Routine ICU BAL

  • Routine culture - yes
  • Myco-bacterial culture - optional
  • Fungal culture - on request
  • Aspergillus Antigen - on request
  • Legionella culture - on request
  • Nocardia culture - on request
  • Full Resp Panel PCR - optional
  • PJP PCR - on request
  • CMV PCR - no

Chest Unit BAL

  • Routine culture - yes
  • Myco-bacterial culture - yes
  • Fungal culture - on request
  • Aspergillus Antigen - on request
  • Legionella culture - on request
  • Nocardia culture - on request
  • Full Resp Panel PCR - no
  • PJP PCR - on request
  • CMV PCR - no

Immunocompromised BAL

  • Routine culture - yes
  • Myco-bacterial culture - yes
  • Fungal culture - yes
  • Aspergillus Antigen - optional
  • Legionella culture - optional
  • Nocardia culture - on request
  • Full Resp Panel PCR - optional
  • PJP PCR - optional
  • CMV PCR - optional

The following are also available for certain complex / immunocompromised patients on discussion with Microbiology medical team:

  • Multiplex PCR panel (BioFire FilmArray® pneumonia / ventilator-associated pneumonia (VAP) panel) with multiple bacterial, viral and antibiotic resistance gene targets (performed in house)
  • Pan fungal PCR (reference laboratory test)

Sample type

  • Bronchoalveolar Lavage (BAL) or Bronchoalveolar Washings / Brushings / Aspirates; must be obtained by skilled personnel with appropriate protection / isolation facilities
  • Transbronchial / Lung Biopsy Samples

Specimen requirements

Send in a sterile universal container

Minimum volume

  • Routine culture - 1ml
  • Mycobacterial (TB) culture - 5ml ideally
  • Further testing - 0.5-5ml, depending on number and type of tests required. Discuss with Microbiology medical staff.

Frequency of test

  • Culture tests - daily
  • Molecular tests - some molecular tests are run daily, others batched less frequently; urgent samples can usually be processed more quickly on discussion with Microbiology medical staff

Turnaround time

  • Routine culture - 4 days
  • Fungal culture - 21 days
  • Mycobacteria culture - 8 weeks
  • Legionella culture - 12 days
  • Nocardia culture - 31 days
  • Aspergillus antigen test - 2 days
  • PCP PCR - 6 days
  • BioFire Respiratory (Community-acquired) or Pneumonia (VAP) panels - <24 hours
  • Mycology Reference Laboratory Fungal PCR TaT - 2 working days