Microbiology Collection Instructions for Collection and Handling of Microbiology Specimens for Culture Culture Collection Instructions 1. Identify patient using corporate compliance guidelines. 2. Decontaminate skin. 3. Label specimen with patient’s first and last name, date and time of collection, and source of specimen. Label must be attached directly to culture tube or container. 4. Specimens should be transported to ThedaCare Laboratories via courier on same day of collection. Blood cultures, cerebrospinal fluid, GC (Neisseria gonorrhoeae), synovial fluid, and urogenital specimens should never be refrigerated. 5. When possible, specimens should be collected during an acute phase of illness and collected before antibiotics have been administered.
Routine Culture Transport Collection Procedure 1. 2. 3. 4. 5. 6.
Obtain syringe or culture transport swab (supplied). Wash hands. Decontaminate patient’s skin. Remove syringe or swab from package. Collect specimen directly from source of infection. Remove needle from syringe and replace with sterile cap or place swab into tube. Label tube and fill out requisition with appropriate information: date, time, specimen source, diagnosis, antibiotics given, and specific culture requested. Specimen (Source) Organism
Container/Transport Device
Other Considerations
Antrum
Syringe with fluid (preferred) or culture transport Remove needle from syringe prior to transport and swab replace with sterile cap.
Blood
Cleanse stopper with 70% alcohol. (Do not use iodine.) Draw directly into bottles using blood collection adapter system or by needle and syringe. Adults—10 mL per bottle BacT/ALERT® (FA) Aerobic (green cap) BacT/ALERT® (SN) Anaerobic (purple cap) Pediatric or difficult draw Adults - 1 mL to 4 mL in BacT/ALERT® (PF) (yellow cap) Pediatric - up to 4 mL in BacT/ALERT® (PF) (yellow cap)
A minimum of 2 and maximum of 3 separate collections per 24 hours is recommended. Specimens should be drawn 30 minutes apart unless otherwise specified. Specimen must be drawn with aseptic technique as follows: 1. Adults and children over 2 months of age: cleanse site with chlorohexidine gluconate 2%; 70% alcohol applications, using a scrubbing motion for 30 seconds. Allow area to dry for 30 seconds. 2. If further palpation of vein is necessary, cleanse finger with same method. 3. Children under 2 months of age: cleanse site with 70% alcohol. Let dry for 30 seconds.
Body Fluids
Leave in capped syringe or place in sterile, green- Collect with sterile syringe and needle; remove top (heparinized) VACUTAINER®. needle from syringe before submitting specimen to laboratory. If submitting in green-top (lithium or sodium heparin) tube, expel air from syringe prior to placing in VACUTAINER®. Do not refrigerate.
Catheter Tips
Screw-capped, sterile vial or container 2 cm to 3 cm long segments
Disinfect surrounding entry site, remove catheter, and aseptically clip off 2 cm to 3 cm of tube into sterile container. Foley catheter tip is not acceptable.
Specimen (Source) Organism
Container/Transport Device
Other Considerations
Cerebrospinal Fluid Bacterial Pathogens
Screw-capped, sterile vial
Deliver to laboratory immediately. Do not refrigerate or freeze.
Viral
Screw-capped, sterile vial
Collect m2 mL of spinal fluid. Deliver to laboratory immediately. Send specimen refrigerated. Specimen cannot be frozen.
Ear
Culture transport swab
Exudates (Drainages, Transudates, Ulcers)
Syringe (preferred) or culture transport swab
Remove needle from syringe prior to transport and replace with sterile cap.
Eyes (Conjunctiva) Bacterial Pathogens
Culture transport swab or small collection swabs Do not refrigerate.
Chlamydia DNA Probe
GEN-PROBE® Collection Kit
Fecal Material Bacterial Pathogens
Cary-Blair transport media supplied or screwcapped, sterile container
Fresh specimen recommended. Send specimen refrigerated.
Clostridium difficile
Screw-capped, sterile container
Send specimen refrigerated.
Giardia/ Cryptosporidium
Screw-capped, sterile container or 10% formalin Send specimen refrigerated. vial
Ova and Parasite
ECOFIX™ vial to Mayo
Mix thoroughly
Rectal Swab
Culture transport swab
Indicate if for Neisseria gonorrhoeae. Do not refrigerate.
Rotovirus
Screw-capped, sterile container
Send specimen refrigerated.
Viral
Screw-capped, sterile vial or rectal swab in viral Fresh specimen recommended. Send specimen transport media supplied refrigerated.
Genitourinary (Cervix, Vagina) Bacterial Pathogens
Culture transport swab
Forward promptly at ambient temperature only. Do not refrigerate. Indicate if for Neisseria gonorrhoeae.
Candida (yeast) DNA Probe
Affirm™ VPIII Collection Kit supplied
Using the swab from the kit, obtain a specimen from the posterior vaginal fornix. Twist or roll swab 3 times. Swab lateral vaginal wall while removing the swab. Immediately place swab into specimen collection tube. With swab touching bottom of tube, break swab off at second prescored line. Swab handle will fit into cap. Transport collection device within 72 hours at ambient or refrigerated temperature.
Chlamydia DNA Probe
GEN-PROBE® Collection Kit for males or females supplied
Follow collection instructions outlined in kit.
Specimen (Source) Organism
Container/Transport Device
Other Considerations
Genitourinary (Cervix, Vagina) (Cont.) Gardnerella DNA Probe
Affirm™ VPIII Collection Kit supplied
Using the swab from the kit, obtain a specimen from the posterior vaginal fornix. Twist or roll swab 3 times. Swab lateral vaginal wall while removing the swab. Immediately place swab into specimen collection tube. With swab touching bottom of tube, break swab off at second prescored line. Swab handle will fit into cap. Transport collection device within 72 hours at ambient or refrigerated temperature.
Herpes
Herpes transport media supplied
Follow collection instructions outlined in kit. Deliver to laboratory immediately.
DNA Probe
GEN-PROBE® Collection Kit for males or females supplied
Follow collection instructions outlined in kit.
Culture
Culture transport swab
Do not refrigerate.
Neisseria gonorrhoeae
Trichomonas vaginalis Wet Prep
Swab in small amount of sterile saline in a screw- Obtain swab of fresh vaginal discharge. Deliver to capped, sterile vial or VACUTAINER®. laboratory immediately. Specimen cannot be frozen or refrigerated.
DNA Probe
Affirm™ VPIII Collection Kit supplied
Yeast
Using the swab from the kit, obtain a specimen from the posterior vaginal fornix. Twist or roll swab 3 times. Swab lateral vaginal wall while removing the swab. Immediately place swab into specimen collection tube. With swab touching bottom of tube, break swab off at second prescored line. Swab handle will fit into cap. Transport collection device within 72 hours at ambient or refrigerated temperature.
Culture transport swab
Nasopharynx Bordetella pertussis
Special Collection Kit supplied
Follow collection instructions outlined in kit. Deliver to laboratory immediately.
Influenza A/Influenza B Nasopharyngeal collection and transport system Pass gently through nose into nasopharynx and supplied rotate. Place swab in transport tube. Deliver to laboratory immediately. Respiratory Syncytial Virus
Nasopharyngeal collection and transport system Pass gently through nose into nasopharynx and supplied rotate. Place swab in transport tube. Deliver to laboratory immediately.
Respiratory (Bronchial, Sputum, Washings)
Bacterial Pathogens
For sputum, if possible, have patient rinse mouth and gargle with water prior to specimen collection. Collect a fresh specimen from “deep cough” or induced by respiratory therapy. A first-morning specimen is preferred. Deliver to laboratory immediately. Screw-capped, sterile container
Specimen (Source) Organism
Container/Transport Device
Other Considerations
Respiratory (Bronchial, Sputum, Washings) (Cont.) Fungi
Screw-capped, sterile container
Legionella
Screw-capped, sterile container
Mycobacteria AFB (TB) Screw-capped, sterile container Throat Bacterial Pathogens
Culture transport swab
Rapid Strep
Culture transport swab
Group A Strep DNA Probe
Culture transport swab
Swab tonsillar areas, pharynx, and areas of ulcerations. Avoid oral contamination.
Transtracheal Aspirate
Culture transport swab or screw-capped, sterile container
Sinus
Syringe (preferred) or culture transport swab
Remove needle from syringe prior to transport and replace with sterile cap.
Tissue
Screw-capped, sterile container
Place representative specimen aseptically into container.
Screw-capped, sterile container; syringe with sterile cap; or Becton-Dickinson urine tube
For midstream, clean voided, or catheterized collection, a first-morning, clean-catch, midstream specimen is recommended. If catheterized, obtain free flow from mouth of catheter. Catheter bag is not acceptable for culture. Deliver to laboratory immediately; refrigerate specimen after collection if transport will be delayed.
Urine (Midstream, Clean Voided, or Catheterized) Bacterial Pathogens
For suprapubic aspirate, this technique should be used if anaerobic bacteriuria is suspected. Collect with sterile needle and syringe, expel air from syringe, remove needle and replace with sterile cap. Mycobacteria AFB (TB) Screw-capped, sterile container (as much urine as A first-morning, clean-catch, midstream possible [minimum volume: 40 mL]) specimen is recommended. Deliver to laboratory immediately; refrigerate specimen after collection if transport will be delayed. Cytomegalovirus (CMV) Screw-capped, sterile container
Wounds (Abscesses)
Syringe (preferred) or culture transport swab
15 mL to 20 mL of fresh urine. Refrigerate specimen after collection. Deliver to laboratory immediately. Collection with needle and syringe is preferred. Expel air before injection into VACUTAINER®. Swabs can be used but provide limited material. If swab is used, avoid skin contamination. Deliver to laboratory immediately.
