Microbiology Specimens

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The patient’s name and the source of specimen must be on both the requisition and the specimen. A culture is only as accurate as the method used for collection. Outside microorganisms may contaminate a specimen during each phase of handling. This can lead to misleading or erroneous results. Take care at all times to avoid contamination.

CODE	NAME	SPECIMEN REQUIREMENTS
3762	Acid Fast Culture	Sputum: 5 to 10 mL of early morning expectorant from a deep cough. Blood: 10 mL for adults or 1.5 mL for children collected aseptically and placed in SPS (yellow) tubes. Collect specimen in container and hold at room temperature until courier pickup. No preservative is necessary.
701	Acid Fast Smear	Sputum: 5 to 10 mL of early morning expectorant from a deep cough. Blood: 10 mL for adults or 1.5 mL for children collected aseptically and placed in SPS (yellow) tubes. Collect specimen in container and hold at room temperature until courier pickup. No preservative is necessary.
745	Anaerobic Culture	Be sure specimen is from suitable anaerobic sterile body site or deep body cavity. Send a culture swab immersed in transport media or fluid in syringe with air expelled and needle removed. Hold at room temperature until courier pickup. Submit promptly for optimal recovery of pathogens.
705	Blood Culture	Ideally, 20 mL of blood is drawn and split between an aerobic bottle and an anaerobic bottle. For pediatric draws, 1 to 2 mL blood may be submitted in an aerobic bottle. Hold at room temperature until courier pickup. Use the following aseptic technique: Clean the blood collection site with alcohol. Disinfect the site with iodine and allow to dry 1 to 2 minutes. Clean the diaphragm of the bottles with alcohol. Do not touch the phlebotomy site after disinfection. Draw blood with a sterile syringe and needle. Immediately transfer 20 mL of blood to each bottle. Mix the bottles by inversion to prevent blood from clotting. Remove iodine from the patient’s arm with alcohol.
5630	Chlamydia Aptima Probe (Amplified DNA)	Two swabs are provided for collection of specimen. The first is used to remove mucus. The second is used for collection and is broken off into the vial provided. Swab can be used for male or femile genital collection source. Hold at room temperature until courier pickup. Urine in a sterile container is also acceptable for testing. Refrigerate.
732	Chlamydia Culture	A conical centrifuge tube containing viral transport media is provided. Use a swab to collect the specimen. It is broken off into the tube and should be immersed in the liquid media. Please include source. Refrigerate.
750	Clostridium difficile Culture	Submit fresh stool specimen in sterile container. Hold at room temperature until courier pickup.
656	Clostridium difficile Toxin	Submit fresh stool specimen in sterile container. Refrigerate.
3740	CMV Culture	All specimens need to be refrigerated as soon as possible. Blood: Draw 10 mL blood aseptically into heparin (green-top) tube. Urine: Collect random specimen in a sterile container. Other: Submit sample in viral transport media.
1542	Cryptococcal Antigen	CSF or blood may be submitted in a sterile container. Refrigerate.
309	Cryptosporidium Stain	Submit fresh stool specimen in vial containing formalin. Hold at room temperature until courier pickup.
706	CSF Culture	Submit CSF in sterile container. Submit promptly for optimal recovery of pathogens. Hold at room temperature until courier pickup.
1060	Fecal Leukocytes	Submit fresh stool specimen in sterile container or fresh stool in vial containing formalin. Hold at room temperature until courier pickup.
728	Fungus Culture (skin, hair, nails)	Submit specimen in sterile container. Please specify source. Hold at room temperature until courier pickup.
728	Fungus Culture Blood	Blood specimens should be collected aseptically and submitted in Isolator tubes. Appropriate sample size for adults is 10 mL. Pediatric specimens of 1.5 mL are acceptable. Hold at room temperature until courier pickup.
710	GC Culture	A culture swab with transport media may be submitted. A Jembec plate is also acceptable. The plate is inoculated by rolling the swab on the agar surface in a Z-pattern. A CO2 generator capsule is then placed in the space provided. The plate is then sealed in the provided plastic sack. Hold at room temperature until courier pickup.
5620	GC Aptima Probe (Amplified DNA)	Two separate swabs are provided for collection of the specimen. The first is used to remove mucus. The second is used for collection and is broken off into the vial provided. Swab can be used for male or female genital collection source. Hold at room temperature until courier pickup.
721	Gram Stain	Smear glass slide with specimen at time of collection and air dry. Always smear slide frosted side up. Label slide in pencil on frosted area with patient’s name and source. Culture swabs and specimens submitted in sterile containers can also be submitted for gram stain. Hold at room temperature until courier pickup.
702	Group A Strep	Submit specimen on a culture swab immersed in transport media. Hold at room temperature until courier pickup.
5810	Herpes Simplex Culture	Use special collection vial (M4 transport media) and swab. After swabbing the base of the lesion, place swab in viral transport vial. Label with the patient name and date. Refrigerate.
5872	Herpes Simplex Typing	Body fluid in a sterile container or sterile swab in viral transport media (M4 transport media) is required. Refrigerate.
7239	Influenza A&B Screen	Nasal washing or swab, throat swab in viral transport media (M4 media). Note: only polyester tipped swabs with aluminum or plastic shafts are acceptable. Refrigerate.
7237	Influenza H1N1 (Swine Flu) by RT-PCR	Nasal washing or swab, throat swab in viral transport media (M4 media). Note: only polyester tipped swabs with aluminum or plastic shafts are acceptable. Refrigerate.
7238	Influenza A, B, H1N1 Panel by RT-PCR	Nasal washing or swab, throat swab in viral transport media (M4 media). Note: only polyester tipped swabs with aluminum or plastic shafts are acceptable. Refrigerate.
722	KOH Preparation	Skin scrapings may be submitted in a clean 50 mL screw cap container. A swab of mucus membrane may be submitted. Do not submit specimens crushed between two slides. Hold at room temperature until courier pickup.
723	Occult Blood Single Screen	Hemoccult slides may be submitted. Following the directions on the slide, one side is lifted and stool is smeared in the provided areas. Hold at room temperature until courier pickup.
2057	Occult Blood Screen x3	Hemoccult slides may be submitted. Following the directions on the slide, one side is lifted and stool is smeared in the provided areas. Hold at room temperature until courier pickup.
724	Ova & Parasite Fecal x1	Submit fresh stool specimen in stool preservative vials (one formalin and one PVA vial). Fecal leukocytes can be performed with this specimen. No more than three parasitology specimens are recommended. Three O & P specimens will pick up 99% of parasitic pathogens. Hold at room temperature until courier pickup.
737	Ova & Parasite Fecal x3	Submit fresh stool specimen in stool preservative vials (one formalin and one PVA vial). Fecal leukocytes can be performed with this specimen. No more than three parasitology specimens are recommended. Three O & P specimens will pick up 99% of parasitic pathogens. Hold at room temperature until courier pickup.
725	Pinworm Slide	Plastic paddle specimens are preferred. Clear tape may be acceptable but is not recommended. Collect first thing in the morning by gently pressing the sticky side of the paddle against the anus. Frosted tape cannot be used. Hold at room temperature until courier pickup.
993	Rotavirus Screen	Submit fresh stool specimen in a clean container. Sample must not be contaminated with urine. Refrigerate.
741	Routine Culture	Fluid: Submit in sterile tube or syringe with needle removed. Swab: Submit a culture swab in transport media. Tissue: Submit in a sterile container immersed in a small amount of sterile saline. Please specify source. Hold a room temperature until courier pickup.
1002	RSV Screen	Submit nasal washing collected in a sterile container. Refrigerate.
712	Sputum Culture	Submit sputum expectorated by deep cough into a sterile container. The Adequacy of Sputum Cultures: At CPL, a gram stain is performed on all sputum cultures reporting bacteria, epithelial cells and inflammatory cells. This information can be used to assess the adequacy of the sputum collection. A specimen containing greater than 10 squamous epithelial cells/low power field suggests oropharyngeal contamination, and the gram stain will be reported as "possible oropharyngeal contamination". Gram stains exhibiting minimal oropharyngeal contamination will be reported with the number of epithelial cells and inflammatory cells. Because recollection may be difficult or may delay clinical evaluation, CPL does not cancel the sputum culture in cases of possible oral cavity contamination, unless the client communicates with the Microbiology department. If the client feels the collection was inadequate based on the gram stain report, a recollection should be considered. Refrigerate.
713	Stool Culture	Submit fresh stool specimen uncontaminated by urine in a vial containing Cary Blair transport media. No more than two bacteriology specimens are recommended. Two specimens will pick up 99% of bacterial pathogens. Hold at room temperature until courier pickup.
702	Streptococcus Culture– Throat	Submit specimen on a culture swab immersed in transport media. Hold at room temperature until courier pickup.
3066	Streptococcus B Culture– Cervical	Submit specimen on a culture swab immersed in transport media. Hold at room temperature until courier pickup.
714	Throat Culture	Submit specimen on a dual culture swab immersed in transport media. Hold at room temperature until courier pickup.
715	Urine Culture	Urine placed in gray-top transport tube is preferred. Urine collected in sterile container is also acceptable. Directions for proper collection: 1. Females should clean the periurethral area with water. 2. Males should clean the glans penis area with water. 3. Allow the initial flow of urine to commence and then collect a midstream portion into a sterile container. 4. Submit sealed container refrigerated or transfer urine to gray-top preservative tube at room temperature. Note: If urinalysis is also ordered, an unpreserved sample should be submitted for that test. Susceptibility testing is not routinely performed on voided specimens with mixed urogenital flora or on colony counts below 10,000 CFU/mL.
716	Vaginal Culture	Specimens should be submitted on a culture swab immersed in transport media. Hold at room temperature until courier pickup.
3785	Viral Culture	Body fluid in a sterile container or sterile swab immersed in viral transport media is required. Refrigerate.
1061	Wet Prep	Place swab in 0.5 mL saline. To detect Trichomonas, specimen should be examined as soon as possible. Hold at room temperature until courier pickup.