Micro= biology Specimen Collection and Transport
Result quality is largely a product of specimen sour= ce, collection method, and the manner in which it is transported to the laboratory.
The following should be considered for sample collec= tion and transport:
1. = Collect culture specimens before antibiotic therapy whenever possible.
2. = The specimen must be representative of the infection with as little contaminati= on from normal flora as possible. Consider the stage of the disease and collect material from where the suspected organism will most likely be found.
3. = Utilize appropriate collection devices, use sterile equipment and aseptic technique= to collect specimens.
4. = Collect an adequate amount of specimen. Inadequate amounts of specimen may yield fa= lse-negative results.
5. = Collect specimens in sturdy, sterile, leakproof contain= ers.
6. = Clear and specific instructions on proper collection techniques must be given to patients when they must collect their own specimens (for example: a clean catch urine or a sputum for AFB culture).
7. = The specimen must be transported promptly and maintained in a manner that allows survival of fastidious organisms and prevents overgrowth by more hardy organisms.
8. = Specimens that are collected in syringes are best maintained by dead-capping the syri= nge, expelling excess air, and transporting to the laboratory in the syringe. Transferring from a syringe into a sterile cup or transport swab is general= ly undesirable.
9. = A fluid or tissue specimen is generally a more desirable specimen than a swab= .
|
SPECIMEN |
COLLECTION
METHOD & EQUIPMENT |
TRANSPORT |
INSTRUCTIONS
&
COMMENTS |
|
Anaerobes |
Biopsy Specimen Sterile Container Dead-capped syringe Anaerobic swab&nb= sp; transport device |
No refrigeration needed. Original container, dead-= capped syringe or anaerobic transport swab |
Avoid O2 exposure. Expel air from syringe. Label properly |
|
Blood |
Bactec Aerobic & <= /p> Anaerobic bottles |
Bactec bottles. Do not refrigerate. If sending through the pneumatic tube place bottles in the h= ard plastic Bactec bottle holders. |
Sterile prep of venipuncture<= /span> site required. Do not repalpate the s= kin after it is disinfected. Decontaminate tops of bottles with alcohol. |
|
Body Fluids (exclu=
ding
blood, urine, and CSF) |
Decontaminate skin |
Sterile container or dead-capped syringe for aspir= ate. |
Deliver to laboratory immediately. |
|
Bronchial Brushing=
s |
Tube with 1 mL TrypSoy Broth |
Transport in broth tube |
Obtain broth from microbiology before procedure. D= eliver immediately after collection. |
|
Bronchial Washings=
|
Sterile container, screw cap tube or sputum trap |
Original container |
Deliver to laboratory immediately. |
|
=
Cath
tips |
Catheter tips |
2- to 3-inch catheter tips in a sterile container<= /p> |
Deliver to laboratory immediately. Do not submit tips greater than 5 inches. |
|
CSF |
Sterile prep and collection by physician. Sterile = screw capped or snap cap tubes. |
Original tube. Do not refrigerate. |
Sterile prep of site. Obtain 4-5 mL of CSF for optimal recovery. Handle as a STAT specimen and transport immediately. |
|
Ear |
Aspirate from tympanocentesis= (otitis media) Swab of drainage |
Syringe or sterile container if fluid. Use transport media for swabs. |
Clean external ear surface and carefully sample representative area. |
|
Eye |
Small swab from each eye or Corneal scraping (by physician) |
Use transport media for swabs. Use plated medium f= or scrapings |
Do not touch external skin. Obtain maximum materia= l, culture both eyes. Swab conjunctival surface, don’t collect just surface drainage. Corneal scrapings should be pl= ated directly at patient bedside. Also prepare slides for gram stain. |
|
Feces |
Clean or sterile container Swab (only if necessary) Cary-Blair media for stool cultures only |
Refrigerate stools for C. dif= ficile. Use = Cary-Blair transport media for swabs. Do not refrigerate stools for culture. |
Best sample is a diarrheal stool in sterile contai= ner. Swab is satisfactory in acute cases if unable to obtain stool. Insert swab beyond anal sphincter. Swab must show feces. Swabs and formed stool are NOT acceptable for C. <= span class=3DSpellE>difficile toxin testing. |
|
Genital |
Swab |
Do not refrigerate. Use transport media. |
Collect cervical samples with a swab inserted thro= ugh a speculum. Avoid touching swab to uninfected mucosal surfaces. Clean external urethra before taking urethral spec= imen. Use transport media and plate immediately in laboratory. Prepare slides for gram stain on males. |
|
=
Nasopharynx |
Naso/urethral Calgi-swab |
Do not refrigerate. Use transport medium. |
Nasal speculum helpful. Pass through the nose into= nasopharynx. Allow to remain for a few seconds (20-= 30). Carefully withdraw swab. |
|
Nose |
Swab |
Use transport medium |
Swab anterior nares on= ly |
|
Sinus |
Curet or surgical spec= imen, aspirate |
Use transport medium |
Insert and remove carefully. |
|
Sputum |
Sterile cup |
Refrigerate if needed. Transport in collection container. |
Carefully instruct patient to cough deeply (not to= spit). First morning specimen is best (no 24 hour collection). Transport immediately, seal container tightly. Consider sputum potentially contamin= ated with M. Tuberculosis. |
|
Throat |
Swab (tongue blade necessary) |
Use transport medium except for rapid strep |
Use tongue blade; flashlight is helpful. Sample on= ly back of throat between and around tonsillar a= rea. Avoid cheeks, teeth, tongue, etc. |
Urine, CVS |
Sterile cup |
Transport immediately in sterile cup. |
Give patient clear and detailed instructions. Clea= n with soap, or PVP iodine disinfectant. Refrigerate if there will be longer tha= n 1 hour delay until cultured, but no longer than 24 hours prior to culture. = Seal container tightly. |
|
Urine, Catheter |
Sterile container. Use needle and syringe as neces= sary. |
Sterile container or dead-capped syringe. |
Collect from catheter line; never collect from bag= . Foley tips will not be cultured. Decontaminate line as with venipuncture or use port. Refrigerate if there will= be longer than 1 hour delay until cultured, but no longer than 24 hours prio= r to culture. |
|
Urine, Suprapubic
Aspirate |
Needle and syringe (by physician) |
Dead-capped syringe is preferred. Sterile containe= r is acceptable. |
Procedure is performed by physician. Transport to laboratory immediately. Processed as wound aspirate. |
|
Wound, Surface |
Swab |
Use transport medium. |
Decontaminate surrounding skin. Open lesion and express pus onto swab; sample adva= ncing margin of the lesion. |
|
Wound |
Biopsy specimen Aspirate in syringe Swab |
Sterile container for biopsy, or dead-capped syrin= ge for aspirate. Anaerobic transport swab (do not put tissue in swab transport)<= /p> |
Avoid O2 exposure if possible. Expel air from syringe. |
Specimens that will not be processed include the following:
· Saliva
· 24 hour urine, stool, or sputum specimens
· Foley catheter tips
· Urine specimens >1 hour since collection = without refrigeration
· Most duplicate specimens received on the same date; exceptions include: blood cultures, CSF, tissues, and sterile body fl= uids excluding urine
· Specimens contaminated with another type of specimen. For example: a urine specimen should not contain stool and vice versa
· Certain clinical specimens are unsuitable for anaerobic culture
· Port-a-cul swabs= are unsuitable for acid fast culture and fungus culture
· Dry swabs
· Gram stain for GC on specimens from cervical, vaginal, or anal crypts
· Specimens received in formalin
Document Control
Facility: Central Maine Med=
ical
Center, 300 Main Street, Lewiston, Maine&n=
bsp;
04240
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