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Bronchial culture, routine (Calgary/South)
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Test Name:
Bronchial culture, routine (Calgary/South)
Organism(s)/Disease(s):
Haemophilus influenzae
Moraxella catarrhalis
Nocardia species
Pneumonia, bacterial
Respiratory infection
Streptococcus pneumoniae
Body Source(s):
Bronchial alveolar lavage (BAL)
Bronchial wash (BW)
Clinical Prerequisite(s):
Provision of relevant, clinical information is important to ensure a clinically relevant result
Always provide/record:
•  specimen source
•  current antibiotic therapy and the start date
•  clinical history - symptoms, signs and duration
•  travel history
Is there underlying respiratory disease?
•  bronchiectasis
•  cystic fibrosis
•  COPD
•  asthma
•  malignancy
Is the patient immunocompromised?
•  steroid therapy
•  chemotherapy
•  post-transplant
•  immunosuppressive therapy
•  neutropenia
•  malignancy

Note:  If Nocardia is suspected, it must be indicated on the requisition

Collection Device/Tube Type:
60 mL sterile, plastic container
Specimen trap, sterile
Collection Instructions:
  1. Collect samples before the initiation of antibiotics or, following treatment failure
  2. Ensure adequate volume is collected for all requested testing.
    • If there are multiple requests, laboratory staff must contact the Microbiologist-on-call to determine testing priority
  3. DO NOT package specimens from multiple body sites or from multiple patients in the sample specimen transport bag
  4. Place all the individual specimen transport bags from the same patient and body site into a large re-sealable, plastic bag
  5. Ensure containers do not leak and are not cross-threaded
Handling/Storage Comments:
  • Store samples at room temperature for up to 2 hours.
  • If there is a delay in transport to the testing laboratory, then refrigerate the samples
  • Specimens must be received at the Diagnostic & Scientific Centre (DSC) within 2 hours of receipt in the hospital laboratory

Turnaround Times
See Microbiology Information»
Comments:
Only specimens collected as per Bronchoscopy Guideline VAPP-004 (AHS Insite) are processed for quantitative culture.  Those specimens not collected accordingly are processed as a Bronchial Wash

Quantitation of BAL Culture - Interpretation Guidelines
  • In BAL cultures, bacteria-causing pneumonia are usually present at greater than or equal to 104 CFU/mL
  • Oropharyngeal flora is usually present at grater than 104 CFU/mL

Quantitation of Intracellular Organisms in Stain - Interpretation Guidelines

  • Performed when potential pathogens are reported from stain or culture
  • The percentage of intracellular bacteria contained in polymorphonuclear neutrophils and macrophages is predictive of pneumonia
  • An exact cut-off is not established, but is believed to be around 5%

NOT suitable for anaerobic culture unless protected brush specimen

If patient is at risk for dimorphic/endemic fungi or invasive mold infections, collect a specimen for fungal culture.  Fungal culture, bronchial (Calgary/South)


Last Reviewed:
19 May 2023
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