Pneumonia Panel Film Array
| 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. Pneumonia Panel Film Array | |
| 2. | |
| 3. | |
| 4. | |
| 5. | |
| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
LAB4779
Specimen Type:
1 mL sputum or tracheal aspirate in a sterile container.
Cause for Rejection:
Quantity not sufficient, improper specimen type, improper storage/transport, mislabeled, or unlabeled.
Storage:
Transport refrigerated required from off campus location. Upon arrival in laboratory, store refrigerated.
Availability:
Monday-Friday 07:00-23:00, Saturday/Sunday 07:00-15:00
Methodology:
Multiplexed nucleic acid test intended for the simultaneous qualitative detection and differentiation of nucleic acids from multiple viral and bacterial respiratory organisms.
Special Instructions:
The Pneumonia Panel Film Array must be ordered in conjunction with an appropriate respiratory culture (Tracheal Aspirate Culture or Sputum Culture).
The Pneumoniae Panel Film Array can be performed on bronchoalveolar lavage (BAL) samples, but that source is not approved for use at Akron Children's. To submit a BAL for the Pneumonia Panel Film Array, please order the BioFire Pneumonia Panel, BAL (LAB3806) and the sample will be forwarded to Summa Health for analysis.
The Pneumoniae Panel Film Array can be performed on bronchoalveolar lavage (BAL) samples, but that source is not approved for use at Akron Children's. To submit a BAL for the Pneumonia Panel Film Array, please order the BioFire Pneumonia Panel, BAL (LAB3806) and the sample will be forwarded to Summa Health for analysis.
Lab/Phone:
330-543-8406
TAT:
Two hours from the time the specimen arrives in the Akron laboratory, unless the sample is received outside of normal availability (see Availability section), then the TAT is 18 hours.
CPT Code:
87633
Panel Includes:
Targets include the following:
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.
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.
