lab tech
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. Submit promptly for optimal recovery of pathogens. Submit in a leak-proof container at room temperature unless otherwise specified.

 

NAME

SPECIMEN REQUIREMENTS

 

 

Acid Fast Culture

 

Collect specimen in container and keep at room temperature. No preservative is necessary.

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.

Urine:  1st morning midstream void.

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 or place fluid in a heparin (green top) tube. Submit promptly for optimal recovery of pathogens.

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. Use the following aseptic technique:

  • Clean the blood collection site with chloraprep.
  • Clean the diaphragm of the bottles with alcohol.
  • Do not touch the phlebotomy site after disinfection.
  • Draw blood with a sterile syringe and needle or butterfly.
  • Immediately transfer 10 mL of blood to each bottle.
  • Mix the bottles by inversion to prevent blood from clotting.

Bordetella by PCR

Package with instructions is available upon request. Sent to the Rhode Island Department of Health for processing.

Chlamydia DNA Probe

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. It can be stored at room temperature.

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. Refrigerate.

Clostridium difficile Toxin

Submit fresh stool specimen in sterile container. Refrigerate or freeze.

CMV

All specimens except blood needs to be refrigerated as soon possible.

Blood: Aseptically draw 2 10 mL green top heparin tubes.  Keep at room temperature. 

Urine: Collect first morning specimen in a sterile container.

Other: Submit sample in viral transport media.

Cryptococcal Antigen

CSF or blood may be submitted in a sterile container. Refrigerate.

Cryptosporidium Stain

Submit fresh stool specimen in vial containing formalin.

CSF Culture

Submit CSF in sterile container. Submit promptly for optimal recovery of pathogens.  Note: tube #2 is the tube for culture. 

Fecal Leukocytes

Submit fresh stool specimen in sterile container or fresh stool in vial containing formalin.

Fungus Culture

(skin, hair, nails)

Submit specimens in sterile container.

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.

Fungus Culture Other

Submit specimens in sterile container. Swabs are acceptable but not recommended.

GC Culture

A culture swab with transport media may be submitted.

GC DNA Probe

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. It can be stored at room temperature.

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 the source. Culture swabs and specimens submitted in sterile containers can also be submitted for gram stain.

Group A Strep Rapid

Use dual culture swabs and be sure to inoculate both swabs. Culture is performed on all negatives.

Herpes Simplex Culture

Use special collection vial and swab. After swabbing the base of the lesion, place swab in viral transport vial. Label with the patient name and date. Refrigerate.

Herpes Simplex Typing

Body fluid in a sterile container or sterile swab in viral transport media is required. Refrigerate.

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.

Occult Blood Single Screen

Select slides may be submitted. Following the directions on the slide, one side is lifted and stool is smeared in the provided areas.

Occult Blood Screen x3

Select slides may be submitted. Following the directions on the slide, one side is lifted and stool is smeared in the provided areas.

Ova & Parasite

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.

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. Raw stool is not acceptable.

Pneumocystis carinii

Submit biopsy, sputum or bronchial washings in sterile container.

Rotavirus Screen

Submit fresh stool specimen in a clean container. Sample must not be contaminated with urine. Refrigerate.

Routine Culture

Fluid: Submit in sterile tube or syringe with needle removed.

Swab: Submit a culture swab in transport media within 48 hours of collection.

RSV Screen

Submit nasal washing collected in a sterile container. Refrigerate.

Sputum Culture

Submit sputum expectorated by deep cough into a sterile container.

The Adequacy of Sputum Cultures:

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" and the sputum culture will be cancelled. Gram stains exhibiting minimal oropharyngeal contamination will be reported with the number of epithelial cells and inflammatory cells. 

Stool Culture

Submit fresh stool specimen uncontaminated by urine in a vial containing Cary Blair transport media or clean container within 24 hours of collection. No more than two bacteriology specimens are recommended. Two specimens will pick up 99% of bacterial pathogens.

Streptococcus Culture –

Throat

Submit specimen on a culture swab immersed in transport media.

Streptococcus B Culture –

Pregnancy

Submit specimen on a culture swab media.

 

Throat Culture

Submit specimen on a dual culture swab immersed in transport media.

Urine Culture

Urine placed in gray-top, sterile cup or yellow top vacutainer tube. Urine collected in sterile container is also acceptable. Directions for proper collection:

1. Females should clean the periurethral area with 2 benzalkonium chloride wipes.

2. Males should clean the glans penis area with 2 benzalkonium chloride wipes.

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 or yellow-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.

Vaginal Culture

Specimens should be submitted on a culture swab immersed in transport media.

Viral Culture

Body fluid in a sterile container or sterile swab immersed in viral transport media is required. Refrigerate.

Wet Prep

Place swab in 0.5 mL saline. To detect Trichomonas, specimen should be examined as soon as possible.

MRSA Screen

Accepted on: culture swabs, urine specimens, sputum specimens, stool specimens.

VRE Screen

Accepted on: culture swabs, rectal swabs, urine specimens.

Note:  nasal swabs are inappropriate.

Rapid Flu

Accepted on: culture swabs, nasopharyngial swabs.