Specimen Requirements

Acceptable Specimens:

Body fluid (peritoneal, pleural, synovial), bronchial washings, cerebrospinal fluid (CSF), drainage, exudate, eye, hair, nails, pus, sputum, skin, tissue/biopsy, transtracheal aspirate, urine, or vagina/cervix

 

Submit only 1 of the following specimens:

 

Body Fluid

Container/Tube: Sterile container(s)

Specimen Volume: 2 mL (minimum volume: 1 mL) of body fluid

Collection Instructions:

1. Aseptically collect body fluid.
2. Transfer body fluid to sterile container(s).
3. If collected with a needle and syringe, remove needle and cap syringe.
4. Label container(s)/syringe with patient’s legal name, date and actual time of collection, and type of specimen.

Bronchial Washing

Container/Tube: Sterile container(s)
Specimen Volume: 1 mL to 2 mL of bronchial washing

Collection Instructions: Label container with patient’s legal name, date and actual time of collection, and type of specimen.

 

CSF

Container/Tube: Sterile tube(s)

Specimen Volume: 2 mL (minimum volume: 1 mL) of CSF

Collection Instructions:

1. Aseptically collect 1 mL to 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.

Drainage, Exudate, Pus

Aspirate

Container/Tube: Sterile container(s)
Specimen Volume: 0.5 mL of aspirate

Collection Instructions: Aspirate material using sterile syringe as follows:

1. Disinfect skin surface with 70% alcohol. Allow to dry.
2. Aspirate with sterile needle and syringe or catheter.
3. Transfer aspirate to sterile container.
4. If aspirated in a syringe, replace needle with a sterile, rubber cap prior to transporting specimen.
5. Label container/syringe with patient’s legal name, date and actual time of collection, and type of specimen.

ALTERNATE:

 

Swab

Container/Tube: Swab(s)
Specimen Volume: Entire specimen

Collection Instructions:

1. If unable to collect aspirate, 2 sterile culture swab may be used to obtain specimen.
2. Insert swabs into moist sponge in swab container to preserve specimen.
3. Label container with patient’s legal name, date and actual time of collection, and type of specimen.

Eye

 

Call Logan Health Medical Center Laboratory Microbiology Department at 406-752-1737 to obtain media prior to collection if direct plating is necessary. Media may be inoculated at bedside with exudate or corneal scrapings due to small amount of inoculum available.

 

Specimen must arrive as soon as possible after collection.

 

Submit only 1 of the following specimens:

Swab

Container/Tube: Swab(s)
Specimen Volume: Entire specimen

Collection Instructions: Collect specimen as follows:

1. Take swab for culture before application of topical anesthetics because topical anesthetics possess antimicrobial activity. Take corneal scraping after application of anesthetics.
2. Cleanse skin around eye with mild antiseptic.
3. Gently remove makeup and ointment with sterile cotton and saline.
4. Collect specimen by swabbing.
5. Moisten sterile swab with sterile saline.
6. Pass moistened swab 2 times over lower conjunctiva.
7. Avoid eyelid border and lashes. (Culture these separately in a similar fashion, if indicated.)
8. Insert swab into moist sponge in swab container to preserve specimen.
9. Label container with patient’s legal name, date and actual time of collection, type of specimen, and as right or left eye.

Note: Specimen source (right or left eye) is required.

 

Scraping

Container/Tube: Sterile container(s) with medium
Specimen Volume: Entire specimen

Collection Instructions:

1. Scraping should be done by an ophthalmologist.
2. Use local anesthetic and platinum spatula.
3. Rub spatula with scrapings gently over small area on medium.
4. If too dry, use very small amount of sterile water.
5. Label container with patient’s legal name, date and actual time of collection, type of specimen, and as right or left eye.

Note: Specimen source (right or left eye) is required.

 

Hair
            Container/Tube: Sterile container(s)

Specimen Volume: 10 to 12 affected hairs with the shaft intact

Collection Instructions:

1. Use a Wood’s lamp during collection, if possible (some infected hairs exhibit fluorescence).
2. Use sterile forceps to pluck 10 to 12 hairs which are broken off or appear diseased.
3. If diseased hair stubs are not apparent, use sterile scalpel to scrape edges of scalp lesion as follows:

• Cleanse lesion with 70% isopropyl alcohol.
• Scrape from outer periphery or border of lesion or involved area.

1. Place specimen in container.
2. Label container with patient’s legal name, date and actual time of collection, and type of specimen.

 

Nails
            Container/Tube: Sterile container(s)

Specimen Volume: Material or debris from under the nail

Collection Instructions:

1. Remove nail polish.

2. Cleanse with 70% isopropyl alcohol.

3. Clip a generous portion of affected nail and obtain scrapings of excess keratin produced beneath nail.

4. Place specimen in container.
5. Label container with patient’s legal name, date and actual time of collection, and type of specimen.

 

Skin

Container/Tube: Sterile container(s)

Specimen Volume: Entire specimen

Collection Instructions:
1. Cleanse lesion with 70% isopropyl alcohol.
2. Scrape from outer periphery or border of lesion or involved area.
3. Place specimen in container.

4. Label container with patient’s legal name, date and actual time of collection, and type of specimen.

 

Sputum

Submit only 1 of the following specimens:

    Note: 1. A “deep cough” specimen, not saliva, must be collected for an adequate evaluation.

 

Expectorated

Container/Tube: Sterile container(s)
Specimen Volume: 2 mL (minimum volume: 1 mL) of sputum-24-Hour collection is not acceptable.

Collection Instructions:

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: 2 mL (minimum volume: 1 mL) of sputum-24-Hour collection is not acceptable.

Collection Instructions:

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. Instruct 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.

 

Tissue/Biopsy

Container/Tube: Sterile container that contains 5 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 5 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.

 

Transtracheal Aspirate 

Container/Tube: Sterile container(s)
Specimen Volume: 2 mL (minimum volume: 0.5 mL) of transtracheal aspirate

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.

 

Urine

Submit only 1 of the following specimens:

 

   Container/Tube: Sterile container(s) or VACUTAINER® Urine Collection System
   Specimen Volume: 2 mL (minimum volume: 0.5 mL) from a random urine collection

   Collection Instructions:

1. A first-morning specimen is preferred. No preservative.
2. Specimen Source is Required
3. Indicate method of collection (Catheterized, Clean Catch, Midstream, U-bag or Pedi-bag)
4.  If using VACUTAINER® Urine Collection system, fill gray-top tube (minimum volume: 1 mL) with urine.

 

           Collect as follows:

 

 

Catheterized
1. Do not collect urine from drainage bag.
2. Disinfect catheter collection port with 70% alcohol.
3. Use a needle and syringe to aseptically collect urine.
4. Transfer specimen to sterile container.

5. Label container/tube with patient’s legal name, date and actual time of collection, and type of specimen.

 

 

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.

 

 

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.

 

 

Infants or Small Children

1. After cleansing appropriately, as above, place a sterile urine bag (U-Bag, Pedi-Bag) over labia or penis.

2. After 30 minutes, observe for presence of urine. If no urine is present, recleanse patient and attach a new bag.

3. Transfer specimen to container.

4. Label container with patient’s legal name, date and actual time of collection, and type of specimen.

 

 

Suprapubic Aspiration

1. Expose area above pubis.
2. Scrub area with povidone-iodine surgical scrub. Cover area with povidone-iodine solution. Allow to dry.
3. Using a sterile needle and syringe, urine from bladder.
4. Transfer urine to container.
5. Label container with patient’s legal name, date and actual time of collection, and type of specimen.
6. Indicate method of collection (suprapubic aspiration).

 

Vagina, Cervix

    Container/Tube: Swab(s)

    Specimen Volume: Entire specimen

    Collection Instructions:

1. Wipe away excess vaginal secretion or discharge.
2. Insert 2 large culture swabs into vagina and swab endocervix.
3. Insert swabs into moist sponge in swab container to preserve specimen.
4. Label container with patient’s legal name, date and actual time of collection, and type of specimen.