Colony count

You can request the colony count through your NJH patient portal. It usually takes 4 + weeks after you send in your culture and maybe 8-10 weeks for it to be final. It is also included on the final report that you see in the patient portal.

Well, there's the trick then. It is through my local ID, goes to a local lab, and then they send to NJH for further identification and susceptibilities. I asked my local ID and he said that NJH doesn't provide that information. Hmmmm....

If your sputum sample is being processed through the NJH lab, you should get three culture reports: AFB, fungal, and respiratory. The respiratory and fungal culture reports have fairly fast turn-around times. The AFB culture report, however, can take up to 12 weeks to post. This is the report that will give you the status of your AFB smear and AFB culture. In the AFB culture section, it will give you your colony count. Below that will be listed the species and then the susceptibility test results. You may want to ask your doctor for a copy of the final report.

Thanks. It's going through local doctor and local lab for AFB then to NJH for further identification. I see the final report that NJH sends. It identifies subspecies and susceptibility but shows no colony count. I am an established patient at NJH but wasn't diagnosed by them and they aren't handling my case this go round. I guess I'd have to submit directly to my NJH doctor. I think it might be time to a visit to them since it's been 6 months with no conversion.

OK, so if it's first going to a local lab for AFB culturing, then it makes sense that you don't get the colony count. If you send the sputum sample directly to NJH, they go through a long painstaking process of hand counting the colonies on a grid. There are very few labs that do this. Local labs will just test to see if it's AFB positive.

That makes sense. Thanks! I guess I'll have to send one directly to my doctor at NJH then if I want that information.

In my heal the system, cultures go first to the MNDept of Health for the AFB test (we are a high TB area, so that must be ruled out.) Then to NJH to be grown out and sensitivity tested. The doc needs to request all 3 (AFB, sensitivity & count) in the order, otherwise only the AFB is done.
Sue

What does AFB stand for?
lj

Mycobacteria are very slow growing bacteria, so finding and identifying them isn't as easy as strep or staph germs.
In the AFB test - "Acid Fast Bacillus" or "Acid Fast Bacteria" - the sputum is spread on a slide, with a dye, and grown for a couple days to see if any bacteria appear there (Mycobacteria include TB as well as MAC.) If anything shows, a culture must be grown (4-8 weeks) to see what exactly the bacteria is, and then it is further tested (2-4 more weeks) to see which antibiotic(s) it is susceptible to.
If you have had a previous positive MAC culture, the lab may send the sample for culturing, even if the AFB test doesn't show positive, because treatment may have severely reduced the number of bacteria in your system.
At the same time, a portion of the sputum sample may be cultured to look for other bacteria like pseudomonas, as well as some fungal infections, since the symptoms may be similar.
Sue

Thanks Sue for the explanation. Very helpful.
lora jo