AFB Smear
- Synonyms: ACID FAST SMEAR
- LIS Mnemonic: SMAFB
Collect
See Remarks below
Volume Required
See Remarks below
Minimum Required
0.5mL
Transport
All specimens must be delivered to the laboratory promptly, within 30 minutes of collection. If this is not possible, refrigerate. Gastric aspirates must be sent immediately or will be rejected.
Stability
2 hours
(Exception gastric specimens which must be sent to laboratory immediately)
Unacceptable conditions
Swabs are unacceptable; stool (unless diagnosis is HIV); urine in urine transport tubes; CSF volumes < 5mL
Saliva specimens (Consult with Respiratory Therapy regarding induced sputum samples if having difficulty obtaining a sputum)
Days Performed
7 days a week
Reported
Same day
CPT
87206
Methodology
Screen: Fluorescent, Confirmatory : Kinyoun Stain
Remarks
SPECIMEN COLLECTION INFORMATION:
Blood & Bone marrow: see CAFBLG (Culture and Smear, AFB Blood)
Bronchial: collect in sterile leak-proof container; avoid contaminating with tap water
Gastric aspirate: send 3 consecutive first morning specimens obtained before patient awakens; collect in sterile leak-proof screw cap container [see Nursing procedures 4:4a Collection of Tb specimens]
Sputum: send first morning specimen on 3 consecutive days; collect in sterile leak-proof screw cap container
Urine: send first morning specimen on ice; collect in sterile leak-proof screw cap container
CSF: optimal volume is 5-10 mL; if less is available consider direct PCR testing for M. tuberculosis
Stool: collect in sterile leak-proof container; for HIV patients only
Tissue: submit in a sterile leak-proof container with the specimen wrapped in moist sterile gauze to prevent drying. Do not add saline, which is toxic for AFB.
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VOLUME REQUIRED:
Bronchial: 1 mL
Gastric aspirate: > 2mL
Sputum: at least 2 mls
Urine: 2-5 mL
CSF: 5-10 mL
Stool: 2-5 tablespoons
Tissue: as much as possible; larger size improves yield
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ADDITIONAL NOTE:AFB smears not performed on CSF specimens due to poor sensitivity, however, if required, must be approved through the Infectious Disease Department
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