Lab Test

Culture, Respiratory

Throat, pharynx, nasopharynx, pharyngitis, epiglottis, nasal, nose, nostril, nares, sinus, lung, LRT, sputum, bronchoscopy, bronchoalveolar, bronchoalveolar lavage, BAL, bronch wash, bronch brushing

Test Codes

 EPIC  LAB Code 
 Culture, Respiratory, Lower, Routine  LAB5500
 Culture, Throat/Pharynx  LAB7177
 Culture, Nasopharynx  LAB7176
 Culture, Sinus Contents  LAB7178

Specimen Collection Criteria

Collect: Upper or lower respiratory specimen using aseptic technique and place in a sterile collection container. Specimen types and containers are given below.

Upper Respiratory

  • Throat, Nasal, Nasopharynx (NP): Collect specimen in an ESwab transport container.

Lower Respiratory

  • Sputum: Single productive cough specimen (not saliva) in a sterile, tightly capped collection container, preferably collected in the early morning. The patient should rinse his/her mouth with water prior to specimen collection.
  • Bronchoscopy (bronch wash, BAL, bronch brushings): Sterile, tightly capped collection container.
  • Tracheal aspirate, trans-tracheal aspirate: Sterile, tightly capped collection container.
  • Lung Aspirate: Sterile, tightly capped sterile collection container or sterile sealed syringe (without the needle).
  • All Lower Respiratory specimens must be considered STAT. Transport to the Laboratory immediately after collection.

Physician Office/Draw Specimen Preparation

  • Upper respiratory specimens: Specimens must be stored at room temperature (20-26°C or 68-78.8°F) until transport.
  • Lower respiratory specimens: Deliver specimen to the Laboratory immediately after collection, refrigerated (2-8°C or 36-46°F). Courier Services must be contacted for a STAT pickup at 1-800-551-0488.

Preparation for Courier Transport

Transport: Lower respiratory specimens, refrigerated (2-8°C or 36-46°F), or upper respiratory specimens, at room temperature (20-26°C or 68-78.8°F).

Rejection Criteria

  • Specimens submitted in containers with formalin or that previously contained formalin.
  • Upper respiratory specimens delayed in transit (greater than 24 hours from time of collection).
  • Expectorated sputum specimens in non-sterile or leaking containers.
  • Non-productive sputum specimens consisting of saliva as indicated by Gram Stain result.
  • Lower respiratory specimens delayed in transit (greater than 2 hours from time of collection) will be tested, with reporting at the discretion of the Microbiology System/Associate Director.

Inpatient Specimen Preparation

Transport specimens immediately to the Laboratory for testing. 

In-Lab Processing

A Gram Stain will be performed on lower respiratory specimens.


Specimen Stability for Testing:

Upper Respiratory Specimens
Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Lower Respiratory Specimens
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 8 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days


Farmington Hills sent to Royal Oak Microbiology Laboratory for testing.
Grosse Pointe sent to Royal Oak Microbiology Laboratory for testing.
Royal Oak Microbiology Laboratory
Troy sent to Royal Oak Microbiology Laboratory for testing.


Sunday – Saturday, 24 hours a day.
Preliminary results available within 24 hours. 

Reference Range

No pathogens recovered.

Test Methodology

Gram stain (lower respiratory specimens), aerobic culture, identification and susceptibility testing (if indicated).


The recovery of aerobic bacteria from an appropriate, properly collected specimen may be indicative of an infectious disease process.

Clinical Utility

This test is used to recover and identify aerobic bacteria that may be involved in human infections.


  1. Vandamme, P.A.R., 2015. Specimen Collection, Transport, and Processing: Bacteriology, pg. 228-272. Jorgensen, J.H., Editor-in-Chief. Manual of Clinical Microbiology. 11th Edition. ASM Press. Washington, D.C., p. 228-272.
  2. Gilligan, P.A., et al. 2016. Respiratory Tract Cultures. Clinical Microbiology Procedures Handbook. 4rd Edition. Leber, A.L., Editor-in-Chief. ASM Press, Washington, D.C. Section 3.11.

CPT Codes

87070 (Aerobic Culture), 87205 (Gram Stain), if necessary
LOINC:  Nasopharynx 43214-6, Throat/Pharynx 17898-8, Respiratory Lower Routine 32355-0


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