Martin Health System Stuart, Florida Laboratory Services
Microbiology Specimen Collection
The recovery of pathogenic organisms responsible for an infectious process is dependent on proper collection and transportation of a specimen. An improperly collected or transported specimen may lead to failure to isolate the causative organism(s) of an infectious disease or may result in the recovery and subsequent treatment of contaminating organisms. Improper handling of specimens may also lead to accidental exposure to infectious material.
GENERAL GUIDELINES FOR COLLECTION:
1. Follow universal precaution guidelines, treating all specimens as potentially hazardous. 2. Whenever possible, collect specimen before antibiotics are administered. 3. Collect the specimen from the actual site of infection, avoiding contamination from adjacent tissues or secretions. 4. Collect the specimen at optimal time i.e. Early morning sputum for AFB First voided specimen for urine culture Specimens ordered x 3 should be 24 hours apart (exception: Blood cultures which are collected as indicated by the physician) 5. Collect sufficient quantity of material for tests requested. 6. Use appropriate collection and transport container. Refer to the Microbiology Quick Reference Chart or to the specific source guidelines. Containers should always be tightly sealed and leak-proof 7. Label the specimen with the Patient’s First and Last Name Date of Birth Collection Date and Time Collector’s First and Last Name Source 8. Submit specimen in the sealed portion of a Biohazard specimen bag. 9. Place signed laboratory order in the outside pocket of the specimen bag. 10. Include any pertinent information i.e. recent travel or relocation, previous antibiotic therapy, unusual suspected organisms, method or environment of wound infliction 11. Transport at the proper temperature, i.e. room temp, 2-8c and deliver to the Laboratory as quickly as possible.
Organism Identification and Sensitivity will be performed on all significant isolates.
CLM.20 1
Specific Collection and Transportation Guidelines:
1. Abscess Culture: Please refer to Wound/Abscess
2. Aerobic Culture: Please refer to Source
3. Anaerobic Culture:
*Must be ordered with an Aerobic Culture
Container: Anaerobic Specimen Collector (one per site) *Do not use expired tubes or if the indicator (E) is pink
Transport: Room Temperature
Specimen: Wound, Tissue, or Abscess
The best specimen for anaerobic culture is obtained using a needle and syringe. When a swab must be used to collect a specimen, an Anaerobic Specimen Collector should be used. Special care must be taken to sample the active site of a deep wound infection.
Unacceptable Specimens:
Superficial Wound sites Throat or Nasopharyngeal Swabs Gingival or Mouth Swabs Expectorated or Induced Sputum Voided or Catheterized Urine Vaginal or Cervical Swabs
Specimen Collection Procedure:
*Do not remove stopper during collection.
a. Collection by Swab:
1) Peel apart package (G) and remove specimen collector. 2) Remove plunger with sterile swab attached (B). 3) Decontaminate skin surface using 70-95% alcohol. Obtain specimen. 4) Replace swab through holes and into inner tube (C). 5) Hold tube at a 45° angle. Press down on disc portion of plastic plunger (B) with continuous gentle force until plastic disc rests against top of rubber stopper (A) forcing the inner tube (C) into outer tube (F).
CLM.20 2
Note: The hole will be plugged by the plastic plunger and the small inner tube will be detached from the stopper.
6) Hold tube at approximately a 10 - 30° angle and rotate with a swirling motion. This is to facilitate mixing of air in inner tube with the hydrogen atmosphere in outer tube. 7) Transport to laboratory. For collectors containing liquid specimens, maintain in an upright position.
b. Collection of Liquid or Purulent Specimens:
1) Decontaminate the skin surface using 70-95% alcohol. 2) Collect specimen with sterile syringe and needle or a flexible plastic catheter. 3) Air trapped in syringe should be expelled by holding syringe and needle upright. Expel air at tip of syringe into alcohol saturated sponge. 4) Peel apart package (G) and remove specimen collector. 5) Remove swab plunger unit (B) and expel liquid material into inner tube (C). (Tissue: Aseptically cut tissue into small pieces and place in inner tube) 6) Replace swab through holes into inner tube (C). 7) Hold tube at a 45° angle. Press down on disc portion of plastic plunger (B) with continuous gentle force until plastic disc rests against the rubber stopper (A) forcing the inner tube (C) into the outer tube (F).
Note: The hole will be plugged by the plastic plunger and the small inner tube will be detached from the stopper.
8) Hold tube at approximately a 10 - 30° angle and rotate with a swirling motion. This is to facilitate mixing of air in inner tube with the hydrogen atmosphere in outer tube. 9) Transport to laboratory. For collectors containing liquid specimens, maintain in an upright position.
4. Beta Strep Culture:
Throat - Refer to collection procedure for Throat Culture. Specify Beta Strep Screen
Prenatal Screen - please collect vaginal and rectal specimen for Group B Strep
5. Biopsy/Tissue/Aspirate:
Container: Sterile Specimen Container Syringe with safety cap – No needles! CLM.20 3
Anaerobic Transport vial Universal Transport Media (UTM)
Specimen: Abscess, Tissue, Wound
A few drops of sterile non-bacteriostatic saline or water may be added to prevent desiccation. If an anaerobic culture is desired, transfer a portion of the biopsy tissue to an Anaerobic transport vial. For Viral Culture, place a portion of tissue in Universal Transport Media. Do not submit tissue for culture in formalin. If surgical pathology is also desired, please submit a separate biopsy/tissue in formalin with a Pathology Requisition. Submit specimens in separate biohazard bags. If only one specimen is obtained and both culture and pathology are desired, please contact the Laboratory at 223-5945, Ext. 6928 (Microbiology) or Ext. 3146 (Histology) for further instructions.
Preferred specimens for sinus tract:
Aspiration material obtained by needle or catheterization Curetting from lining of sinus tract. Swabs specimens of sinus tract are acceptable only if the above cannot be obtained. (Swabs of sinus tract may not accurately reflect underlying disease process)
Transport: Room Temperature 2 - 8°C (UTM)
Specimen Collection Procedure:
1) Aseptically transfer tissue to a sterile container. 2) Include material from both the center and edges of lesion.
6. Blood Culture: (See Blood Culture Procedure, LSCM.11)
7. Body Fluid Culture: Excludes CSF and Urine
Container: Sterile Specimen Container Sterile conical tube Sterile Syringe w/ Safety Cap (No needles) Aerobic Blood Culture bottle – peritoneal fluid only (10 mL) Plain Red Vacutainer tube (No gel) Anaerobic Specimen Collector Universal Transport Media (UTM)
Volume: 5 – 10 mL per test (Minimum of 1 mL) CLM.20 4
Transport: Room Temperature 2 - 8°C (UTM)
Specimen Collection Procedure:
1) Vigorously cleanse aspirate site for one minute with Chlorascrub skin disinfectant. 2) Allow Chlorascrub to air dry. 3) Collect the fluid using sterile needle and syringe or evacuated bottles. (A small amount of sterile heparin may be added to prevent clotting) 4) Aliquot specimen into the appropriate containers.
Note: 10 mL of peritoneal fluid may be added to an aerobic blood culture bottle. (Peritoneal is the only fluid that should be cultured in blood culture media)
8. Bone Marrow Culture:
Container: Standard Aerobic Blood Culture bottle (Blue) MycoF/Lytic Blood Culture bottle (White) EDTA tube Dark Green tube
Volume: 3 -5 ml for Blood Culture bottles 4 ml for EDTA and Dark Green tubes
Transport: Room Temperature
Specimen Collection Procedure:
1) If using blood culture bottles, remove the protective shield from the bottles. 2) Cleanse the rubber stopper with Alcohol. 3) Physicians should wear gowns, masks and gloves during specimen collection. 4) Open ChloraScrub one-step applicator. 5) Prep site with ChloraScrub. Do not use ChloraScrub for children less than 2 months. Use alcohol, followed by betadine. Pinch the wings of the applicator to break the ampule and release the antiseptic. Press swab against the treatment area using repeated back and forth strokes for approximately 30 seconds to completely wet the treatment area. Allow to air dry for approximately 30 seconds. Do not blot, blow on or wipe the area. 6) Drape the surrounding skin with sterile drape. 7) Aspirate the marrow percutaneously using a sterile needle and syringe. 8) Immediately transfer the specimen to the appropriate containers. CLM.20 5
9. Bordetella pertussis Culture and DFA:
Specimen: Nasopharyngeal
Container: Regan/Lowe Bordetella
Transport: Room Temperature
Specimen Collection Procedure: Refer to Nose/Nasopharyngeal
Note: DFA stain, in addition to culture, is suggested for diagnosis of Bordetella pertussis.
10. Catheter Tip Culture:
Container: Sterile Container
Specimen: 2 inch segment of catheter tip
Transport: Room Temperature
Specimen Collection Procedure:
1) Disinfect the intravenous catheter insertion site with Chlorascrub. 2) Withdraw catheter and snip off catheter tip, above the site of skin contact with sterile scissors. 3) To prevent desiccation, place sterile gauze moistened with sterile water on the bottom of the transport cup. Place catheter tip on top of the moistened gauze.
Unacceptable Specimen: Urinary Foley Catheter Tips
11. Cerebrospinal Fluid Culture:
Specimen: CSF
Container: Sterile Specimen Container Universal Transport Media (UTM)
Volume: 5 ml (minimum of 1 ml)
Transport: Room Temperature
Specimen Collection Procedure:
CLM.20 6
1) Vigorously cleanse the site for one minute with Chlorascrub skin disinfectant. (Do not use on children under 2 months. Use alcohol, followed by betadine) 2) Allow the Chlorascrub to air dry. 3) Collect the fluid using sterile needle and syringe or evacuated bottles. (A small amount of sterile heparin may be added to prevent clotting) 4) Aliquot specimen to the appropriate number and types of containers needed for tests requested. 5) Deliver to the laboratory immediately.
12. Chlamydia/GC by PCR: Refer to source; Eye, Genital, Urine
Urine: First void urine (10-15 mL)
13. Clostridium difficile Toxin:
Specimen: Stool
Container: Sterile Specimen Container
Transport: Refrigerate (2-8°C)
Specimen Collection Procedure: See Stool/GI Tract
14. Cutaneous Fungus Culture:
Specimen: Skin, Hair or Nails
Container: Sterile Specimen Container
Transport: Room Temperature
Specimen Collection procedure:
a. Skin 1) Cleanse the skin with 70-95% alcohol. 2) Collect epidermal scales with a scalpel. 3) Place specimen in a dry, sterile container.
b. Hair 1) Scrape the scalp with a blunt scalpel. 2) Place specimen in a dry, sterile container.
Acceptable: Hair stubs Contents of plugged follicles Skin scales Hair plucked from scalp with forceps
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Not acceptable: Cut hair
c. Nails 1) Clean the nail with 70-95% alcohol. 2) Remove the outermost layer by scraping with a scalpel. 3) Place specimen in a dry, sterile container.
Acceptable: Clippings from any discolored or brittle parts of the nail Deeper scrapings and debris under the edges of the nail
15. Ear Culture:
Specimen: Swab from outer ear canal
Container: Culturette or NP Swab (One swab per test)
Transport: Room Temperature (Transport to Laboratory within 6 hours)
Specimen Collection Procedure:
1) Clean the external ear with antiseptic (70% alcohol acceptable) 2) Allow to air dry 3) Rotate swab in outer canal 4) Replace swab (or minitip) into the culturette for transport.
Note: Ear cultures are processed as superficial wounds. If the diagnosis is otitis media, the specimen of choice is middle ear fluid collected by tympanocentesis. Middle ear fluid is processed as a sterile body fluid.
16. Eye Culture:
Specimen: Swab, Scraping or Aspirate from eye
Specimen Containers: Culturette NP Swab Universal Transport Media (UTM) Choc / Blood Agar Plates (Corneal Scrapings) Sabaroud Agar (Corneal Scrapings)
Call laboratory (ext. 6929) to obtain the required media prior to collection time.
Specimen Collection Procedure:
a. Conjunctivitis: CLM.20 8
1) Cleanse the skin around the eye with a mild antiseptic. 2) Using a regular culturette or minitip swab gently swab the conjunctiva. 3) Collect one swab for each request. 4) Place swab into culturette tube for routine culture; viral transport media for viral culture.
b. Corneal Infection: 1) Collection should be performed by a licensed practitioner. 2) Cleanse the skin around the eye with a mild antiseptic. 3) Collect multiple corneal scrapings directly onto bacterial media, fungal media and/or viral transport media.
c. Intraocular Fluid: 1) Cleanse the skin around the eye with a mild antiseptic. 2) Collect specimen by surgical needle aspiration. 3) Dispense to appropriate collection devices for test(s) required.
17. Fecal Fat, Qualitative:
Specimen: Stool
Container: Sterile Specimen Container
Volume: 5 g aliquot
Transport: Room Temperature, within 1 hour of collection Refrigerate (2-8°C), if > 1 hour after collection
Specimen Collection: See Stool/GI Tract
18. Fungus Culture: Refer to Source or Cutaneous Fungus
Note: If di-morphic fungal infection is suspected it is essential that the physician notify the Microbiology Laboratory. These specimens must be collected, transported and processed immediately. Organisms causing these infections are extremely fastidious in nature. They are very susceptible to temperature variation; they have slower growth rates and are frequently found in low numbers, making overgrowth by other organisms much more likely and recovery more difficult.
19. GC/Genital Culture:
Specimen: Genital or Rectal swab (Stool is not acceptable)
CLM.20 9
Container: Sterile Swab
Transport: Room Temperature
Specimen Collection Procedure:
a. Genital – see Genital Culture
b. Rectal 1) Moisten swab with sterile water and insert swab into the anal canal, just beyond the anal sphincter. 2) Allow 10 –30 seconds for the absorption of the organism onto the swab.
Note: If disseminated gonococcal infection is suspected, culture blood and any suspicious site such as petechial or joint fluid.
20. Genital Culture:
Specimen: End cervix, Genital, Vaginal, Penis, Urethral, or Cervical swab *One swab per test
Container: Sterile Swab (Beta Strep, Fungus, KOH, Wet Prep) Swab with Saline (KOH, Wet Prep) Probe Tec Swab, Female – Pink (GC/Chlamydia) Probe Tec Swab, Male – Blue (GC/Chlamydia) Universal Transport Media (UTM) (Herpes)
Transport: Room Temperature (Culture Swab) 2-8°C (Probe Tec Swabs, UTM, Diogenes HPV)
Specimen Collection Procedure:
a. Genital, Female 1) Place patient in the lithotomy position. 2) Insert speculum (unlubricated, except for warm water) 3) Visualize cervix. 4) Remove excess blood and mucous from the exocervix with a swab. Discard this swab. 5) Insert second swab or brush (provided in collection kit) 1 to 1.5 cm into the endocervix and rotate the swab clockwise for 15-30 seconds to ensure adequate sampling. 6) Withdraw swab carefully, avoiding any contact with the vaginal mucosa. 7) Tap transport tube to ensure media is at the bottom of the tube. 8) Unscrew cap and insert specimen swab from appropriate kit. (Do not use swabs with wooden shaft) CLM.20 10
9) Break the swab off at the score line. For culturette, just insert swab into transport tube. 10) Replace cap securely.
b. Genital, Male 1) Do not allow patient to urinate for at least one hour prior to collection. 2) Insert swab from the collection kit 2-4 cm into the urethra and rotate swab for 3 to 5 seconds to ensure adequate sampling. 3) Withdraw swab. 4) Tap transport tube to ensure media is at the bottom of the tube. 5) Unscrew cap and insert specimen swab from appropriate kit. (Do not use swabs with wooden shaft) 6) Break the swab off at the score line. For culturette, just insert swab into transport tube. 7) Replace cap securely.
Note:
1) Blood in specimen may interfere with DNA Probe testing 2) Specimens without a swab in transport media are unacceptable (Wooden or cotton swabs are unacceptable for GC/Chlam probe and viral culture. Wire swabs are also unacceptable for GC/Chlamydia probe.) 3) Culture is recommended for Chlamydia trachomatis and Neisseria gonorrhea detection in cases of suspected sexual abuse or suspected failure of therapy.
21. Giardia/Cryptosporidium Antigen Screen:
Specimen: Stool
Container: Sterile Specimen Container
Transport: Refrigerate (2-8°C)
Specimen Collection Procedure: See Stool/GI Culture
22. Herpes Culture: Refer to Source
Specimen: Throat, buccal mucosa, eye, genital, rectal swab, vesicle swab or fluid, Broncho alveolar lavage (BAL), or tissue.
Container: M4 Viral Media
Transport: Refrigerate (2-8°C)
Specimen Collection Procedure: Refer to source
CLM.20 11
Stability: (collection to initiation of testing): Ambient: 2 hours; Refrigerated: 72 hours; Frozen: Unacceptable
Note:
1) Collect specimen within first three days of lesion 2) Avoid collecting from external area of lesion 3) If fluid is present in the vesicles, a tuberculin syringe and needle can be used to aseptically aspirate the contents of several vesicles. Expel fluid into viral transport media, flushing syringe with transport media. 4) If vesicle fluid is not present, unroof several vesicles with a needle or scalpel and use a culturette swab to obtain cells from the base of the lesion. 5) Unacceptable: Blood, CSF, plasma, or serum. Calcium alginate, dry, or wood swabs.
23. HPV (Human papillomavirus):
Specimen: Cervical Biopsy – fresh tissue up to 5 mm in cross-section.
Container: Cervical brush in HPV Digene Collection Kit
Transport: Refrigerated (2-8°C)
Specimen Collection:
Follow collection instructions included in the Digene HPV collection kit.
Stability: (collection to initiation of testing): Digene transport medium: Ambient: 2 weeks; Refrigerated: 3 weeks; Frozen: 3 months
Note: 1) Obtain specimen after PAP smear and prior to acetic acid for colposcopic exam. 2) Females should avoid high concentrations of antifungal cream, contraceptive jelly, or douche at time of collection. 3) Vaginal specimens are not recommended due to limited clinical correlative data. 4) Unacceptable Conditions: Swabs or specimens in any other transport media. Urethral swabs.
24. KOH Prep:
Specimen: Skin, Hair, Nails, Genital
Container: Swab with Sterile Saline Sterile Specimen Container CLM.20 12
Sterile Swab
Transport: Room Temperature
Specimen Collection Procedure: Refer to Cutaneous Fungus or Genital Culture
25. Nose/Nasopharyngeal Culture:
Specimen: Nose or Nasopharyngeal
Container: Nasopharyngeal Swab
Temperature: Room Temp
Specimen Collection Procedure:
a. Nose: The only appropriate test from this source is an assessment for staphylococcal colonization.
1) Insert culture swab ~¾ inch into nares and rotate swab against anterior nasal mucosa for 3 seconds. 2) Using the same swab, repeat for the other nares.
b. Nasopharyngeal Swab: 1) Seat patient comfortably and tilt head back at a 70° angle 2) Insert a nasopharyngeal swab through a nostril into the posterior nasopharynx. 3) Gently rotate swab about 5 seconds to collect a mucosal epithelial specimen. 4) Remove the swab and place into appropriate transport media
c. Nasopharyngeal Slides: 1) Using a separate swab for the slides, follow steps 1-3 for nasopharyngeal swab collection. 2) Gently roll the swab across two frosted edge glass microscope slides. 3) Label both slides with the patient’s name and date of birth. Place slides in a slide mailer. 4) Transport to laboratory immediately at Room Temperature
d. Washings: 1) Fill a 3 – 5 mL syringe attached to a rubber tube or a sterile bulb with sterile saline. 2) Insert tube or bulb through a nostril into the nasal cavity. 3) Inject saline into the nostril and immediately recover it by aspiration. CLM.20 13
4) Transfer 3mL of washings to Universal Transport Media (equal amounts of specimen to media).
e. Aspirate: 1) Attach mucous trap to suction pump and catheter 2) Turn on suction and adjust to suggested pressure. 3) Without applying suction, insert catheter into nose, directed posteriorly and toward the opening of the external ear. Depth of insertion necessary to reach posterior pharynx is equivalent to distance between the anterior nares and external opening of ear. 4) Apply suction. 5) Using a rotating movement, slowly withdraw catheter. 6) Transfer up to 3 mL of aspirate into Universal Transport Media (equal to the amount of media).
26. Ova and Parasite Exam:
Giardia/Cryptosporidium Antigen is preferred test
Ova and Parasite Exam requires pre-approval by Microbiology Lab.
Patient must be immunocompromised or have recent travel history.
Please call Microbiology Lab: (772) 223-5945, ext. 6927
27. Pinworm Slides:
Because of the migratory habits of the female pinworm, specimens are best obtained a few hours after the person has retired, between the hours of 9:00 pm and midnight; or in the morning immediately upon rising. Collect specimen before bathing or bowel movement.
Container: Pinworm Paddle
Transport: Room Temperature
Specimen Collection Procedure:
1) Remove the paddle from the tube by holding the paddle by the cap. 2) Separate the buttocks. 3) Press the tacky surface against several areas of the perianal region. 4) Place paddle in tube and secure lid tightly.
28. Respiratory Culture:
Specimen: Sputum Bronchial Lavage CLM.20 14
Bronchial Brush
*When tests ordered x3, collect one early morning specimen per day.
Container: Sterile Specimen Container
Temperature: Room Temperature (Within 1 hour of collection) Refrigerate if > 1 hour (2-8 °C)
Volume: 10-15 mL (minimum = 5 ml for culture, 10 ml for cytology)
Specimen Collection Procedure:
a. Sputum:
First morning specimen is preferred since secretions tend to pool in the lungs during sleep. Specimen submitted should be the results of a deep cough not saliva.
1) Instruct patient to brush teeth and rinse mouth with water to reduce contamination with food or saliva. 2) Have patient inhale and exhale deeply, forcing air from lungs using diaphragm. 3) Repeat until the patient coughs and is able to produce a deep cough sputum specimen. (Avoid post nasal drainage) 4) Collect expectorate into a dry, sterile container.
Note:
1) If patient is unable to comply or produce a good sputum specimen, obtain an induced sputum or tracheal aspirate. Consult a respiratory therapist for assistance. Clearly indicate collection method on specimen and test request. 2) Pooled (24 hour) sputum specimens are not acceptable. 3) Sputum specimens for cultures will be examined microscopically for adequacy.
b. Bronchial Washings and Lavage:
1) Collect as much material as possible in a sterile E-T Suctions container 2) Transfer to sterile container for transport
c. Bronchial Brushings:
1) Spread a thin film of specimen over a 1 cm square area of a clean glass slide. 2) Prepare one slide for each stain procedure requested. CLM.20 15
3) Allow slides to air dry. 4) Write patient’s name and date of birth on frosted edge of each slide. 5) Transport slides in slide mailer.
29. Rotavirus Antigen:
Specimen: Stool
Container: Sterile Specimen Container
Transport: Refrigerate (2-8°C)
Specimen Collection Procedure: Refer to Stool/GI Tract Culture
30. Shiga Toxin Antigen:
Specimen: Stool
Container: Sterile Specimen Container
Transport: Refrigerate (2-8°C)
Specimen Collection Procedure: Refer to Stool/GI Tract Culture
31. Stool/GI Tract Culture:
Specimen: Stool, Bowel Aspirate, Duodenal Aspirate, Gastrointestinal
Container: Sterile Specimen Container
Volume: Formed Stool - Walnut size portion l Liquid – 1 Tablespoon
Transport: Refrigerate (2-8°C)
Stool Specimen Collection Procedure:
1) Collect specimen in clean, dry container, avoiding contamination with urine or toilet water. 2) Select portions of stool from areas which appear bloody, slimy, or watery. 3) If the stool is formed (hard), try to sample small amounts from each end and middle. 4) Transfer specimen into a sterile container.
Note:
CLM.20 16
1) For acute episodes of infectious diarrhea, specimens should be collected within the first three days of onset. 2) Specimens should be collected prior to or one week after barium. Avoid use of antacids, bismuth, anti-diarrheal medication or laxatives prior to specimen collection.
32. Throat Culture:
Specimen: Throat Swab
Container: Sterile Swab
Transport: Room Temperature
Specimen Collection Procedure:
1) Ask patient to sit down with head tilted back 2) Use a tongue blade and a good light source to ensure good visualization 3) Reach behind the uvula to swab both of the tonsillar fauces, posterior pharynx, and any ulcerations, exudates, lesions or areas of inflammation. 4) Avoid touching the tongue or lips. 5) Place swab in transport media. 6) If Viral Culture is ordered, collect a second swab in the same manner.
Note: Please indicate if C. diphtheria or N, gonorrhea is suspected.
33. Urine Culture
Specimen: Urine
Source: Clean Catch Catheter Cysto Kidney Aspirate Ureter Aspirate Supra Pubic Aspirate
Container: Sterile Specimen Container Urine C& S Transport Tube (Contains a Preservative)
Volume: 10 – 15 mL (minimum = 2 mL) - 5 mL – C&S Transport Tube
Transport: Refrigerate (2-8°C) – within 24 hours of collection – Sterile Container Room Temperature – Preserved in C& S Transport Tube
Specimen Collection Procedure: CLM.20 17
a. Female: 1) Remove undergarments and open sterile cup. 2) Wash hands thoroughly with soap and water. Rinse and dry. 3) Spread the labia with one hand and keep apart until urine is voided into the cup. 4) Take a single cleaning towelette and wipe vulva from front to back, once. Discard. 5) Repeat the front to back wash one time with 2nd towelette. Discard. 6) Take the open cup in the other hand without touching the rim or inner surface. 7) Begin to void into the toilet. After the urine begins to flow, catch the urine into the cup without stopping the stream. Do not touch legs, vulva or clothing with the cup. 8) When finished, close lid securely on cup and wipe outside of container.
b. Male: 1) Wash hands with soap and water. Rinse and dry thoroughly. 2) Retract the foreskin on the penis completely. 3) Cleanse the tip of the penis with the towelette. 4) Begin to void into the toilet. After the urine begins to flow, catch the urine into the cup without stopping the flow of urine. Do not touch the cup with the penis. 5) When finished, close lid securely on cup and wipe outside of container.
c. Indwelling Catheter:
1. Do not collect urine from the drainage bag because growth of bacteria outside the catheter may have occurred at this site. 2. Clean the catheter “aspirating port” with a sterile alcohol pad and allow alcohol to dry. 3. Use sterile needle and syringe to aspirate urine directly from tubing. 4. Transfer the urine to a sterile leak-proof container. 5. Close lid securely on the cup and wipe outside of container.
34. Viral Culture: Refer to Source
Specimen: Abscess, Tissue, Wound, Body Fluid, Bone Marrow, CSF, Eye, Nose, Nasopharyngeal, Sputum, Endotracheal, Bronchial Washing, Throat, Urine
Container: Universal Transport Media (UTM)
Transport: Refrigerate (2-8°C)
Specimen Collection Procedure: Refer to source CLM.20 18
35. Wound/Abscess Culture:
Specimen: Swab or Aspirate from Wound or Abscess
*Aspiration is preferred, but swab is acceptable on freshly expressed exudates
Container: Sterile Swab Anaerobic Specimen Collector
Transport: Room Temperature
Specimen Collection Procedure:
1) Cleanse area around wound edges with antiseptic swab to remove excess debris and colonizing flora. Allow to air dry. 2) Express exudate and pass culture swab as far as possible into the wound. Avoid touching skin surface. 3) Vigorously swab the base of the wound. 4) Place swab into the appropriate transport media. 5) Repeat with second swab for gram stain.
Note:
1) For closed wounds, refer to Biopsy/Tissue/Aspirate section. 2) The following are preferred specimens for Sinus Tract: Aspiration material obtained by needle or catheterization Curettings from lining of sinus tract Swabs of sinus tract are acceptable only if the above specimens cannot be obtained. Swabs of sinus tract may not accurately reflect the underlying disease process. 3) Biopsy tissue of advancing margin of wound is the preferred specimen for AFB, Fungus and Anaerobic cultures. 4) Swabs are not recommended for AFB and Fungus cultures. 5) Cultures of superficial lesions should not be submitted for anaerobic culture. 6) Never collect exudates from skin unless it is a separate culture. Label as “Skin”.
CLM.20 19