Advanced Diagnostic Laboratories

Sinus Culture

Test Code

CXSIN

Description

Sinus culture is used to determine the possible bacterial causes of rhinosinusitis. This test includes a Gram stain and culture

Specimens sent under anaerobic conditions will be cultured for both aerobic and anaerobic pathogens. Specimens not sent under anaerobic conditions will only be examined for aerobic pathogens. Anaerobic conditions include a syringe with the air expelled or anaerobic transport media.

Collect

Rigid endoscopy: Patient will take intranasal decongestant and a topical anesthetic. Aspirate from the middle meatus adjacent to the maxillary sinus ostium ipsilateral.

Maxillary aspiration: An aspiration of the drainage is preferred, but drainage can be submitted on a swab. Clean anterior nares with antiseptic solution, then apply topical anesthetic. Puncture the maxillary antrum and aspirate secretions with needle and syringe. If no material was aspirated, irrigate with 2ml of nonbacteriostatic saline.

Nasal wash: Nasal washes are not a recommended specimen type. Nasal washes and nasal aspirates lack specificity to diagnose sinusitis or lower respiratory disease. These will be accepted but minimal pathogens will be identified.

All specimen sources should to be collected in a sterile container or syringe. Remove the needle and cap syringe before sending to the laboratory.

Aspirates are preferred over swabs because swabs typically have insufficient volume..

Preferred volume: 3 mL
Minimum Volume: 1 mL

Patient Prep

Avoid antibiotic administration prior to sample collection.

Unacceptable Conditions

Specimens received outside of temperature storage requirements
Specimens received outside of stability time frame
Specimens that do not meet the minimum volume requirement
Specimens in non-sterile containers
Specimens in expired transport media
Specimens from a source not acceptable for this testing
Specimens that are excessively leaking
Mislabeled or unlabeled specimen
Anaerobic portion of testing will not be performed if the samples was not submitted under anaerobic conditions

Stability

For optimal recovery of potential pathogens, specimens should arrive within 2 hours at room temperature (20-25°C)
If transportation is delayed, specimens may remain at room temperature (20-25°C) for a maximum of 24 hours

Performed

7 days a week from 8am to 6pm

Methodology

Aerobic and anaerobic (if appropriately collected) bacterial culture

Turnaround Time

2-5 days

Department

Microbiology Lab

Synonyms

Upper respiratory culture

Study Offerings

CAP/CLIA

Reference Interval

Semi-quantification of normal sinus flora

Interpretation

The table below describes reportable organisms and if antimicrobial suscecdptibility testing (AST) is routinely included. If susceptibilities are needed for an organism that AST is not routinely included, please submit the request through EPIC using the OP Add-On/Comm Message type addressed to NJH LAB ADD-ON POOL.

Threshold for Reporting	Organism	Testing Performed
Any	Anaerboes (<3 morphologies)	ID
	Haemophilus influenzae	ID; β-lactamase
	Mold	ID
	Moraxella catarrhalis	ID; β-lactamase
	Streptococcus pneumoniae	ID and AST
	Streptococcus pyogenes (group A)	ID
Pure or Predominant	Enterobacterales	ID and AST
	Pseudomonas aeruginosa	ID and AST
	Staphylococcus aureus	ID and AST
	Viridans group Streptococcus	ID and AST

NOTE: only pure pathogens will be reported for nasal washes and nasal aspirates.