SPECIMEN COLLECTION CHART for Bacteriology and Mycology Specimens

This document provides practical guidelines for the proper collection and handling of specimens which are to be analyzed in the clinical microbiology laboratory.

SPECIMEN
TYPE
COLLECTION
DEVICE
TRANSPORT*
TIME/TEMP.
AND/OR
MINIMUM VOL.


STORAGE IN
LAB
TIME/TEMP.

REF.
NUMBER
Abscess:
Open Swab transport system < 2 hours/RT < 24 hours/RT 33
Closed Anaerobic transport system, > 1ml < 2 hours/RT < 24 hours/RT 9,13,33
Bite wound: See Abscess
Blood culture:
Bacteria: blood culture vials < 2 hours/RT < 24 hours/RT,
or per instructions
10,23,25,
30,31
Adult: 10-20ml/set
Infant: 1-2ml/set
Fungi:
1. Biphasic culture
2. Lysis centrifuge

Catheter:
i.v. Sterile screw cap
tube or cup
< 15 min./RT < 24 hours,
4 degrees C.
12,22,24
Foley Do not culture ,
growth represents distal urethral flora
26
SPECIMEN
TYPE
COLLECTION
DEVICE
TRANSPORT*
TIME/TEMP.
AND/OR
MINIMUM VOL.


STORAGE IN
LAB
TIME/TEMP.

REF.
NUMBER
Cellulitis:
Capped syringe
or sterile tube
< 15 min./RT < 24 hours/RT 33,34
CSF:
Sterile screw cap tube Bacteria: never refrigerate < 24 hours/RT 14,29,35
Bacteria, > 1ml < 15 min./RT < 24 hours/RT
Fungi, > 2ml < 15 min./RT < 24 hours/RT
AFB, > 2ml < 15 min./RT < 24 hours/RT
Virus send on ice < 72 hours,
4 degrees C.
Virus, > 1ml < 15 min.,
4 degrees C.
Decubitis ulcer:
Swab transport or
anaerobic system
< 2 hours/RT < 24 hours/RT 33
Dental culture:
gingival,
periodontal,
periapical,
Vincent's stomatitis


Anaerobic
transport system
< 2 hours/RT < 24 hours/RT
Ear:
Inner Sterile tube,
swab transport medium,
or anaerobic system

< 2 hours/RT < 24 hours/RT 2
Outer Swab transport < 2 hours/RT < 24 hours,
4 degrees C.
2
Eye:
Conjunctiva Direct culture inoculation:
BAP and CHOC or
swab transport medium

Plates:
< 15min./RT
Swabs:
< 2 hours/RT


< 24 hours/RT 1,20
Corneal scrapings Direct culture inoculation:
BHI+Bld, CHOC,
and inhibitory mold agar

< 15 min./RT < 24 hours/RT 1,20
SPECIMEN
TYPE
COLLECTION
DEVICE
TRANSPORT*
TIME/TEMP.
AND/OR
MINIMUM VOL.


STORAGE IN
LAB
TIME/TEMP.

REF.
NUMBER
Feces:
Routine culture Sterile, leakproof,
wide-mouth container or enteric transport system, > 2g
Unpreserved:
< 1 hour/RT
< 24 hours, 4 degrees C.
Enteric transport system:
< 48 hours/RT

32
Clostridium difficile Sterile, leakproof,
wide-mouth container,
> 5ml

< 1 hour/RT
1-24 hours,
4 degrees C.
24 hours,
-20 deg. C.



31,21,32
Escherichia coli 0157:H7 Sterile, leakproof,
wide-mouth container
or enteric transport system, >2ml

Unpreserved:
< 1 hour/RT
< 24 hours, 4 degrees C.
Enteric transport system:
< 48 hours/RT

32
Leukocytes:
Sterile, leakproof,
wide-mouth container
or 10% formalin and/or PVA, >2ml

Unpreserved:
< 1 hour/RT
< 24 hours, 4 degrees C.
In formalin or PVA: indefinite/RT
17
Rectal swab:
Swab transport < 2 hours/RT < 24 hours/RT
Fistulas: See Abscess
Fluids:
abdominal,
ascites, bile,
joint, pericardial,
peritoneal, pleural,
synovial



Sterile
screw cap tube or
anaerobic transport system, > 1ml

< 15 min./RT < 24 hours/RT, except pericardial fluid and fungal cultures
Gangrenous tissue: See Abscess
SPECIMEN
TYPE
COLLECTION
DEVICE
TRANSPORT*
TIME/TEMP.
AND/OR
MINIMUM VOL.


STORAGE IN
LAB
TIME/TEMP.

REF.
NUMBER
Gastric:
wash or
lavage fluid
Sterile leakproof container < 15 min./RT,
or neutralize
within 1 hour
of collection


< 24 hours,
4 degrees C.
6
Genital - female:
Amniotic Anaerobic transport system, > 1ml < 15 min./RT < 24 hours/RT 36
Bartholin Anaerobic transport system, > 1ml < 2 hours/RT < 24 hours/RT
Cervix Swab transport < 2 hours/RT < 24 hours/RT 11
Cul-de-sac Anaerobic transport system, >1ml < 2 hours/RT < 24 hours/RT
Endometrium Anaerobic transport system, > 1ml < 2 hours/RT < 24 hours/RT
Products of conception Sterile tube or
anaerobic transport system
< 2 hours/RT < 24 hours/RT
Urethra Swab transport < 2 hours/RT < 24 hours/RT 11
Vagina Swab transport < 2 hours/RT < 24 hours/RT 11
Genital - female or male lesion:
Swab transport < 2 hours/RT < 24 hours/RT
Genital - male:
Prostate Swab transport or
sterile tube
< 2 hours/RT < 24 hours/RT 8
Urethra Swab transport < 2 hours/RT < 24 hours/RT
Hair:
dermato-phytosis Clean container,
10 hairs
< 24 hours/RT 16
SPECIMEN
TYPE
COLLECTION
DEVICE
TRANSPORT*
TIME/TEMP.
AND/OR
MINIMUM VOL.


STORAGE IN
LAB
TIME/TEMP.

REF.
NUMBER
Nail:
dermato-phytosis Clean container, enough scrapings to cover head of thumbtack < 24 hours/RT 16
Pilonidal cyst: See Abscess
Respiratory tract - lower:
BAL, BBW, tracheal aspirate Sterile container, >1ml < 2 hours/RT < 24 hours,
4 degrees C.
Sputum Expectorate Sterile container, >1ml < 2 hours/RT < 24 hours,
4 degrees C.
Induced Sterile container < 2 hours/RT < 24 hours/RT 4
Respiratory tract - upper:
Oral Swab transport < 2 hours/RT < 24 hours/RT
Nasal Swab transport < 2 hours/RT < 24 hours/RT
Nasopharynx Direct medium inoculation or swab transport Plates:
< 15 min./RT
Swabs:
< 2 hours/RT


< 24 hours/RT 2
Throat Swab transport < 2 hours/RT < 24 hours/RT
Skin:
dermato-phytosis Clean container, enough scrapings to cover head of thumbtack < 24 hours/RT 16
SPECIMEN
TYPE
COLLECTION
DEVICE
TRANSPORT*
TIME/TEMP.
AND/OR
MINIMUM VOL.


STORAGE IN
LAB
TIME/TEMP.

REF.
NUMBER
Tissue:
Anaerobic transport system < 15 min./RT < 24 hours/RT
Urine:
Female, midstream Sterile wide-mouth container, > 1ml, or urine transport kit Unpreserved:
< 2 hours/RT
< 24 hours, 4 degrees C.
Preserved:
< 24 hours/RT

7
Male, midstream Sterile wide-mouth container, > 1ml, or urine transport kit Unpreserved:
< 2 hours/RT
Preserved:
< 24 hours/RT


< 24 hours,
4 degrees C.
7
Straight catheter Sterile leakproof container Unpreserved:
< 2 hours/RT
Preserved:
< 24 hours/RT


< 24 hours,
4 degrees C.
7
Indwelling catheter Sterile leakproof container Unpreserved:
< 2 hours/RT
Preserved:
< 24 hours/RT


< 24 hours,
4 degrees C.
8
Wound: See Abscess

Abbreviations:
AFB: acid-fast bacilli
BAL: bronchoalveolar lavage
BAP: blood agar plate
BHI+Bld: brain heart infusion plus 10% sheep blood
BBW: bronchial brushing or washing
CHOC: chocolate agar
CSF: cerebrospinal fluid
deg.: degrees
i.v.: intravenous
PVA: polyvinyl alcohol fi-xative
RT: room temperature.










* Transport all specimens in leakproof plastic bags with a separate compartment for the requisition.

REFERENCES

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2. Bannatyne, R.M., et al. 1979. Cumitech 10; Laboratory Diagnosis of Upper Respiratory Tract Infections , American Society for Microbiology, Washington, D.C.

3. Bannister, E.R. 1993. Clostridium difficile and toxin detection. Clin. Microbiol. Newsl. ; 15:121-123.

4. Bartlett, J.G., et al. 1987. Cumitech 7A; Laboratory Diagnosis of Lower Respiratory Tract Infections , American Society for Microbiology, Washington, D.C.

5. Balows, A. 1985. Manual of Clinical Microbiology , 4th ed. American Society for Microbiology, Washington, D.C.

6. Carr, D.T., et al. Mayo Clin. Proc. ; 42:23-25.

7. Clarridge, J.E., et al. 1987. Cumitech 2A; Laboratory Diagnosis of Urinary Tract Infections , American Society for Microbiology, Washington, D.C.

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11. Eschenbach, D., et al. 1983. Cumitech 17; Laboratory Diagnosis of Female Genital Tract Infections , American Society for Microbiology, Washington, D.C.

12. Goldmann, D.A. and Pier, G.B. 1993. Pathogenesis of infections related to intravascular catheterization, Clin. Microbiol. Rev. ; 6:176-187.

13. Finegold, S.W., and George, W.L. (ed.). 1989. Bite infections, p. 455-463; Anaerobic Infections in Humans , Academic Press, Inc., San Diego, CA.

14. Gray, L.D., and Fedorko, D.P. 1992. Laboratory diagnosis of bacterial meningitis, Clin. Microbiol. Rev. ; 5:130-145.

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16. Haley, L.D. et al. 1980. Cumitech 11; Practical Methods for Culture and Identification of Fungi in the Clinical Microbiology Laboratory , American Society for Microbiology, Washington D.C.

17. Harris, J.C., et al. 1972. Fecal leukocytes in diarrheal illness, Ann. Intern. Med. ; 76:697-703.

18. Isenberg, H.D., et al. 1979. Cumitech 9; Collection and Processing of Bacteriological Specimens , American Society for Microbiology, Washington, D.C.

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24. Karan, S., (ed.). 1980. Controversies in Surgical Sepsis , Praeger, New York, NY.

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27. Guidelines for Laboratory Safety , CAP Environment, Safety, and Health Committee, Clinical Laboratory Standards Institute (CLSI - formerly NCCLS), Villanova, PA.

28. Protection of Laboratory Workers from Infectious Disease Transmitted by Blood, Body Fluid, and Tissue , Tentative Standard; M29-T2, Vol. 11, No. 14. 1991. Clinical Laboratory Standards Institute (CLSI - formerly NCCLS), Villanova, PA.

29. Ray, C.G., et al. 1982. Cumitech 14; Laboratory Diagnosis of Central Nervous System Infections , American Society for Microbiology, Washington, D.C.

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