<p> Virology/Serology sample instructions. Please click on the hyperlink to be taken to the relevant test entry in the Test Database</p><p>Molecular CHLAMYDIA Aptima Urine Sample (PCR) detection TRACHOMATIS AND  The patient should not have urinated for at least 1 hour prior to specimen collection. of GC/CT GONOCOCCI PCR  Direct patient to provide a first-catch urine (approximately 20 to 30 mL of the initial urine stream) into a urine collection cup free of any preservatives. (Collection of larger volumes of urine may result in EYE SWAB CHLAMYDIA rRNA target dilution that may reduce test sensitivity). PCR  Female patients should not cleanse the labial area prior to providing the specimen.  Remove the cap and transfer 2 mL of urine into the urine specimen transport tube using the CHLAMYDIA PCR MEDICO disposable pipette provided. The correct volume of urine has been added when the fluid level is LEGAL between the black fill lines on the urine specimen transport tube label. 4. Re-cap the urine specimen transport tube tightly. </p><p>Aptima vaginal swabs (orange label)  Partially peel open the swab package. Remove the swab. Do not touch the soft tip or lay the swab down. If the soft tip is touched, the swab is laid down, or the swab is dropped, use a new APTIMA Vaginal Swab Specimen Collection Kit.  Hold the swab, placing your thumb and forefinger in the middle of the swab shaft covering the score line. Do not hold the swab shaft below the score line.  Carefully insert the swab into the vagina about 2 inches (5 cm) past the introitus and gently rotate the swab for 10 to 30 seconds. Make sure the swab touches the walls of the vagina so that moisture is absorbed by the swab and then withdraw the swab without touching the skin.  While holding the swab in the same hand, unscrew the cap from the tube. Do not spill the contents of the tube. If the contents of the tube are spilled, use a new APTIMA Vaginal Swab Specimen Collection Kit.  Immediately place the swab into the transport tube so that the score line is at the top of the tube.  Carefully break the swab shaft at the score line against the side of the tube.  Immediately discard the top portion of the swab shaft.  Tightly screw the cap onto the tube.</p><p>Aptima endocervical swabs (white and purple label)  Remove excess mucus from the cervical os and surrounding mucosa using the cleaning swab (white shaft swab in the package with red printing). Discard this swab. Note: To remove excess mucus from the cervical os, a large-tipped swab (not provided) may be used.  Insert the specimen collection swab (blue shaft swab in the package with the green printing) into the endocervical canal. Gently rotate the swab clockwise for 10 to 30 seconds in the endocervical canal to ensure adequate sampling.  Withdraw the swab carefully; avoid any contact with the vaginal mucosa.  Remove the cap from the swab specimen transport tube and immediately place the specimen Virology/Serology sample instructions. Please click on the hyperlink to be taken to the relevant test entry in the Test Database</p><p> collection swab into the transport tube.  Carefully break the swab shaft against the side of the tube at the scoreline and discard the top portion of the swab shaft; use care to avoid splashing of contents.  Re-cap the swab specimen transport tube tightly. </p><p>Aptima male urethral swabs (white and purple label)  The patient should not have urinated for at least 1 hour prior to sample collection.  Insert the specimen collection swab (blue shaft swab in the package with the green printing) 2 to 4 cm into the urethra.  Gently rotate the swab clockwise for 2 to 3 seconds in the urethra to ensure adequate sampling.  Withdraw the swab carefully.  Remove the cap from the swab specimen transport tube and immediately place the specimen collection swab into the transport tube.  Carefully break the swab shaft against the side of the tube at the scoreline and discard the top portion of the swab shaft; use care to avoid splashing of contents.  Re-cap the swab specimen transport tube tightly.</p><p>Aptima eye swabs (orange label)  Partially peel open the swab package. Remove the swab. Do not touch the soft tip or lay the swab down. If the soft tip is touched, the swab is laid down, or the swab is dropped, use a new APTIMA Swab Specimen Collection Kit.  Hold the swab, placing your thumb and forefinger in the middle of the swab shaft covering the score line. Do not hold the swab shaft below the score line.  Hold the swab parallel to the cornea and gently rub the conjunctiva in the lower eyelids from nasal side outwards.  Swab any pus or exudates as well as any lesion of interest.  While holding the swab in the same hand, unscrew the cap from the tube. Do not spill the contents of the tube. If the contents of the tube are spilled, use a new APTIMA Vaginal Swab Specimen Collection Kit.  Immediately place the swab into the transport tube so that the score line is at the top of the tube.  Carefully break the swab shaft at the score line against the side of the tube.  Immediately discard the top portion of the swab shaft.  Tightly screw the cap onto the tube.  If both eyes are to be swabbed, label swabs ‘right’ and ‘left’ accordingly</p><p>Rectal swab for LYMPHOGRANULOMA Aptima rectal swabs (white and purple label) Virology/Serology sample instructions. Please click on the hyperlink to be taken to the relevant test entry in the Test Database lymphogranulo VENEREUM (LGV) PCR  Partially peel open the swab package. Remove the swab. Do not touch the soft tip or lay the swab ma venereum down. If the soft tip is touched, the swab is laid down, or the swab is dropped, use a new APTIMA Swab Specimen Collection Kit. (LGV)  Hold the swab, placing your thumb and forefinger in the middle of the swab shaft covering the score line. Do not hold the swab shaft below the score line.  Carefully pass the swab through the anus into the rectum and rotate gently.  Withdraw the swab carefully.  Remove the cap from the swab specimen transport tube and immediately place the specimen collection swab into the transport tube.  Carefully break the swab shaft against the side of the tube at the scoreline and discard the top portion of the swab shaft; use care to avoid splashing of contents.  Re-cap the swab specimen transport tube tightly.</p><p>Nasopharyngea MERS-COV For general aspects of taking respiratory samples we recommend that users follow either their local protocols l Aspirate (NPA) CORONAVIRUS REAL- or “The Royal Marsden Manual of Clinical Nursing Procedures”. TIME PCR Nasopharyngeal Aspirate (NPA) HHV6 PCR  NPA should be collected according to local protocols using sterile fluids as the instillate. (QUALITATIVE AND  Recovered mucus/fluid should sent in a 20ml white top sterile sample container or other well sealed QUANTITATIVE) sterile container. </p><p>INFLUENZA A H7N9 REAL-TIME PCR</p><p>RESPIRATORY VIRUSES PCR</p><p>REAL-TIME PCR DETECTION OF BORDETELLA PERTUSSIS Virology/Serology sample instructions. Please click on the hyperlink to be taken to the relevant test entry in the Test Database</p><p>Nose and MERS-COV Nose and throat swabs for virology Throat Swabs CORONAVIRUS REAL-  Use a red topped virology transport medium kit (labelled as Oxoid IDEIA Chlamydia kit). for Virology TIME PCR  Throat: Ask patient to sit upright facing a strong light, tilt head backwards, open mouth and stick out tongue. Depress tongue with a spatula. Ask patient to say ‘Ah’. Quickly but gently roll the swab over INFLUENZA A H7N9 the tonsils and posterior pharynx REAL-TIME PCR  Nose: Ask patient to tilt head backwards. Insert swab inside the anterior nares with the tip directed upwards and gently rotate. MEASLES VIRUS PCR  Place the swab(s) in the transport liquid and snap off the swab shaft at the score line so it fits into the RESPIRATORY VIRUSES sample pot. PCR  Close the cap tightly and label with patient information.  Label as “nose”, “throat” or “nose and throat” HHV6 PCR (QUALITATIVE AND Throat swabs only for REAL-TIME PCR DETECTION OF BORDETELLA PERTUSSIS and MYCOPLASMA QUANTITATIVE) PNEUMONIAE REAL-TIME PCR (Take out nose stuff for these tests):</p><p>INFLUENZA A H7N9 Throat swabs for virology REAL-TIME PCR  Use a red topped virology transport medium kit (labelled as Oxoid IDEIA Chlamydia kit).  Ask patient to sit upright facing a strong light, tilt head backwards, open mouth and stick out tongue. INFLUENZA A Depress tongue with a spatula. Ask patient to say ‘Ah’. Quickly but gently roll the swab over the CONFIRMATORY tonsils and posterior pharynx TYPING  Place the swab in the transport liquid and snap off the swab shaft at the score line so it fits into the sample pot. REAL-TIME PCR  Close the cap tightly and label with patient information. DETECTION OF BORDETELLA PERTUSSIS</p><p>MYCOPLASMA PNEUMONIAE REAL- TIME PCR</p><p>Genital swab for VIRAL GENITAL SWAB Genital swab for virology virology SCREEN  Use a red topped virology transport medium kit (labelled as Oxoid IDEIA Chlamydia kit).  Rotate swab over surface of ulcer collecting any exudate. Virology/Serology sample instructions. Please click on the hyperlink to be taken to the relevant test entry in the Test Database</p><p>GENITAL ULCERATIVE  Place the swab in the transport liquid and snap off the swab shaft at the score line so it fits into the DISEASE SCREEN sample pot. (GUD)  Close the cap tightly and label with patient information. </p><p>Skin swab for SKIN LESION- VIRAL Skin swab for virology virology SCREEN  Use a red topped virology transport medium kit (labelled as Oxoid IDEIA Chlamydia kit).  Rotate swab over surface of ulcer/vesicle collecting any exudate.  Place the swab in the transport liquid and snap off the swab shaft at the score line so it fits into the sample pot.  Close the cap tightly and label with patient information. </p><p>Eye swab for VIRAL EYE SCREEN Eye swab for virology virology PCR  Use a red topped virology transport medium kit (labelled as Oxoid IDEIA Chlamydia kit).  Swab parallel to the cornea and gently rub the conjunctiva in the lower eyelids from nasal side outwards.  Swab any pus or exudates as well as any lesion of interest.  Place the swab in the transport liquid and snap off the swab shaft at the score line so it fits into the sample pot.  Close the cap tightly and label with patient information.  If both eyes are to be swabbed, label swabs ‘right’ and ‘left’ accordingly.</p><p>Mouth swab for VIRAL MOUTH SWAB Mouth swab for virology virology SCREEN  Use a red topped virology transport medium kit (labelled as Oxoid IDEIA Chlamydia kit).  Swab lesion of interest.  Place the swab in the transport liquid and snap off the swab shaft at the score line so it fits into the sample pot.  Close the cap tightly and label with patient information.  If both eyes are to be swabbed, label swabs ‘right’ and ‘left’ accordingly.</p><p>Blood Spots DRIED BLOOD SPOT Click on hyperlink for Dried Blood Spot Testing to take you to the DBS entry on the test database. TESTING Please refer to links on this page for detailed information on how to take dried blood spot samples Virology/Serology sample instructions. Please click on the hyperlink to be taken to the relevant test entry in the Test Database</p><p>EDTA whole ADENOVIRUS VIRAL For taking blood samples we recommend that users follow either their local protocols or “The Royal Marsden blood and/or LOAD Manual of Clinical Nursing Procedures”. plasma CYTOMEGALOVIRUS Lavender top blood (EDTA) samples (CMV) UL97 GENOTYPIC  Sufficient blood for the test should be drawn into lavender topped (EDTA) vacuum tubes. RESISTANCE  Invert tube 8–10 times.</p><p>CYTOMEGALOVIRUS Specific additional instructions for CCR5 tropism already on webpage. VIRAL (CMV) LOAD</p><p>EPSTEIN BARR VIRUS VIRAL LOAD</p><p>ERYTHROVIRUS (PARVOVIRUS B19 )PCR</p><p>HEPATITIS B GENOTYPIC RESISTANCE TESTING</p><p>HEPATITIS B VIRAL LOAD</p><p>HEPATITIS C GENOTYPING</p><p>HEPATITIS C VIRAL LOAD</p><p>HEPATITIS E PCR</p><p>HIV 1 GENOTYPIC RESISTANCE TESTING (PROTEASE AND REVERSE TRANSCRIPTASE Virology/Serology sample instructions. Please click on the hyperlink to be taken to the relevant test entry in the Test Database</p><p>REGION)</p><p>HIV 1 INTEGRASE GENOTYPIC RESISTANCE TESTING</p><p>HIV GP41 - T20 GENOTYPIC RESISTANCE TESTING</p><p>HIV VIRAL LOAD</p><p>HIV2 GENOTYPIC RESISTANCE TESTING (PROTEASE AND REVERSE TRANSCRIPTASE REGION)</p><p>POLYOMAVIRUS VIRAL LOAD</p><p>HEPATITIS C IGG CONFIRMATORY</p><p>HEPATITIS C IGG SCREEN</p><p>HEPATITIS E IGM/IGG ANTIBODY</p><p>HHV6 PCR (QUALITATIVE AND QUANTITATIVE)</p><p>PNEUMOCYSTIS JIROVECII REAL-TIME PCR Virology/Serology sample instructions. Please click on the hyperlink to be taken to the relevant test entry in the Test Database</p><p>HIV CCR5 TROPISM</p><p>Red top blood CYTOMEGALOVIRUS For taking blood samples we recommend that users follow either their local protocols or “The Royal Marsden (Serum) (CMV) IGG Manual of NOT Clinical Nursing Procedures”. INCLUDING antibiotic level CYTOMEGALOVIRUS Red top blood (serum) samples assays (CMV) IGM  Sufficient blood for the test should be drawn into red topped (no additive) vacuum tubes. </p><p>EPSTEIN BARR VIRUS (EBV) ANTIBODY</p><p>ERYTHROVIRUS (PARVOVIRUSB19) IGM/IGG ANTIBODY</p><p>HELICOBACTER IGG</p><p>HEPATITIS A IGG</p><p>HEPATITIS A IGM</p><p>HEPATITIS B CORE ANTIBODY</p><p>HEPATITIS B CORE IGM ANTIBODY</p><p>HEPATITIS B E ANTIBODY</p><p>HEPATITIS B E ANTIGEN</p><p>HEPATITIS B SURFACE ANTIBODY - POST Virology/Serology sample instructions. Please click on the hyperlink to be taken to the relevant test entry in the Test Database</p><p>VACCINATION</p><p>HEPATITIS B SURFACE ANTIGEN CONFIRMATORY</p><p>HEPATITIS B SURFACE ANTIGEN SCREEN HERPES 1/2 TOTAL IGG ANTIBODY</p><p>HIV 1/2 ANTIGEN/ANTIBODY CONFIRMATORY</p><p>HIV 1/2 ANTIGEN/ANTIBODY SCREEN</p><p>HIV P24 ANTIGEN</p><p>MEASLES IGG ANTIBODY</p><p>MEASLES IGM</p><p>MUMPS IGG ANTIBODY</p><p>MUMPS IGM</p><p>RUBELLA IGG</p><p>RUBELLA IGM</p><p>STREPTOCOCCUS TESTING (ASOT)</p><p>SYPHILIS Virology/Serology sample instructions. Please click on the hyperlink to be taken to the relevant test entry in the Test Database</p><p>CONFIRMATORY</p><p>SYPHILIS SCREEN</p><p>VARICELLA ZOSTER IGG ANTIBODY VARICELLA ZOSTER IGM ANTIBODY</p><p>BORRELIA BURGDORFERI (LYME) ANTIBODY</p><p>HEPATITIS C IGG CONFIRMATORY</p><p>HEPATITIS C IGG SCREEN</p><p>HEPATITIS E IGM/IGG ANTIBODY</p><p>CRYPTOCOCCUS ANTIGEN</p>