Table 9.

Laboratory Diagnosis of Central Nervous System Shunt Infections

Etiologic Agents	Diagnostic Procedures	Optimum Specimens	Transport Issues and Optimal Transport Time
Bacterial (1 organism or mixed)
Aerobes: Staphylococcus,  Streptococcus, Enterobacteriaceae, Pseudomonas, Acinetobacter, Corynebacterium spp  Anaerobes: Cutibacterium (Propionibacterium) acnes	Gram stain Aerobic and anaerobic bacterial culture (hold 14 d for C. acnes)	CSF	Sterile, anaerobic container, RT, immediately
Mycobacterium spp (rare)	AFB smear AFB culture	CSF (≥5 mL)	Sterile container, RT, 2 h
Fungal
Candida spp, other fungi	Calcofluor stain Fungal culture	CSF	Sterile container, RT, 2 h

Abbreviations: AFB, acid-fast bacilli; CSF, cerebrospinal fluid; RT, room temperature.