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Alberta Precision Laboratories (APL) Test Directory

Bacterial Culture, aerobic culture only - Bronchoalveolar Lavage (BAL)

Source Bronchoalveolar Lavage (BAL)
Mnemonic M BAL
Specimen Requirements

Submit saline lavage specimen in a sterile container or sterile specimen trap.

Optimal volume for Microbiology testing is 10 mL.  Minimum specimen required for Microbiology testing is 5 mL.

 or

Submitting locations without access to Sunrise Clinical Manager (SCM) must complete the Bronchoalveolar Lavage/ Bronchial Wash Requisition REQ9024MI 

If there are multiple test requests and there is insufficient quantity, Microbiology staff contacts the Microbiologist on Call to determine testing priority. 

• Indicate Quantitative Culture for BAL collections performed using procedure Bronchoscopy Guideline VAPP-004.
• Indicate Routine Culture if BAL collection has not been performed using Bronchoscopy Guideline VAPP-004.




Specimen Handling

Store specimen at room temperature.
DO NOT refrigerate.

Transport STAT to hospital laboratory.
Specimen MUST be received in Microbiology at the Diagnostic and Scientific Centre (DSC) within 2 hours of receipt in the hospital laboratory.

Collecting locations: 
Refer to Bronchoscopy Specimen Packaging Instructions REG5286.
Send all BAL and BW specimens regardless of testing ordered to the Accession area of the laboratory. Specimens from multiple body sites or from multiple patients are not to be packaged in the same specimen transport bag. Place all the individual specimen transport bags from same patient and  body site into a large resealable plastic bag labelled with the Bronchoscopy Specimen Destination Label REG5285. 

Bronchoscopy Specimen Destination Label (REG5285) can be requested from Microbiology.  Order when remaining label inventory is at 5 sheets.
• Email request to MicrobiologyInventoryGroup@cls.ab.ca
• Provide 48 hours notice to allow for the delivery of supply.

Calgary APL Accession staff refer to regional procedure REG02-010 BAL and BW Specimen Flow  for specific specimen handling instructions.

Additional Information

Specimen is NOT suitable for anaerobic culture.

Only specimens collected as per Bronchoscopy Guideline VAPP-004 will be processed for quantitative culture. Those specimens not collected as per VAPP-004 procedure will be processed as a Bronchial Wash.

Quantitation of BAL Culture - Interpretation Guidelines:
In BAL cultures, bacteria causing pneumonia are usually present at greater than or equal to 104 CFU/mL.  Oropharyngeal flora is usually present at less than 104 CFU/mL.

Quantitation of Intracellular Organisms in Stain - Interpretation Guidelines:
Performed when potential pathogens are reported from stain or culture.
The percentage of intracellular bacteria contained in polymorphonuclear neutrophils and macrophages is predictive of pneumonia.
An exact cut off is not established, but is believed to be around 5%.

Turnaround time for negative culture: 2 days.

Testing Location DSC Microbiology
Testing Frequency Daily
Alternate Name(s)

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