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Microbiology Specimen Collection and Transport

SPECIMEN

COLLECTION/ EQUIPMENT

TRANSPORT

COMMENTS

Anaerobes

        Tissue

        Aspirates

 

Tube with 1ml sterile saline

Sterile Container

Dead-capped syringe (needle removed and air expressed)

 

No refrigeration needed.

Original container, dead-capped syringe or  transport swab

Avoid O2 exposure.

Expel air from syringe.

Maintain specimen moisture .

Blood

 Aerobic & Anaerobic bottles

1 aero/1 ana bottle = set

Blood culture bottles

Do not refrigerate.

Sterile prep of venipuncture site

 

Body Fluids  (excluding blood, urine, and CSF)

Decontaminate skin

Sterile container or dead-capped syringe for aspirate.

Deliver to laboratory immediately.

Bronchial Brushings

Tube with 1 mL TrypSoy Broth or sterile saline available from lab

Transport in broth/saline tube

Deliver immediately.

Bronchial Washings

Sterile container, screw cap tube or sputum trap

Original container

Deliver to laboratory immediately.

 

Cath tips

Catheter tips

Do not submit tips greater than 5 inches.

2- to 3-inch catheter tips in a sterile container

Deliver to laboratory immediately.

 

CSF

Sterile prep and collection by physician. Sterile screw capped or snap cap tubes.

Do not refrigerate.

Transport  immediately

Sterile prep of site. Obtain 4-5 mL of CSF for optimal recovery.

Tube #2 preferred for culture.

Ear

Aspirate from tympanocentesis (otitis media)

Transport  Swab of drainage

Syringe or sterile container if fluid.

Room Temp

Clean external ear surface

Eye

Small swab from each eye or Corneal scrapings should be plated directly at patient bedside.

Use transport media for swabs. Use plated medium for scrapings

Obtain maximum material, culture both eyes. Swab conjunctival surface, don’t collect just surface drainage.

Feces

     

Clean or sterile, leak proof  container

 

Refrigerate stools for C. difficile.

Do not refrigerate stools for culture.

Formed stool are NOT acceptable for C. difficile toxin testing.

Genital

Swab

GC-Cultures- Choc or MTM Media- direct specimen inoculation

Do not refrigerate.

Use transport swab or Plate Media.

Transport immediately

Collect cervical samples with a swab

Clean external urethra before taking urethral specimen.

 

Nasopharynx

NP 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 swab

Swab anterior nares only

 

Sinus

Surgical specimen, aspirate

Use swab transport medium or syringe (no needle)

Insert and remove carefully.

Sputum

Sterile cup-(leakproof)

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.

Throat

Swab – EZ II swabs- if Rapid Strep

Use transport medium swab for throat culture only

If rapid strep requested use

media- free EZ II swab

Sample only back of throat between and around tonsillar area. Avoid cheeks, teeth, tongue, etc.

Rapid Strep negative tests reflex to culture


Urine

Sterile cup

Vacutainer Preservative Tube

Foley tips will not be cultured.

 

Transport immediately or

Use preservative tube

 

Give patient clear and detailed cleaning and collection instructions.

Refrigerate >= 1 hour  up to     24hrs after collection.

Gray top preservative tube         <= 48hrs

Wound, Surface/Superficial

Swab

Not acceptable for anaerobes

Use transport medium.

Open lesion and express pus onto swab

Wound, Deep

Biopsy specimen-sterile container

Aspirate in syringe

Swab

Dead-capped syringe for aspirate. Transport swab (do not put tissue in swab transport)

Avoid O2 exposure if possible.

Expel air from syringe.

General Considerations 

Result quality is largely a product of specimen source, collection method, and the manner in which it is transported to the laboratory.

The following should be considered for sample collection and transport:

1.  Collect culture specimens before antibiotic therapy whenever possible.

2.  The specimen must be representative of the infection with as little contamination from normal flora as possible. 

3.  Utilize appropriate collection devices, use sterile equipment and aseptic technique to collect specimens.  Collect specimens in sturdy, sterile, leak proof containers

4.  Collect an adequate amount of specimen. Inadequate amounts of specimen may yield false-negative results.

5.  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).

6.  The specimen must be transported promptly and maintained in a manner that allows survival of fastidious organisms and prevents overgrowth by more hardy organisms.

7.  Specimens collected in syringes are best maintained by removing needle and dead-capping the  syringe, expelling excess air, and transporting to the lab in the syringe.

8.  A fluid or tissue specimen is generally  a more desirable specimen than a swab.

Specimens Unsuitable for Microbiological Testing

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 or preservative
  • Most duplicate specimens received on the same date; exceptions include: blood cultures, CSF, tissues, and   sterile body fluids 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
  • Swabs are not recommended for acid fast culture and fungus culture
  • Dry swabs or dried tissue
  • Gram stain for GC on specimens from cervical, vaginal, or anal crypts
  • Specimens received in formalin

MICROBIOLOGY SPECIMEN COLLECTION AND TRANSPORT CONTAINERS

 

PHOTO

 

DEVICE NAME

TRANSPORT TEMP

USED FOR:

 

 

 

BACTALERT  BOTTLES

 

PURPLE=ANAEROBIC

BLUE=AEROBIC

Pink =PEDS Only

 

1 SET= AER/ANA BTL

 

ROOM TEMP

BLOOD CULTURES

    - BACTERIA

    - FUNGUS

 

Call lab to hold for Fungus

 

 

 

 

CULTURE SWAB PLUS

 

YELLOW TOP

WIRE TIP

 

 

ROOM TEMP

NASOPHARYNGEAL

CULTURES

 

EYE CULTURES

 

 

 

CULTURE SWAB PLUS

 

BLUE TOP

 

ROOM TEMP

 

ANAEROBES=2 COLLECTION KITS

 

AEROBES= 1 COLLECTION KIT

ROUTINE AEROBIC CULTURES

 

ANAEROBIC CULTURES

 

MRSA SCREENS

 

 

 

CULTURE SWAB EZ II

 

PURPLE TOP

RAPID STREP ANTIGEN

 

STREP CULTURE

 

 

 

 

BD MAX COLLECTION KITS

 

Female: Vaginal /Endocervical/Urine

Male: Urine Only

 

GC/Chlamydia/Trichomonas

MOLECULAR

 

Genital/Urine Specimens-Females

 

Males- Urines only accepted

RESPIRATORY TRAP COLLECTOR

 

STERILE CONTAINER

LEAKPROOF

RESPIRATORY

CULTURE

    -SPUTUM

    -BW

    -BAL

 

 

 

CSF COLLECTOR

 

STERILE CONTAINER

LEAKPROOF

CSF CULTURE

 

Tube #2 preferred for culture

Tube #3 may also be used for testing.

 

 

 

URINE CONTAINER

 

STERILE ( 60 ml)

LEAKPROOF CUP

Refrigerate if >1 hour

 

 

 

VACUTAINER COLLECTION TUBE WITH PRESERVATIVE

URINE CULTURE

 

URINE CULTURE-  MIDSTREAM Instruct patient on midstream clean catch collection

 

 

 

 

 

 

 

 

 

STOOL CONTAINER

 

Sterile Container

Leakproof

 

Leaking specimens will be discarded and recollect requested

 

STOOL CULTURES

C DIFF Toxin

PARASITOLOGY EIA

 

 

Reviewed by Frankie Rice        Date  1/30/2018

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