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Category: Clinical Microbiology
Specimen Collection and Processing, Page 1 of 2
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This section serves two purposes; to assist medical staff in the details of selection, collection, and transport of clinical specimens for microbiologic analysis, and provide a model for use in writing the specimen management portion of the laboratory procedures manual. It deals with the selection, collection and processing of body fluid specimens such as abdominal-peritoneal fluid (paracentesis, ascites), blood specimens and cerebrospinal fluids. Subsequently procedures for gastrointestinal specimens such as duodenal contents, gastric-antral biopsy samples for Helicobacter pylori and gastric contents are discussed in the chapter. The chapter talks about collection and processing of respiratory specimens including bronchoscopy-bronchial washing, nasal specimens and nasopharyngeal specimens. Throat specimens, urine specimens and cystoscopic specimens are also discussed in the section. Specimens and collection methods for Chlamydia testing are tabulated in the chapter. Specimens for the detection of Mycoplasma spp. are usually of respiratory or urogenital origin, although other specimens such as blood can be submitted. Specimens and collection methods for viral testing have also been discussed in the chapter.
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Drawing of an Entero-Test capsule. In comparison to intubation, this capsule allows a less invasive examination of duodenum contents for parasitic infection.
Drawing of an Entero-Test capsule. In comparison to intubation, this capsule allows a less invasive examination of duodenum contents for parasitic infection.
Diagram of the stomach, showing the antral region.
Diagram of the stomach, showing the antral region.
Plastic collection device for obtaining specimen for pinworm analysis.
Plastic collection device for obtaining specimen for pinworm analysis.
Alternative method for pinworm collection when a paddle device is unavailable. Adapted from reference 34.
Alternative method for pinworm collection when a paddle device is unavailable. Adapted from reference 34.
Disposable sanitary device for collection of stool specimens. Oral and written directions for specimen timing, preservation, and transport to the laboratory should be provided to the patient.
Disposable sanitary device for collection of stool specimens. Oral and written directions for specimen timing, preservation, and transport to the laboratory should be provided to the patient.
For parasitology studies, patients must be given one or two special transport vials and directions for their use.
For parasitology studies, patients must be given one or two special transport vials and directions for their use.
Illustrated instructions on how to use the parasitology transport and preservative vial(s) may be helpful to patients. A non-mercury-containing fixative may be used in place of polyvinyl alcohol (PVA). Adapted from reference 34.
Illustrated instructions on how to use the parasitology transport and preservative vial(s) may be helpful to patients. A non-mercury-containing fixative may be used in place of polyvinyl alcohol (PVA). Adapted from reference 34.
Specimen quality is judged microscopically. The presence of epithelial cells usually signals the presence of commensal floras.
Specimen quality is judged microscopically. The presence of epithelial cells usually signals the presence of commensal floras.
A Lukens trap is used for collecting many respiratory aspirates.
A Lukens trap is used for collecting many respiratory aspirates.
Diagram of the nose and nasopharyngeal region. While nasal and nasopharyngeal specimens may be obtained by swab, a needle aspirate is the only specimen of choice for determining the etiologic agent(s) of sinusitis.
Diagram of the nose and nasopharyngeal region. While nasal and nasopharyngeal specimens may be obtained by swab, a needle aspirate is the only specimen of choice for determining the etiologic agent(s) of sinusitis.
Sterile, prepackaged sputum collection containers are provided to patients along with oral and written instructions on how to collect an appropriate specimen. In this system, sputum is collected in the funnel-shaped device. The tube that contains the specimen is removed, and the cap is firmly applied.
Sterile, prepackaged sputum collection containers are provided to patients along with oral and written instructions on how to collect an appropriate specimen. In this system, sputum is collected in the funnel-shaped device. The tube that contains the specimen is removed, and the cap is firmly applied.
Proper technique for obtaining throat specimens. Firmly sampling only the inflamed areas of the throat and tonsils and avoiding other oral sites will enhance detection of etiologic agents.
Proper technique for obtaining throat specimens. Firmly sampling only the inflamed areas of the throat and tonsils and avoiding other oral sites will enhance detection of etiologic agents.
Sterile, prepackaged urine collection cups, some with special transport tubes, are made available to patients along with oral and written instructions.
Sterile, prepackaged urine collection cups, some with special transport tubes, are made available to patients along with oral and written instructions.
Wound specimens should, at the least, be labeled as “surface wound” or “deep wound.” The laboratory depends on this information for selecting appropriate culture media and interpreting results.
Wound specimens should, at the least, be labeled as “surface wound” or “deep wound.” The laboratory depends on this information for selecting appropriate culture media and interpreting results.
Diagram of the ear. A swab is not the specimen of choice for laboratory diagnosis of otitis media because it obviously will not reach the infected area. Preparing the ear for specimen collection is a critical step in obtaining an appropriate specimen.
Diagram of the ear. A swab is not the specimen of choice for laboratory diagnosis of otitis media because it obviously will not reach the infected area. Preparing the ear for specimen collection is a critical step in obtaining an appropriate specimen.
Diagram of the eye. The nature and potential severity of infections of the eye dictate special attention to the details of specimen management and an accurate description of the specimen submitted for analysis.
Diagram of the eye. The nature and potential severity of infections of the eye dictate special attention to the details of specimen management and an accurate description of the specimen submitted for analysis.
Specimen management of sterile body fluids a
a Adapted from reference 4.
b WBC, white blood cell. Any cytocentrifuged sediment can be cultured or stained.
Specimen management of sterile body fluids a
a Adapted from reference 4.
b WBC, white blood cell. Any cytocentrifuged sediment can be cultured or stained.
Conditions and protocols for collecting blood specimens
Conditions and protocols for collecting blood specimens
Characteristics of preservatives used to transport feces for parasite examination a
a Data from L. S. Garcia and D. A. Bruckner, 1993, Diagnostic Medical Parasitology, 2nd ed., American Society for Microbiology, Washington, D.C.
b MIF, merthiolate–iodine–formalin; SAF, sodium acetate–acetic acid–formalin; PVA, polyvinyl alcohol.
c Formalin (5 or 10%) is often selected by manufacturers as an all-purpose fixative.
d The iodine in MIF allows observation of protozoa (cysts), eggs, and larvae without further staining.
e A good choice if a single preservative is preferred, but albumin-coated slides are required.
f Iron hematoxylin stain provides a better view of organism morphology.
g Trichuris eggs and giardia cysts are not concentrated as easily as from formalin. Isospora oocysts may not be seen. Strongyloides larval morphology is poor.
h Many of these fixatives use a zinc sulfate base rather than a mercuric chloride base.
Characteristics of preservatives used to transport feces for parasite examination a
a Data from L. S. Garcia and D. A. Bruckner, 1993, Diagnostic Medical Parasitology, 2nd ed., American Society for Microbiology, Washington, D.C.
b MIF, merthiolate–iodine–formalin; SAF, sodium acetate–acetic acid–formalin; PVA, polyvinyl alcohol.
c Formalin (5 or 10%) is often selected by manufacturers as an all-purpose fixative.
d The iodine in MIF allows observation of protozoa (cysts), eggs, and larvae without further staining.
e A good choice if a single preservative is preferred, but albumin-coated slides are required.
f Iron hematoxylin stain provides a better view of organism morphology.
g Trichuris eggs and giardia cysts are not concentrated as easily as from formalin. Isospora oocysts may not be seen. Strongyloides larval morphology is poor.
h Many of these fixatives use a zinc sulfate base rather than a mercuric chloride base.
Genital specimens for culture
Genital specimens for culture
Agents of genital infection in women
Agents of genital infection in women
Specimens and collection methods for Chlamydia testing
Specimens and collection methods for Chlamydia testing
Specimens and collection methods for viral testing
Specimens and collection methods for viral testing
Methods of collecting specimens from the eye
a CAT, computed axial tomography.
Methods of collecting specimens from the eye
a CAT, computed axial tomography.