Specimen Requirements

Optimal times for specimen collection must be based upon both the type of infectious disease process and ability of laboratory to expertly process specimens. The Microbiology Laboratory is not as well staffed during evening and late night hours. Specimens collected late in the evening often do not produce adequate growth by next morning. STAT testing is available at all times for critical tests including blood cultures, body fluid Gram stains, etc.
 
Specimen must arrive within 2 hours of collection.
 
Submit only 1 of the following specimens:

 

Abdomen, Ascetic Fluid, Bile Fluid, Biopsy Material, Gastric Fluid, Miscellaneous, Peritoneal Fluid, Pleural Fluid, Synovial Fluid

1. Aseptically collect specimen using a sterile syringe or culture swab.

2. Place specimen in a screw-capped, sterile container or swab in culture transport tube.

3. Label container/tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

4. Place container/tube in biohazard transport bag.

5. Maintain sterility and forward promptly.

Note:  1. Specimen source and site are required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Appendix, Bone, Bone Marrow, Gallbladder, Joint, Prostate

1. Aseptically collect aspirate or biopsy material using a sterile syringe or culture swab. (Superficial material collected with culture swab is not acceptable.)

2. Place specimen in a screw-capped, sterile container or swab in culture transport tube.

3. Label container/tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

4. Place container/tube in biohazard transport bag.

5. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Bronchial Brushings or Washings

1. Aseptically collect and place bronchial brushings or washings in a screw-capped, sterile container.
2. Label container with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

3. Place container in biohazard transport bag.

4. Maintain sterility and forward promptly.

Note:  1. Specimen source and site are required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Catheter Tip (Urine or Non-Urine)

1. Aseptically collect a 2-inch distal segment of catheter by clipping off end of catheter directly into a screw-capped, sterile container at the time catheter is removed.
2. Label container with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

3. Place container in biohazard transport bag.

4. Maintain sterility and forward promptly.

Note:  1. Catheter type is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Central Nervous System

1. Aseptically collect abscess aspirate or biopsy material using a sterile syringe or culture swab.

2. Place specimen in a screw-capped, sterile container or swab in culture transport tube.

3. Label container/tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

4. Place container/tube in biohazard transport bag.

5. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Ear

1. Cleanse external canal with mild detergent.

2. Carefully swab drainage from tympanocentesis (otitis media) using a sterile culture swab.

3. Place swab in culture transport tube.

4. Label tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

5. Place tube in biohazard transport bag.

6. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Eye

Corneal Scrapings

Submit physician collected material (maximum amount) from conjunctiva or corneal scrapings as follows:

1. Collect before application of antibiotics.

2. Avoid touching external skin.

3. Both eyes should be cultured.

4. Place specimen in a screw-capped, sterile container.

5. Label container with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

6. Place container in biohazard transport bag.

7. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Conjunctiva Swab

1. Aseptically collect conjunctiva specimen using a sterile culture swab. Roll swab over inferior tarsal conjunctiva (inside surface of eyelid).

2. Place swab in culture transport tube.

3. Label tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

4. Place tube in biohazard transport bag.

5. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Genital Tract, Female

1. Aseptically collect culdoscopy specimen, endometrial aspirate obtained by suction or protected collector, abscess aspirate obtained by sterile syringe, biopsy material or culture swab obtained surgically, or an IUD. (Vaginal or cervical swab is not acceptable.)

2. Place specimen in a screw-capped, sterile container or swab in culture transport tube.

3. Label container/tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

4. Place container/tube in biohazard transport bag.

5. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Head and Neck

1. Aseptically collect abscess aspirate obtained by sterile syringe. When aspiration is not feasible, submit culture swab or biopsy material obtained surgically. (Throat or nasopharyngeal swab is not acceptable.)

2. Place specimen in a screw-capped, sterile container or swab in culture transport tube.

3. Label container/tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

4. Place container/tube in biohazard transport bag.

5. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Large Bowel

Only for culture or toxin assay for suspected involvement of Clostridium difficile or Clostridium botulinum.

 

1. Aseptically collect tissue from large bowel and place in a screw-capped, sterile container.

2. Label container with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

3. Place container in biohazard transport bag.

4. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Lung

1. Aseptically collect transtracheal aspirate, material from percutaneous lung puncture, anaerobic swab or biopsy material surgically obtained, or a bronchoscopic specimen obtained by protected brush or thoracotomy. (Expectorated sputum, induced sputum, or endotracheal aspirate is not acceptable.)

2. Place specimen in a screw-capped, sterile container or swab in culture transport tube.

3. Label container/tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

4. Place container/tube in biohazard transport bag.

5. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Nasopharyngeal

1. Instruct patient not to swallow during procedure.
2. Hyperextend patient’s head (approximately 70° angle). Suction approximately 4 mL of sterile, normal saline into a sterile bulb. (Bloody specimen is not acceptable.)
3. Insert bulb into nostril.
4. Instill saline into nostril with 1 squeeze of the bulb, and immediately release bulb to collect recoverable nasal washing.
5. Empty bulb into a screw-capped, sterile container.
6. Repeat above steps on the other nostril.

7. Label container with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

8. Place container in biohazard transport bag.

9. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Oral Mouth (Gums, Socket, Tongue)

1. Aseptically collect specimen using a sterile culture swab. (Superficial material collected from skin surface or edges of wound is not acceptable.)

2. Place swab in a screw-capped, sterile container or in culture transport tube.

3. Label container/tube with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

4. Place container in biohazard transport bag.

5. Maintain sterility and forward promptly.

Note:  1. Specimen source and site are required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Rectum
1. Insert a sterile swab approximately 1 inch (2.5 cm) beyond anal sphincter.
2. Gently rotate swab to sample anal crypts.
3. Avoid fecal contamination as much as possible.

4. Place swab in culture transport tube.
5. Label tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

6. Place tube in biohazard transport bag.

7. Maintain sterility and forward promptly.
Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Skin

1. Aseptically collect abscess aspirate obtained by sterile syringe. When aspiration is not feasible, submit culture swab or biopsy material obtained surgically.

2. Place specimen in a screw-capped, sterile container or swab in culture transport tube.

3. Label container/tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

4. Place container/tube in biohazard transport bag.

5. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Soft Tissue

1. Aseptically collect aspirate obtained by sterile syringe, biopsy material obtained surgically, aspirate from sinus tract obtained by sterile needle and small plastic catheter, deep aspirate of open wound margin, or surface ulcer. (Superficial material collected from skin surface or edges of wound is not acceptable.)
2. Place specimen in a screw-capped, sterile container.

3. Label container with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

4. Place container in biohazard transport bag.

5. Maintain sterility and forward promptly.

Note:  1. Specimen source and site are required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Spinal Fluid

1. Submit 1.5 mL of spinal fluid aseptically collected surgically by physician in a screw-capped, sterile vial.

2. Label vial with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

3. Place vial in biohazard transport bag.

4. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Stomach and Small Bowel

Only for workup of blind-loop malabsorption syndrome.

 

1. Aseptically collect tissue from stomach or small bowel and place in a screw-capped, sterile container.

2. Label container with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

3. Place container in biohazard transport bag.

4. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Tracheal Brushings

1. Aseptically collect and place tracheal brushings in a screw-capped, sterile container.
2. Label container with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

3. Place container in biohazard transport bag.

4. Maintain sterility and forward promptly.

Note:  1. Specimen source and site are required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Tracheal Washings
1. Aseptically collect and place tracheal washings in a screw-capped, sterile container.
2. Label container with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

3. Place container in biohazard transport bag.

4. Maintain sterility and forward promptly.

Note:  1. Specimen source and site are required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Urethra
1. Cleanse external urethra before collecting urethral specimen.

2. Insert a wire-shafted swab 2 cm to 4 cm into urethral lumen.

3. Avoid touching swab to uninfected mucosal surfaces.
4. Rotate swab and leave in place for at least 2 seconds.
5. Place swab in culture transport tube.

Note:  1. If possible, inoculate Thayer-Martin plate at patient’s bedside.

2. Submit streaked plates for off-site collections or delayed shipments in Swirley Bag with CO₂ generator obtained from laboratory.

 

6. Label tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

7. Place tube in biohazard transport bag.

8. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Urinary Tract

1. Aseptically collect suprapubic aspirate or catheterized urine in a screw-capped, sterile container. (Voided urine is not acceptable.)

2. Label container with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

3. Place container in biohazard transport bag.

4. Maintain sterility and forward promptly.

Note:  1. Specimen source is required on request form for processing.

2. Physician request sheet must accompany specimen.

 

Vagina

1. Wipe away excessive amount of secretions or discharge.
2. Collect secretions from mucosal membrane of vaginal vault with a sterile culture swab.
3. Unscrew cap of transport tube, insert swab into transport tube containing 1 mL of sterile saline, and break swab at score line. Replace cap securely making sure swab fits into cap, and then screw on cap until it clicks into place.
4. Label tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

5. Place tube in biohazard transport bag.
6. Maintain sterility and forward promptly.
Note:  1. Specimen source is required on request form for processing.
2. Maximum storage of specimen is 24 hours at ambient temperature. Specimen will not be processed if transport/storage times are exceeded. Extended storage of specimen (beyond 2 hours) will decrease motility of organism, therefore, making organism more difficult to detect. Extended storage will also increase bacterial numbers.
3. Trichomonas vaginalis is most easily detected when the organism is motile.

 

Vesicle Fluid

1. Wash vesicle with sterile saline.

2. Aseptically collect vesicle fluid aspirate or biopsy material using a sterile syringe or culture swab.

3. Place specimen in a screw-capped, sterile container or swab in culture transport tube.

4. Label container/tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

5. Place container/tube in biohazard transport bag.

6. Maintain sterility and forward promptly.

Note:  1. Specimen source and site are required on request form for processing.

2. Physician request sheet must accompany specimen.