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Viral Cultures

Clostridium Difficile Toxin B Assay

Patients suspected of having antibiotic-associated colitis should have 5-10 grams of fresh stool sent to the Virology Laboratory for a Clostridium difficile toxin assay. The stool should be placed in a sterile container. Rectal swabs are not acceptable. The stool can be stored at 4°C for 48 hours or frozen immediately at -20°C if transportation is delayed. The assay is set up daily. A preliminary result is ready 24 hours after inoculation and the final report is given at 48 hours.

If culture for C. difficile or Toxin A is desired, submit a small amount of stool in a clean container to the UWMC specimen procurement services with a Microbiology Clinical lab request form.

Search "CLDT" code in the online Laboratory Test Catalog for information on C. Difficile Toxin Assay

Buffy Coat Culture

All buffy coat (peripheral blood leukocyte) cultures include both the Herpes group viral culture and the CMV antigenemia assay. The CMV antigenemia assay for buffy coat is stained for CMV antigen the day after it is drawn. The buffy coat specimen should be collected in either a heparinized or EDTA tube. Buffy coat cultures are maintained for 28 days before being finaled as negative.

Search "VCCMVA" code in the online Laboratory Test Catalog for information on CMV Antigenemia & Culture

Herpes Simplex Virus Sub-typing or Identification of Non-HSV Isolate

The Virology Laboratory can complete the identification of viruses isolated in other laboratories. HSV isolates are confirmed as HSV-1 or HSV-2 by FA. Non-HSV isolates are identified and confirmed by monoclonal antibody. Submit the infected cell culture as soon as possible after detecting cytopathic changes in the cell monolayer. Call the laboratory (206) 987-2088 to arrange this service.

Isolation of Epstein Barr Virus is not routinely available-see PCR or serologic detection methods. PCR for Human Herpes Virus type 6 (HHV6) and HHV8 are also available. Please see the Molecular Diagnostic (PCR) section for PCR tests.

Search "HSST" code in the online Laboratory Test Catalog for information on Herpes Simplex Virus - Subtype 1 & 2 Only.

Viral Culture-Herpes Group

Specimens submitted for this assay are processed primarily for the identification of Cytomegalovirus (CMV), Herpes simplex type 1 (HSV-1), Herpes simplex type 2 (HSV-2) and Varicella Zoster Virus (VZV). Appropriate specimens include lesions, genital sites, conjunctival swabs, throat swabs, rectal swabs, buffy coats (EDTA or heparinized), BAL fluid or tissues. First morning voids of urine are more concentrated and contain the highest titers of virus.

Specimens to rule out HSV-1 or HSV-2 are read daily for 5 days, and then every other day before being reported as negative after 14 days of observation. CMV and VZV are slow growing viruses and their cultures are maintained up to 28 days before being reported. All negative Herpes group cultures receive a preliminary report after 5 days incubation. Positive culture results are called to the ordering location or physician as soon as virus is detected. All positive cultures are confirmed by FA and HSV isolates are subtyped with monoclonal antisera.

Herpes group Viral cultures can be combined with either the Herpes group FA, the CMV antigenemia assay, the CMV rapid assay, or the VZV rapid assay. Because of the extreme lability of VZV, any culture for this virus is automatically combined with the Herpes group FA to detect VZV antigen.

Search "VCIT" code in the online Laboratory Test Catalog for information on Viral Culture & Herpes Group FA, Tissue for tissue samples.

Search "VCHG" code in the online Laboratory Test Catalog for information on all other sample types of Herpes Group Culture (HSV 1 & 2, CMV, VZ).

Viral Culture-SARS or Avian Influenza

Clinical specimens from suspect Influenza A (H5N1) cases and SARS-CoV cases may be tested by PCR assays using standard BSL 2 work practices in a Class II biological safety cabinet. In addition, commercial antigen detection testing can be conducted under BSL 2 levels to test for influenza.

CDC does not recommend that virus isolation studies on respiratory specimens from patients who meet criteria for suspected avian influenza A ( H5N1) be conducted unless stringent BSL 3+ conditions can be met. Therefore, respiratory virus cultures should not be performed in most clinical laboratories and cultures should not be ordered for patients suspected of having H5N1 infection. Contact the Washington State Epidemiologist at (206) 361-2831 with questions.

The UW Virology laboratory has a BSL 3 facility and is capable of setting up cultures for either suspect A (H5N1) cases or SARS-CoV cases if the CDC clinical criteria are met for such cultures. For the safety of our laboratory technicians, please contact the laboratory before sending any specimens for culture, PCR or antigen detection assays to assure adequate safety conditions.

Search "VCSARS" code in the online Laboratory Test Catalog for information on Viral Culture: SARS for culture test.

Search "SARPCR" code in the online Laboratory Test Catalog for information on SARS Qualitative for PCR test.

Viral Culture Screen

Specimens that are submitted for a Viral culture screen are processed to detect the following:

  • Adenovirus
  • Coxsackie
  • Echoviruses
  • Herpes Group Viruses
  • Influenza
  • Measles
  • Mumps
  • Parainfluenza
  • Polio
  • Respiratory Syncytial Virus (RSV)
  • Rhinovirus

Appropriate specimens include throat swabs, nasopharyngeal swabs, nasal washes, rectal swabs, conjunctival swabs, lesion swabs, urine, CSF and tissues. Positive culture results are called the day the virus is detected. All positive cultures are confirmed by monoclonal antibody (FA). Order "Viral Culture: Screen".

Specimens are read every other day for 14 days before a final report is issued. Some specimen sites are appropriate for CMV or VZV isolation which are slower growing viruses. In this case, a preliminary negative report is issued at 14 days and the final report follows in 28 days.

Search "VCT" code in the online Laboratory Test Catalog for information on Viral Culture Screen, Tissue for tissue samples.

Search "VCS" code in the online Laboratory Test Catalog for information on Viral Culture Screen for all other sample types.


Viral cultures can be performed alone or combined with several antigen detection assays to yield a rapid preliminary result. The Viral culture screen can be combined with any of the procedures listed below:

Adenovirus Rapid Assay

For rapid detection of Adenovirus, the specimen is inoculated by centrifugation onto a monolayer and stained for Adenovirus antigen with monoclonal antibody at 24 and 72 hours post inoculation (in addition to standard viral culture). Swabs (in Viral Transport Media), body fluids or tissue can be submitted.

Search "ADSV" code in the online Laboratory Test Catalog for information on Adenovirus Shell Vial.

CMV Antigenemia Assay

For rapid detection of Cytomegalovirus (CMV) in peripheral blood, the leukocytes are isolated, cytocentrifuged onto a glass slide, and stained with a fluorescent antibody to an early CMV antigen. Results from the CMV antigenemia assay are available within 24 hours of specimen receipt in the laboratory. Freshly drawn specimens received in the laboratory before 2 P.M. Monday through Friday are processed the same day and read the following day. All peripheral blood specimens or buffy coat cultures (EDTA or heparinized) are set up for viral culture to increase the sensitivity of virus detection or for antiviral sensitivity testing of the isolate if desired. Transport blood at room temperature.

Search "CMVA" code in the online Laboratory Test Catalog for information on CMV Antigenemia Surveillance.

CMV Rapid Assay

For rapid detection of Cytomegalovirus (CMV), the specimen is inoculated by centrifugation onto a monolayer and stained for CMV antigen with monoclonal antibody at 24 and 48 hours post inoculation in addition to standard viral culture. Swabs (in Viral Transport Media), body fluids or tissue can be submitted. This test is recommended for all lung biopsies, bronchoalveolar lavage specimens and tissue specimens.

Search "RPDCMV" code in the online Laboratory Test Catalog for information on Rapid Detection Cytomegalovirus.

Herpes Group FA

The Herpes group FA detects Herpes Simplex virus (HSV) or Varicella Zoster virus (VZV) antigens in infected cells. A slide is usually prepared at the Virology Laboratory from cells in the vial of transport media. HSV subtyping (HSV-1 vs. HSV-2) is done on culture isolates only. Lesions must be aggressively swabbed to obtain adequate numbers of cells for a valid assay. Order "Viral Culture: Herpes Group, plus Herpes Group FA".

In addition to being more rapid than Viral culture, FA can detect viral antigens in infected cells even if the virus is no longer viable. Due to the extreme lability of Varicella Zoster Virus, FA is routinely performed on all VZV culture requests and is recommended on all skin/eye sites.

Search "FAHS" code in the online Laboratory Test Catalog for information on Herpes Simplex & Varicella Zoster FA.

Respiratory FA

Fluorescent antibody (FA) staining of respiratory epithelial cells is the most rapid method to identify Respiratory Syncytial Virus (RSV), Parainfluenza, Adenovirus, and Influenza A and B. We recommend that a nasal wash be submitted - if not, then combine a throat and nasopharyngeal swab in the same vial of transport media. The Respiratory FA is offered only with a Viral culture; order "Viral Culture: Screen, plus Respiratory FA", except during the "flu season" (Jan./Feb. - varies slightly every year). During this time we will perform a respiratory FA alone if requested to rule out Influenza. In addition, a RSV direct FA is available during respiratory virus season (Nov. - Apr.). This test is not recommended during the off season (May - Oct.). For a summary of seasonal virus detections, see UW Clinical Virology Laboratory.

*Note: For immunocompromised patients, a full brochoalveolar lavage workup is recommended. This includes CMV and RSV rapid assays and both a herpes group and respiratory with FA.

Search "FARV" code in the online Laboratory Test Catalog for information on Respiratory Virus FA.

RSV Rapid Assay

For rapid detection of Respiratory Syncytial Virus (RSV), the specimen is inoculated by centrifugation onto a monolayer and stained for RSV antigen with monoclonal antibody at 24 and 72 hours post inoculation in addition to standard viral culture. Nasal washes or NPT swabs are the specimen of choice; BAL fluid is appropriate as well.

Search "RSVSV" code in the online Laboratory Test Catalog for information on RSV Shell Viral Assay.

VZV Rapid Assay

For rapid detection of Varicella Zoster Virus (VZV), the specimen is inoculated by centrifugation onto a monolayer and stained for VZV antigen with monoclonal antibody at 48 and 96 hours post inoculation in addition to standard viral culture. Lesion specimens, skin sites, BAL fluid or tissue can be submitted.

Search "VZVSV" code in the online Laboratory Test Catalog for information on Varicella Zoster Virus (VZV) Shell Vial Assay.

Rotavirus / Enteric Adenovirus

These are EIA assays for the detection of antigens in stool. These viruses do not grow in standard tissue culture so this is the preferred method of detection.

Search "SORTA" code in the online Laboratory Test Catalog for information on Rotavirus Antigen by EIA, STL.

Search "SADEIA" code in the online Laboratory Test Catalog for information on Enteric Adenovirus by EIA, STL.

Last updated: 11/27/12

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