Yersinia culture  

 
IMPORTANT! Pre-approval needed from state or local health department. Local or State Health Department. Send approval to NPHL@unmc.edu or call (402) 559-9444.

NPHL has moved to an electronic ordering system, NUlirt, and it is now the preferred method to order all tests. Once ordered, print a "batch list" (see NUlirt Guide).

Forms Required - Nulirt batch list or NPHL Test Request Form (completed in entirety) must accompany the specimen to include the following information: symptoms and date of onset, pregnancy status, travel and vaccine history. Testing will not be performed without all required information.

Please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459 for further clarification.

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Test: Yersinia Culture
Order in NUlirt or complete NPHL Test Order Form with Supplemental Form http://nphl.org/documents/CDC_Submission_Form_50.34_2020.pdf  
Synonym: Yersinia associated diarrhea, Yersiniosis  
Method: Standard reference procedures for Yersinia culture and identification. 
Note: All manipulations of suspected plague (Y pestis) should be performed safely in the BioSafety Cabinet. Perform only required LRN protocol to rule out or refer to NPHL. Contact the NPHL emergency pager 402.888.5588 for guidance if Y pestis is suspected.  
Availability: For Yersinia spp other than Y pestis, see CDC Test Directory at https://www.cdc.gov/laboratory/specimen-submission/detail.html?CDCTestCode=CDC-10418   
Specimen: Immediately reserve stool in maintenance media (Cary-Blair or Enteric Plus)  
Collection Device: Sterile stool container with maintenance media. Media can be obtained from NPHL Client Services.
Specimen Labeling: Test subject to CLIA regulations and requires 2 patient identifiers and specimen source on container.  
Volume: 10mL stool in maintenance media  
Storage/Transport:

Prior to and during shipment: Refrigerate 2-8°C
Shipping instructions, including specimen-handling requirements during transport: Seal screw-top tubes with Parafilm™ or tape and place in biohazard bag with absorbent material.

Place specimen inside leak proof secondary container (biohazard bag and if transporting by air, use Tyvek™ Envelope) with adsorbent material. The secondary container must be packed inside an approved Category B shipping container filled with frozen gel-packs to keep specimen refrigerated. Position NUlirt packing list or NPHL Test Order form between secondary container and box lid. Seal with tape.  Label outer box as UN3373 Category B, Biological Substance. Transport by NPHL ground courier. If courier not available, ship by FedEx, UPS, or USPS (1st Class, Priority or Express Mail). Follow appropriate DOT/IATA Regulation Guidelines.  For assistance, call NPHL State Training Coordinator at (402) 559-3590.  
See instructions and shipping address: http://nphl.org/

NUlirt packing list or appropriate paperwork (completed in entirety) must accompany specimens.

 
Unacceptable: Frozen specimens unacceptable. Nonsterile or leaking container, multiple specimens in 24hr period, dry specimens, diapers, or delayed transport to lab in inappropriate preservative   
Specimen Stability: Stable at Refrigerated 2-8°C up to 72h   
Reference Interval: Culture negative for Yersinia spp.  
Reportable Disease: Report positive Yersinia results from stool within 7d to local and state health department. Refer to Nebraska DHHS Title 173, Communicable Diseases. All positive Yersinia ssp reports from GI Stool panels or isolates should be submitted to the NPHL for molecular sequencing to supplement and epidemiological investigation.   
Comments: Pre-approval needed from state or local health department.  Send documented approval to NPHL@unmc.edu or call (402) 559-9444.
Antibiotic treatment will reduce the sensitivity of culture; samples should be collected pre-treatment. 

Indicate suspected organisms and available patient history, especially any recent travels, on the test request form. Maintenance media is available from Client Services. 

NUlirt packing list or appropriate paperwork (completed in entirety) must accompany specimens.

Test performed at the CDC. Submit all specimens for CDC through the NPHL, NOT directly to the CDC.

For more information, please review the current clinical guidelines for Yersinia testing at https://www.cdc.gov/laboratory/specimen-submission/detail.html?CDCTestCode=CDC-10418

NUlirt packing list or appropriate paperwork (completed in entirety) must accompany specimens.  
Revised: 6/21/2021 
If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459.

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