Significance 

There are a variety of microorganisms found in the water of healthcare facilities that are not generally pathogenic for healthy individuals but may be pathogenic for the immunocompromised patient. The conditions associated with increased risk of acquiring an infection from a waterborne pathogen include: hematological malignancy, immunosuppression, transplantation and burns. These infections can result in significant morbidity and mortality. The CMS pathogens panel is designed for use in healthcare facilities to evaluate the potential for exposure to six waterborne pathogens: Legionella, Pseudomonas aeruginosa, Stenotrophomonas maltophilia. Acinetobacter species, Burkholderia cepacia, and non-tuberculosis mycobacteria. 

Test Method 

Legionella spp.
Filter concentration method using BCYE, DGVP, GVPC and CCVC media, incubation 36.5 + 0.50 C for 7 to 10 days. Direct plating is also included in the event of high concentrations of the organism. Heat treatment and acid treatment may be utilized on samples with bacterial overgrowth. Special Pathogens Laboratory follows a modified version of the ISO Standard 11731:2017, Water Quality-Enumeration of Legionella. Special Pathogens Laboratory is accredited by the American Association for Laboratory Accreditation (A2LA), New York ELAP, and the State of Connecticut Department of Health to perform this test. 

Learn more about Legionella

Pseudomonas aeruginosa
Filter concentration method using M-PA-C selective media, incubation 41.5 + 0.50 C for 48 to 72 h. Modification of the ASTM International Standard Test Method for the Isolation and Enumeration of Pseudomonas aeruginosa from water (D5246) with the addition of direct plating in the event of high concentrations of the organism. Special Pathogens Laboratory is accredited by the American Association for Laboratory Accreditation (A2LA) to perform this test. 

Learn more about Pseudomonas

Stenotrophomonas maltophilia
Filter concentration method using Trypticase Soy Agar with imipenem selective media, incubation 36.5 + 0.50 C for 48 to 72 h. Direct plating is also included in the event of high concentrations of the organism. Modification of the ASTM International Standard Test Method for the Isolation and Enumeration of Pseudomonas aeruginosa from water (D5246).  

Learn more about Stenotrophomonas

Acinetobacter species
Filter concentration method using Leeds Acinetobacter medium, incubation 36.5 + 0.50 C for 48 to 72 h. Direct plating is also included in the event of high concentrations of the organism. Modification of the ASTM International Standard TestMethod for the Isolation and Enumeration of Pseudomonas aeruginosa from water (D5246). 

Learn more about Acinetobacter

Burkholderia cepacia
Filter concentration method using Burkholderia selective agar, incubation 36.5 + 0.50 C for 72 to 96 h. Direct plating is also included in the event of high concentrations of the organism. Modification of the ASTM International Standard Test Method for the Isolation and Enumeration of Pseudomonas aeruginosa from water (D5246).

Learn more Burkholderia.

Non-tuberculosis Mycobacterium (NTM)
Filter concentration and decontamination with 0.2 M KCL-HCL, pH 2.2. Cultivation using Middlebrook 7H10, incubation at 30° C for 6 weeks.  

Learn more about NTM

Test Code 

130 

Turn Around Time 

6 to 8 weeks 

Sampling Instructions 

The sample volume is 1 liter and should be collected as follows: 

  1. Complete the Chain of Custody form 
  2. Use waterproof pen to label bottle with sample location, description, and date. 
  3. Turn on hot water and immediately fill the bottle (1 liter). Close bottle and invert to mix neutralizer. 
  4. Place bottles in box with insulated liner. 

Sample Transport 

  1. Ship the same day samples are collected for receipt in laboratory. The time from sample collection to analysis should not exceed 30 hours. 
  2. Place bottles in box with insulated liner. 
  3. Place completed Chain of Custody form in plastic document holder and pack in box. 
  4. Ship overnight Monday–Thursday only to: Special Pathogens Laboratory, 1401 Forbes Avenue, Suite 401, Pittsburgh, PA 15219 

Questions? Call 412-281-5335