Covenant Laboratory Microbiology Specimen Guidlines

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CHS Microbiology Specimen Guidelines

**** ALL SPECIMENS MUST BE LABELED **** EXACT SPECIMEN SOURCE IS REQUIRED ON ALL SPECIMENS February 2013

Specimen Source Collection Guidelines Transport Limits Comments

Aerobic/Anaerobic Cultures

Anaerobic Culture clean wound with 70% alcohol <24 hrs if syringe, express air culture swab plus (blue) seal & remove needle Biopsy- tissue sterile screw top container w/ sterile moistened gauze <24 hrs RT Do not place in culturette or use swabs Do not add fixative or formalin Blood Culture Bactec bottles; follow aseptic procedure Bacterial: adult- 10-20 ml/set 3 sets/24 hrs Do not refrigerate during transport infant- 1-3 ml/set Bordetella pertussis by PCR Copan nasopharyngeal swab on wire shaft (green) or Nasal Aspirate <24 hrs refrigerate Catheter Tips cut tip end with sterile scissors & place in <24 hrs refrigerate Foley catheters unacceptable for culture sterile screw cap container CSF (cerebrospinal fluid) sterile screw cap tube transport ASAP 2 ml minimum Do not refrigerate Ear aspirate in sterile tube or culture swab plus (blue) <24 hrs RT Eye culture swab plus (blue) or <24 hrs RT corneal scrapings by ophthamalogist/plated directly <15 mins RT Feces (stool) orange top transport pack <24 hrs 1 per day not to Diapers & leaking containers will be rejected exceed 2 Note: stools are inappropriate for fungal cultures specimens Clostridium difficile (Cdiff) liquid stool in plastic disposable container w/ lid <24 hrs refrigerate 1 per week Formed stools, diapers, parapaks by PCR (stool must be soft enough to take the shape of & leaking containers will be rejected container) Giardia/Cryptosporidium screen Stool in parapaks (pink & gray) <24 hrs 1 stool Diapers & leaking containers will be rejected Ova & Parasite,Comprehensive parapaks (pink & gray) <24 hrs (only done by special request) maximum of 3 in 1 wk, collected on separate days WBC stain stool in plastic disposable container w/lid <24 hrs refrigerate Do not send in transport media Fecal Fat stool in plastic disposable container w/lid <24 hrs refrigerate Diapers, parapaks & leaking containers Rotavirus stool in plastic disposable container w/lid <24 hrs refrigerate will be rejected Occult Blood stool in plastic container or on hemoccult cards cards can be stored up to 10 days 1 per day Fluids Sterile screw-top container, 2 ml minimum <24 hrs RT Do not put in vacutainer tubes with additives (other than blood, CSF, urine) remove needle if sending syringe Do not use swabs CHS Microbiology Specimen Guidelines

Genitals: Vaginal/Cervix Gram stain is recommended for confirmation of Culture swab plus (blue) Do not refrigerate bacterial vaginosis, not cultures. <24 hrs. at room temp Male: urethral Recommend organism specific testing only: GC / Chlamydia DNA probe, Mycoplasma call for Mycoplasma collection media Group B strep, Yeast, Staph aureus, Trichomonas Group B Strep Culture swab (red) or Culture swab plus (blue); insert vaginal, then rectum <24 hrs refrigerate Vaginal Wet Mount 1 swab in 1 ml saline, capped tube transport within 30 minutes dry swab or too much saline gives inaccurate do not refrigerate results and will be rejected Nose (nares) Culture swab (red) or culture swab plus (blue) <24 hrs RT Nasopharyngeal swab on wire shaft, place into culture swab plus for transport <24 hrs RT Respiratory - Sputum, Bronchs, Sputum, not saliva, 1 ml minimum <24 hrs refrigerate 1 per day 1st morning specimen preferred Tracheal Aspirates in sterile, sealed container leaking container will be rejected Sputum for AFB

Throat culture culture swab (red) or culture swab plus (blue) <24 hrs 1 per day

Rapid group A strep culture swab (red) <24 hrs refrigerate cotton swabs on wooden shafts will be rejected Urine culture sterile urine screw top container or urine <24 hrs refrigerate 1 per day leaking containers will be rejected preservation system. Label as clean catch, voided, unpreserved < 2 hrs RT foley, catheterized preserved <24 hrs RT Urine for AFB 50 ML in sterile container <24 hrs refrigerate First morning specimen

Wounds - abscess, lesion clean wound area w/ 70% alcohol <24 hrs Tissue or fluid is the specimen of choice aspirate in sealed syringe or culture swab plus (blue) source is required Mycobacteria - AFB cultures Wounds: Culture Swab Plus (Blue) Body fluids or Tissue Body Fluids: 2 mls <24 hrs at RT (other than respiratory or urine) Tissue: in sterile container w/2 mls saline <24 hrs at RT Blood/Bone Marrow for AFB Blood: collected in Myco/F Lytic Culture Vial <24 hrs at RT Mycology - Fungal cultures fluids- sterile screw top container <24 hrs RT do not refrigerate; swabs are not recommended tissue biopsy sterile screw top container w/ sterile moistened gauze <24 hrs RT do not refrigerate; swabs are not recommended

Hair, skins, nails sufficient scrapings to cover the head of a thumbtack <24 hrs RT do not refrigerate; swabs are not recommended in sterile container call for collection material Blood for Fungus blood drawn in Isolator tube transport ASAP do not refrigerate Virology - Influenza A/B screen Copan nasopharyngeal swab on wire shaft (green) <24 hrs refrigerate cotton swabs on wooden shafts will be rejected deep swab of both nasal passages RSV screen nasopharyngeal aspirate in sterile container <24 hrs refrigerate or transport on ice Copan eSwab with liquid amies Copan nasopharyngeal swab on wire shaft (green) Respiratory Direct Panel nasopharyngeal aspirate in sterile container <24 hrs refrigerate or transport on ice Viral cultures fluids - 1 ml in sterile container <24 hrs refrigerate HSV Swab in viral culture media <24 hrs refrigerate lesion - Culture swab (red) <24 hrs refrigerate blood - Blood in Sodium Heparin Tube (green top) <24 hrs refrigerate