptibility Assay for the Diagnosis of TB. New England Journal of Medicine2006;355:1539-1550.

Test Details

Test Mnemonic:
Specimen Requirements:
Collection: Collect specimens in a sterile, leak-proof container.It is recommended to collect 3 sputum specimens to diagnose tuberculosis, preferable volume5ml. For sputum collection, use the sputum collection kit. Collect complete first morning urine for AFB culture.Specimens for testing: Sputum, respiratory sources, gastric aspirates, feces, autopsy sources, abscesses, skin lesions, urine samples. Swabs are not recommended for optimal recovery of AFB.
Container: Sterile containers
Minimum Volume: Sputum – 1ml; Urine- first morning collection (30ml) for optimum sensitivity
Storage/Transport: Transport to the laboratory as soon as possible after collection. Refrigerate specimens if transport is delayed. Deliver gastric aspirates as soon as possible due to pH changes
Stability: 72 hours
Causes for Rejection: More than three samples per week submitted on the same patient (respiratory sources only), leaking container, insufficient quantity, more than two feces per week. Specimen container unlabeled or labeled incorrectly. No date and time of collection on requisition form.
Reference Range: No Mycobacteria isolated
Turnaround Time: Samples are processed 5 days per week. Smear is reported the day of processing; positive cultures are reported when growth and negative cultures are held 6 weeks. Cultures are incubated for 6 weeks.
Methodology: Acid fast smear, culture for the isolation and identification of Mycobacterium species and antimicrobial susceptibility testing when appropriate
Performed: Clinical Microbiology
Synonyms: AFB Culture; Culture, AFB; Respiratory AFB Culture; AFB Culture, Sputum; TB Culture; AFB CUlture, Urine; AFB Culture, Feces
Clinical Indication: Cultivation of Mycobacterium spp. from non-sterile sources or ifMycobacterium tuberculosisor other Mycobacteria spp. suspected.
Patient Preparation: Productive cough
CPT 4 Code: 87116 – culture, 87206 – smear, 87015 – concentration, additional if indicated
Note: The first positive AFB smear or culture for acid-fast bacilli from respiratory sources is a critical value and the LIP is notified.It is recommended to collect sputum samples 8-24 hours apart and the first morning urine for optimal recovery.The first positive smear from respiratory sources with AFB is considered a critical value.
When ordering tests for which Medicare or Medicaid reimbursement will be sought, physicians should only order tests that are medically necessary for the diagnosis or treatment of the patient. Components of the organ or disease panels may be ordered individually. The diagnostic information must substantiate all tests ordered and must be in the form of an ICD-10 code or its verbal equivalent.

Acid Fast Bacilli (AFB), Blood Culture

One AFB blood culture must be obtained every 24 hours for the course of the study. The collect times should be one minute apart when ordering multiple blood culture tests, regardless of the technology being used.

Test Name Alias

Culture Tuberculosis | 8849 | AFB Blood Culture | TB Culture | Mycobactria Culture | MTB | Tuberculosis

Interface Order Alias

The organisms Nocardia and allied species of aerobic actinomycetes grow well on mycobacterial medium, making the use of AFB culture when infection with this group of organisms is suspected.


Read InstructionsCarefully BACTEC MycoF Vial Preferred Sodium Heparin Acceptable Lithium Heparin Acceptable

Collection Instructions

Whole blood or bone marrow specimens are acceptable. BACTEC MycoF is included within the following container(s): It is preferable to use a vial rather than a green top (Sodium Heparin) (Lithium Heparin) 5 mLM is the preferred volume to collect. 3 mLC is the maximum volume that may be collected. ollection Instructions:

  • Disinfect the bottles or tubes with a CHG swab stick once they have been cleaned. Discard the plastic seal from the bottle and soak the rubber lid in warm water before allowing it to air dry. Prepare the venipuncture site on the patient by opening the vein.
  • Continue to hold the applicator in a downward position
  • Avoid touching the sponge
  • Pinch the ampule once to break it apart. By gently pushing the sponge against the treatment region, you should hear a popping sound. Saturate the sponge with CHG. Rub the treatment area with a vigorous back and forth motion for 30 seconds.
  • Open the packet and saturate the bottle/tube top with one swab stick to prepare the bottle for usage. By thoroughly cleaning the patient’s arm back and forth for 30 seconds with a second swab stick, prepare the arm for the procedure. If a second set of cultures has been requested, the third swab stick can be used to prepare the patient for the second set of cultures.

Betadine applicator for children 2 months of age and younger.

  • Hold the applicator in a downward position
  • Do not contact the tip
  • Pinch the ampule once to break it. You should be able to hear a pop. Start in the middle of the targeted puncture location and work your way outward in concentric rings. Do not return to the beginning place
  • Instead, move forward.

Allow for natural drying. Apply the tourniquet 3 to 4 inches above the puncture site for no more than 1 minute, depending on the severity of the injury. When it comes to painting youngsters, the use of a tourniquet is not always acceptable. Venipuncture should be performed in the sequence of the draw. Take the tourniquet off. Clean gauze should be placed over the puncture site and direct pressure should be applied. Bottles should be gently inverted 8-10 times to prevent clotting. Label the bottles at the bedside (or with the patient) with the following information: patient information, date and time of collection, and the source information that is necessary.

  1. Place the label vertically at the top of the bottle, so that the bar code on the bottle remains visible.
  2. Blood draw frequency and timing: The vast majority of bacteremia cases are discovered by collecting two or three sets of blood from various places (veins).
  3. As an alternative, a single blood culture may overlook the presence of bacteremia and make it difficult to determine the clinical importance of certain species.
  4. Notify Microbiology if you detect a case of any of the following:
  1. If Brucella, Mycobacterium (AFB), Histoplasma, or any fungal or odd organism is suspected, contact your doctor immediately.

The line should not be used to acquire specimens for regular blood cultures. When it comes to determining a diagnosis, cultures collected by a line draw might be deceptive. If a line-related sepsis is suspected, consulting with an Infectious Disease specialist may be beneficial; line draws should be used only to determine the existence of colonization of a line in the ideal situation.

A physician’s order should be sought to collect one set of blood cultures peripherally in order to identify if the infection is real bacteremia or if the line has been contaminated before getting a sample.

Specimen Transport Temperature

Ambient temperature: 24 hours Laboratory Retention: This information is not available.

Test Frequency

The culture was incubated for 42 days.

Reference Range

There was no evidence of Mycobacterium.

Performing Department


Performing Department Laboratory Location

Grand Rapids, Michigan-based Spectrum Health Regional Laboratory


System for Automated Blood Cultures

Beaker LOINC


Additional Information

PolicyTech Procedure 9953 (PolicyTech Procedure 9953)

Beaker Names

AFB BLOOD CULTURE is the name of the procedure in a beaker. AFB Blood Culture Beaker Display Name: AFB Blood Culture AFB BLOOD CULTURE IS THE NAME OF THE BEAKER TEST. THE NAME OF THE BEAKER TEST REPORT IS:AFB Blood Culture.

Beaker Synonyms

There isn’t a synonym on file.

Beaker Location, Container and Temperature

Microbiology at BW: AFB BLOOD CULTURE BOTTLE (Preferred)-Ambient Microbiology at BW: BW MICROBIOLOGY: AEROBIC/ANEROBIC CULT BOTTLES – BLD CULT BOTTLES (Acceptable) -There is no temperature.

Leave a Comment

Your email address will not be published. Required fields are marked *