Rickettsia Real-Time PCR

• Refrigerate at 2-8°C for up to 7 days.
• For storage longer than 7 days, store at -20°C or below for up to 60 days after collection.

• Two patient-specific identifiers required (e.g., patient full name, date of birth, medical record number). 
• Identifiers on specimen must exactly match submission form.

Ship samples: 

• According to Dangerous Good Regulations, IATA, and/or CFR 49.
• Category B Biological Substance, UN3373 shipping requirements apply.
• Handle as infectious agent using universal precautions.
• Triple-contained in accordance with federal shipping regulations for infectious agents.
• If specimens will arrive at the lab within 7 days of collection, refrigerate at 2-8 ̊C and ship overnight on cold packs.
• If specimens will arrive at the lab more than 7 days after time of collection, freeze at -20 ̊C or below and ship overnight on dry ice.

• Real-time PCR

• 2 business days

• A false negative may result if specimen is improperly collected, transported, or handled.
• Clinical specimens collected more than 48 hours after initiation of appropriate antimicrobial treatment may not be positive for Rickettsia due to reduction of Rickettsia organisms and DNA.
• A negative result does not preclude infection.
• Real-time PCR results are considered presumptive until a subject matter expert laboratory confirms with additional Rickettsia real-time PCR results.

• Information on the form and tube do not match.
• Failure to put two forms of identification on tube.
• Specimen received cold greater than 7 days after collection.
• Specimen received ambient.
• Incorrect specimen type.
• Expired media/collection container.
• Insufficient specimen volume.
• Specimen leaked in transit.

• Presumptive positive specimens will be forwarded to the Centers for Disease Control and Prevention (CDC) for further testing.
• If results indicate possible infection by other Rickettsia species, specimens will be forwarded to CDC for further testing.
• Specimens should be collected from patients in the acute phase of disease (within 14 days of onset of symptoms, or while experiencing fever).
• Blood specimens must be collected within 72 hours of patient starting tetracycline-class antibiotic treatment, e.g., doxycycline. However, collection within 48 hours is preferred.