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.

Submit only 1 of the following specimens:

Collect specimen prior to antibiotic administration because most antibiotics concentrate in the urine. If specimen transport is >2 hours, refrigerate.

Indwelling Catheter Specimen
1. Avoid sending urine that has remained stagnant in catheter tubing for any length of time or from catheters that have been in place longer than 5 to 9 days.
2. Do not collect urine from Foley drainage bag. Do not culture Foley tip.
3. Clean the sampling port with 70% alcohol.
4. Use a needle and syringe to aseptically aspirate 2 mL of fresh urine from an indwelling catheter tube through sampling port.

5. Label tube 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. Send specimen refrigerated.

8. Maintain sterility and forward promptly.

Note:  1. Specimen collection method is required on request form for processing.
2. A minimum of 1 mL of specimen is required for routine and fungus cultures. A minimum of 10 mL of specimen is required for acid-fast bacillus (AFB) culture.
3. A minimum of 5 mL of specimen should be added to preservative tubes. Preserved specimens can be stored at refrigerated temperature for up to 24 hours.

4. Voided specimens are acceptable, but not recommended.

Straight Catheter Specimen
2 mL of fresh urine from a straight catheter tube as follows:
1. Clean urethral area with soap and water.
2. Aseptically insert catheter into bladder.
3. Discard first 15 mL of urine.
4. Collect 2 mL of fresh urine from a straight catheter tube from the mid or later-flow into a sterile cup. Seal container tightly.

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

6. Place cup in biohazard transport bag.

7. Send specimen refrigerated.

8. Maintain sterility and forward promptly.
Note:  1. Specimen collection method is required on request form for processing.
2. A minimum of 1 mL of specimen is required for routine and fungus cultures. A minimum of 10 mL of specimen is required for AFB culture.
3. A minimum of 5 mL of specimen should be added to preservative tubes. Preserved specimens can be stored at refrigerated temperature for up to 24 hours.

4. Voided specimens are acceptable, but not recommended.

Midstream Specimen

Specimen must arrive within 30 minutes of collection.

2 mL of urine from a first-morning specimen collected using a Midstream Specimen Collection Power^TM Kit as follows:

Males
1. Wash hands with soap and dry. 
2. Foreskin must be completely retracted, and glans penis is cleansed with soapy water (not disinfectant). Surplus soap is removed with warm, sterile water.
3. Patient should void approximately 20 mL to 25 mL of urine into toilet, and then pass a portion of midstream urine into a sterile cup (“clean-catch”, midstream collection system). Seal container tightly.
4. Label cup with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

5. Place cup in biohazard transport bag.

6. Send specimen refrigerated.

7. Maintain sterility and forward promptly.
Note:  1. Specimen collection method is required on request form for processing.
2. A minimum of 1 mL of specimen is required for routine and fungus cultures. A minimum of 10 mL of specimen is required for AFB culture.
3. A minimum of 5 mL of specimen should be added to preservative tubes. Preserved specimens can be stored at refrigerated temperature for up to 24 hours.

4. Voided specimens are acceptable, but not recommended.

5. If routine urinalysis is ordered on same specimen, you must obtain a request for both.

Females
1. Wash hands with soap and dry.
2. If menstruating, insert a fresh tampon or use cotton to stop flow.
3. With 1 hand, spread labia and keep them continuously apart until urine is voided.
4. Taking a saturated soapy sponge (not disinfectant), wash the vulva well, passing from front to back. Discard sponge. While vulva is still spread, repeat front to back wash with remaining sponges, discarding each as its use is finished. Patient should rinse with warm sterile water to eliminate the possibility of contaminating specimen with soap.
5. Patient should void approximately 20 mL to 25 mL of urine into toilet and then pass a portion of midstream urine into a sterile cup (“clean-catch”, midstream collection system). Cup should be held in such a way that contact with legs, vulva, or clothing is avoided. Seal container tightly.

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

7. Place cup in biohazard transport bag.
8. Send specimen refrigerated.

9. Maintain sterility and forward promptly.

Note:  1. Specimen collection method is required on request form for processing.
2. A minimum of 1 mL of specimen is required for routine and fungus cultures. A minimum of 10 mL of specimen is required for AFB culture.
3. A minimum of 5 mL of specimen should be added to preservative tubes. Preserved specimens can be stored at refrigerated temperature for up to 24 hours.

4. Voided specimens are acceptable, but not recommended.

5. If routine urinalysis is ordered on same specimen, you must obtain a request for both.