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Utah Public Health Laboratory

Bacillus anthracis (Anthrax)

Fee: Please refer to fee schedule

Ordering Recommendation

All clients – Contact Utah Public Health Laboratory prior to submitting specimens.

Performed

Sunday - Saturday as required.

Methodology

LRN Procedures

Reported

<1-3 days

Specimen Required

  • Collect: Culture isolate, cutaneous lesions, stool, rectal swab, blood cultures, whole blood, sputum, CSF, tissue, nasal swab and environmental samples.
  • Specimen Preparation:
    • Cutaneous lesions
    • Vesicular stage: aseptically collect vesicular fluid on sterile swabs from previously unopened vesicle. NOTE: The anthrax bacilli are most likely to be seen by Gram stain in the vesicular stage.
    • Eschar stage: collect eschar material by CAREFULLY lifting the eschar’s outer edge. Insert a sterile swab, and then slowly rotate for 2-3 seconds beneath the edge of the eschar without removing it.
    • Stool – Transfer ≥5 grams of stool directly into a clean, dry, sterile, wide-mouth, leak-proof container. Transport unpreserved stool to laboratory within 1 h. Cary-Blair or equivalent transport media is acceptable. o Rectal swab – For patients unable to pass a specimen, obtain a rectal swab by carefully inserting a swab 1 inch beyond the anal sphincter.
    • Blood culture – Collect appropriate blood volume and number of sets per laboratory protocol. Note: In later stages of disease (2-8 days post-exposure), blood cultures may yield the organism, especially if specimens are obtained prior to antibiotic treatment. Transport directly to laboratory at room temperature. NOTE: Whole blood collected in a purple-top tube may be requested for additional tests.
    • Sputum – Collect >1 mL of a lower respiratory specimen into a sterile screw-capped container. Inhalational anthrax usually does not result in sputum formation.
    • CSF, tissue, autopsy samples – Collect aseptically and place in sterile containers. Transport directly to laboratory at room temperature.
  • Storage/Transport Conditions:For transport time >1h and <24h, refrigerate at 2 to 8°C. Culture isolates may be transported at room temperature.
  • Unacceptable Conditions:Calcium alginate or cotton swabs, swabs with wooden shaft, or dry swabs.
  • Remarks:
  • Stability: Transport directly to laboratory at room temperature. For transport time >1 h and < 24 h, refrigerate at 2 to 8°C.

Results

Detected or Not Detected

Interpretive Data

West Nile virus detected or not detected. Western Equine Encephalitis virus detected or not detected. Saint Louis Encephalitis virus detected or not detected.

Note

It is mandatory that UPHL be contacted prior to submitting samples for testing.

Cross References

American Society of Microbiology Sentinel Level Clinical Laboratory Guidelines http://www.asm.org/index.php/guidelines/sentinel-guidelines