BioFire Pneumonia Panel, BAL
PATIENT INFO |
Patient Name: |
Medical Record #: |
BD: / / Sex: F M |
PHYSICIAN INFO |
Physician Name : |
Address: |
Ph: ( ) - Fax: ( ) - |
Additional Report to: |
Ph: ( ) - Fax: ( ) - |
TESTS REQUESTED | |
Test Name: | ICD9 Code: (required) |
1. BioFire Pneumonia Panel, BAL | |
2. | |
3. | |
4. | |
5. | |
6. |
SPECIMEN INFO |
Collection Date & Time: |
Collected By: |
Hospital: |
For respiratory samples other than BAL (trachael aspirate, sputum), please order the Pneumonia Panel Film Array (LAB4779) performed in-house in the Microbiology Laboratory.
Bacteria
Acinetobacter calcoaceticus baumanni complex, Enterobacter cloacae complex, Escherichia coli, Haemophilus influenzae, Klebsiella aerogenes, Klebsiella oxytoca, Klebsiella pneumoniae group, Moraxella catarrhalis, Proteus spp., Pseudomonas aeruginosa, Serratia marcescens, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes.
Atypical Bacteria
Chlamydia pneumoniae, Legionella pneumophila, Mycoplasma pneumoniae.
Viruses
Adenovirus, Coronavirus, Human Metapneumovirus, Human Rhinovirus/Enterovirus, Influenza A, Influenza B, Parainfluenza Virus, Respiratory Syncytial Virus.
Antimicrobial Resistance Genes
CTX-M, IMP, KPC, NDM, OXA-48-like, VIM, and mecA/C and MREJ.