Specimen Requirements

Acceptable Specimens:
Blood, body fluid, bone marrow, bronchial washings, cerebrospinal fluid (CSF), gastric, sputum, stool, tissue/biopsy, or urine

 

Submit only 1 of the following specimens:

 

Blood

Container/Tube: Green-top (heparin) tube(s)

Specimen Volume: 5 mL (minimum volume: 1 mL) of blood

Collection Instructions: Collect specimen as follows:

1. Disinfect stopper of tube(s) with 70% alcohol and allow to dry. Repeat with iodine.
2. Use ChloraPrep® kit as follows to disinfect skin:

• Peel off package cover to remove ChloraPrep®.
• Hold applicator without touching sponge. Pinch wings once to break ampule. You should hear a pop.
• Saturate sponge with ChloraPrep® by gently pressing it against venipuncture area. Using a back and forth motion, completely wet treatment area for 30 seconds.
• Allow to dry completely (30 to 60 seconds). Do not blot or wipe solution away. Discard applicator after a single use. I

If ChloraPrep® kits are not available, disinfect skin as follows:

1. Thoroughly cleanse venipuncture site with 70% alcohol moving in concentric circles to periphery. Allow to dry. If site must be touched during venipuncture, disinfect gloved fingers.
2. Repeat previous step using iodine. Allow to dry 30 to 60 seconds or wipe with a sterile gauze.
3. Draw blood into tube(s).
4. Gently invert tube(s) 4 to 5 times to mix.
5. Label tube(s) with patient’s legal name, date and actual time of collection, and type of specimen.

 

Note:

1. Blood cultures should not be drawn through a line unless they cannot be obtained by venipuncture. If drawn from a line, discard the first 10 mL.
2. Method of specimen collection and amount of blood drawn directly influence success of recovery of isolates and interpretation of results.
3. Factors directly influencing culture results:

• Volume of blood drawn is perhaps the most important factor.
• Method of skin disinfection is also critical.

Body Fluid

Container/Tube: Sterile container(s)
Specimen Volume: Minimum volume: 2 mL of body fluid

Collection Instructions:

1. If aspirated in a syringe, replace needle with a sterile, rubber cap prior to transporting specimen.
2. Label container/syringe with patient’s legal name, date and actual time of collection, and type of specimen.

 

 

Bone Marrow

Container/Tube: Green-top (heparin) tube(s)

Specimen Volume: Minimum volume: 1 mL of bone marrow

Collection Instructions: Collect specimen as follows; sterile technique must be maintained in all steps of collection.

1. Disinfect stopper of tube(s) with 70% alcohol and allow to dry. Repeat with iodine.
2. Thoroughly cleanse overlaying skin with 70% alcohol, followed by 2% iodine tincture, moving in concentric circles to periphery. Do not remove iodine.
3. Specimen must be collected by physician trained in this procedure.
4. Obtain bone marrow.
5. Place sterile, 18-gauge needle on syringe and inject bone marrow into heparin tube(s) by puncturing stopper with needle.
6. Gently invert tube(s) 4 to 5 times to mix.
7. Label tube(s) with patient’s legal name, date and actual time of collection, and type of specimen.

 

 

Bronchial Washing

Container/Tube: Sterile container(s)
Specimen Volume: Minimum volume: 5 mL of bronchial washings

Collection Instructions: Label container with patient’s legal name, date and actual time of collection, and type of specimen. Submit first sputum specimen after bronchoscopy as well as bronchial washings.

 

 

CSF

Container/Tube: Sterile tube(s)-Anticoagulant tube is not acceptable.

Specimen Volume: Minimum volume: 2 mL of spinal fluid

Collection Instructions:

1. Aseptically collect at least 2 mL of CSF from lumbar puncture. Contamination with normal flora from skin or other body surfaces must be avoided.
2. Divide CSF into 1 to 4 screw-capped, sterile tubes.
3. Tubes should be numbered in order of draw 1, 2, 3, 4 with tube #1 representing first portion of specimen collected.
4. Promptly hand deliver to laboratory. (Do not send in pneumatic tube system).

 

 

Gastric

Container/Tube: Sterile container(s)

Specimen Volume: Minimum volume: 10 mL of gastric specimen

Collection Instructions:

1. Add 10 mg sodium bicarbonate to neutralize pH
2. Send promptly; needs to be processed ASAP

 

 

Sputum

It is recommended to collect 3 early-morning specimens on successive days (48 hours) and send in separate containers.

Do not pool specimens.

 

Submit only 1 of the following specimens:

 

Expectorated

Container/Tube: Sterile container(s)
Specimen Volume: Minimum volume: 5 mL of sputum-24-Hour collection is not acceptable.

Collection Instructions:

Note: A “deep cough” specimen, not saliva, must be collected for an adequate evaluation.

1. Instruct patient to cough deeply and expectorate sputum into container.
2. Label container with patient’s legal name, date and actual time of collection, and type of specimen.

 

Induced

Container/Tube: Sterile container(s)
Specimen Volume: Minimum volume: 5 mL of sputum-24-Hour collection is not acceptable.

Collection Instructions:

Note: A “deep cough” specimen, not saliva, must be collected for an adequate evaluation.

1. Fill ultrasonic nebulizer with 10 mL of 3% sterile sodium chloride solution.
2. Seat patient in front of nebulizer.
3. Turn on nebulizer and note strong flow of nebulizer saline from end of flex tubing.
4. Instruct patient to put end of flex tubing inside lips and inhale aerosol slowly and deeply.
5. nstruct patient to cough deeply and expectorate sputum into container.
6. If patient cannot expectorate sputum, 5 to 10 minutes of chest percussion may be administered to stimulate cough and sputum production.
7. Label container with patient’s legal name, date and actual time of collection, and type of specimen.

 

 

Stool

Container/Tube: Sterile container(s)

Specimen Volume: Minimum volume: 1 gram raw, clean stool

Collection Instructions:

1. Send on ice

 

 

Tissue/Biopsy

Container/Tube: Sterile container that contains about 1 mL of sterile saline

Specimen Volume: 1 piece of tissue

Collection Instructions:

1. Specimens are to be collected from a prepared site using sterile technique.
2. Aseptically transfer tissue into container with about 1 mL of sterile saline. Do not allow tissue to dry out.
3. Label container with patient’s legal name, date and actual time of collection, and type of specimen.

 

Urine

Container/Tube: Sterile container(s)
Specimen Volume: Minimum volume: 40 mL from a clean-catch, random urine collection

Collection Instructions: A first-morning specimen collected on 3 consecutive days is preferred. No preservative. Do not pool specimens. Collect as follows:

 

Clean-Catch, Midstream

 

Males

1. Cleanse glans with soap and water or benzalkonium chloride towelette.
2. Rinse area with water or wet gauze pads.
3. While holding foreskin retracted, begin voiding.
4. After several mL have passed, collect specimen without stopping flow of urine into container.
5. Label container with patient’s legal name, date and actual time of collection, and type of specimen.
6. Indicate method of collection (clean-catch, midstream).

 

Females

1. Thoroughly cleanse urethral area with soap and water or benzalkonium chloride towelette.
2. Rinse area with water or wet gauze pads.
3. While holding labia apart, begin voiding.
4. After several mL have passed, collect specimen without stopping flow of urine into container.
5. Label container with patient’s legal name, date and actual time of collection, and type of specimen.
6. Indicate method of collection (clean-catch, midstream).