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Sentinel Laboratory Response Network Rule Out

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Test Description
  • Contact: Reference Microbiology (319) 335-4335
  • Test Request Form: Special Pathogens
  • SHL OpenELIS Code: 1041, 1042, 1047, 1052, 1053
Rule out suspected high consequence pathogens including B. anthracis, Burkholderia, Brucella, F. tularensis, and Y. pestis.
Reflex Test(s)
Additional confirmatory testing may be performed at CDC. This test and method will be named "Miscellaneous, Miscellaneous" on the SHL result report.
Performed Avg. Turnaround Time Method
Coralville, 24/7
1 - 10 business days Conclusion; conventional and molecular microbiological methods
Fee CPT Code(s)
No Charge 87798, 87077
Specimen Requirements
Specimen Type: Actively growing bacterial organism in pure culture.
Collection Instructions: Actively growing organism in pure culture on a sealed agar plate or slant. Specimen source required.
Shipping:
  • Must be packaged and shipped Category A. For a refresher on Category A training, click here.
  • To order Category A shipping containers, follow the link (https://shl.uiowa.edu/request-clinical-testing-or-kits), scroll to 'Order Clinical Kits', enter the applicable information and select 'Category A Shipper (orderable with approval)'.
  • If your organization does not have an autoclave on site, send all patient material to SHL (blood culture bottles, primary specimens, swabs, plates, etc). Pre-approval from SHL is required.
  • If your organization does have an autoclave on site, isolate any remaining culture material for disposal upon confirmation.
Temperature and Stability: Room Temperature; stable for 72 hours.
Rejection Criteria: Specimens will be rejected if received under these conditions:

Broken or unsealed plate/slant.
Expected Results:
Expected results are dependent on the organism being ruled out.
  • Bacillus anthracis: Negative for B. anthracis, Confirmed Positive for B. anthracis, Presumptive Positive For B. anthracis, Equivocal for B. anthracis (cannot be ruled out or confirmed, both positive and negative confirmatory results), Inconclusive for B. anthracis, Test not done.
  • Brucella species: Negative, Presumptive positive for Brucella species, Confirmed positive for Brucella melitensis, Confirmed positive for Brucella abortus, Confirmed positive for Brucella suis, Confirmed positive for Brucella canis, Presumptive positive for Brucella abortus RB51, Inconclusive, Test not done.
  • Burkholderia species: No Burkholderia mallei or pseduomallei detected, Suspected Burkholderia species, Confirmed positive for Burkholderia mallei, Confirmed positive for Burkholderia pseudomallei, Presumptive positive identification of Burkholderia mallei, Presumptive positive identification of Burkholderia pseudomallei, Test not done.
  • Francisella tularensis Conclusion: Negative for F. tularensis, Presumptive positive for F. tularensis, Confirmed positive for F. tularensis, Inconclusive, Test not done.
  • Yersinia pestis: Negative for Y. pestis, Presumptive Positive for Y. pestis, Confirmed Positive for Y. pestis, Inconclusive for Y. pestis, Test not done.
Comments
  • ASM Ruleout methods must be followed prior to submission
    • ASM Methods for B. anthracis: https://asm.org/getmedia/6d0147f6-07ff-476f-899b-760213b8f5ca/Anthrax-SOP_final.pdf
    • ASM Methods for Brucella: https://asm.org/ASM/media/Policy-and-Advocacy/LRN/Sentinel%20Files/Brucella-2016-March.pdf
    • ASM Methods for Burkholderia: https://asm.org/ASM/media/Policy-and-Advocacy/LRN/Sentinel%20Files/Burkholderia-Marc2016.pdf
    • ASM Methods for F. tularensis: https://asm.org/ASM/media/Policy-and-Advocacy/LRN/Sentinel%20Files/tularemia.pdf
    • ASM methods for Y. pestis: https://asm.org/ASM/media/Policy-and-Advocacy/LRN/Y-pestis-fixed-figures.pdf
    • CDC Biothreat Preparedness Training for Sentinel Laboratories: https://www.cdc.gov/lab-training/php/courses/biothreat-preparedness-sentinel-laboratories.html
  • Maintain a record of who worked with the sample(s) from the affected patient and what activities they performed outside of a Biosafety Cabinet. This information is required if the sample is confirmed, and prophylaxis is needed. Each situation will be different, and consultation at the time of the event will be held to determine action.
  • If the submitted specimen is confirmed as a Select Agent (B. anthracis, Burkholderia, F. tularensis, or Y. pestis) the submitting facility must complete a CDC/APHIS Form 4A-CD and destroy all material related to the confirmed sample within 7 days. For information on completing and submitting a Form 4 see Guidance Document for the Completion of APHIS/CDC Form4A-CD https://www.selectagents.gov/forms/docs/APHIS-CDC_Form-4A-CD_Guidance_508.pdf
The University of Iowa

State Hygienic Laboratory

General inquires
SHL Client Services
319-335-4500 or 1-800-421-IOWA (4692)
ask-shl@uiowa.edu

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