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CSF Culture VP Shunt (Aerobic/ Anaerobic) (8000101343)
Test Mnemonic:

CSF VPS
Specimen Requirements:
Test Included:

Gram stain, aerobic and anaerobic culture, and susceptibility testing on pathogens, when appropriate.
Collection:

Ommaya reservoir fluid or ventricular shunt fluid

  • Clean the reservoir site with antiseptic solution and alcohol prior to removal of fluid to prevent introduction of infection.

  • Remove fluid by aspiration of CSF from the Ommaya reservoir or by collection from the ventricular drain or shunt. Sequentially collect CSF into sterile calibrated tubes, with the number collected depending on the type and number of tests requested for the specimen.
Container:

Sterile, leakproof container or sterile screwcap tube. 
Minimum Volume:

1mL

For samples with multiple tests and insufficient volume, the provider will be contacted to prioritize test requests. 
Storage/Transport:
  • Do not refrigerate
  • Submit to the laboratory immediately
Stability:

This is considered a STAT specimen and should be brought to the laboratory immediately. 
Causes for Rejection:

Missing patient/collection information, improper container, specimens received outside of stability time. 
Reference Range:

No organisms isolated. 
Turnaround Time:

14 days to rule out Cutibacterium spp. 
Methodology:

Gram stain, culture for the isolation of aerobic and anaerobic organisms, and when appropriate, susceptibility testing. 
Performed:

This test is performed on all shifts. 
Synonyms:

Ventriculoperitoneal (VP) Shunt, Ventriculoperitoneal shunts, ventriculoatrial (VA) shunt, ICP monitor, Ommaya resivoir
Clinical Indication:

Per IDSA guidelines, clinical indications of meningitis from CSF shunts and drain include:

  • New headache, nausea, lethargy, and/or chane in mental status
  • Erythema and tenderness over the subcutaneous shunt tubing
  • Symptoms and signs of peritonitis or abdominal tenderness in patients with ventriculoperitoneal shunts, in the abscence of another clear etiology
  • Syptoms and signs of pleuritis in patients with ventriculopleural shunts, in the abscence of another clear etiology. 
  • Demonstration of bacteremia in a patient with a ventriculoaretrial shunt, in the abscence of another clear source of bacteremia.
Note:

If multiple tubes/ containers are collected, Microbiology should receive the 2nd collection container. Tube #1 should not be used due to risk of contamination. 
When ordering tests for which Medicare or Medicaid reimbursement will be sought, physicians should only order tests that are medically necessary for the diagnosis or treatment of the patient. Components of the organ or disease panels may be ordered individually. The diagnostic information must substantiate all tests ordered and must be in the form of an ICD-10 code or its verbal equivalent.
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