Specimen Type

Collection

Guidelines                        Device and/or

                                         minimum vol

Time and Temp

Local       Courier
Transport ^b   or

                  local 
            storage

Replica

limits

Comments

Fluids: abdominal, amniotic, ascites, bile, joint, paracentesis, pericardial, peritoneal, pleural, synovial, thoracentesis

1.  Disinfect overlying skin with 2% iodine tincture.

2.  Obtain specimen via percutaneous needle aspiration or surgery.

3.  Transport specimen to laboratory immediately.

4.  Always submit as much fluid as possible; never submit a swab dipped in fluid.

Blood culture bottle for bacteria and yeast or sterile screw-cap tube or anaerobic transport system.

Bacteria, > 1 ml;

fungi, > 10 ml;

mycobacteria, > 10 ml

< 15 min, RT

< 24 h, RT

Pericardial fluid and fluids for fungal cultures:

< 24 h, 4^oC

None

Amniotic and culdocentesis fluids should be transported in anaerobic system and need not be centrifuged prior to Gram staining.  Other fluids are best examined by Gram staining of a cytocentrifuged preparation.  See Table 4.

Gangrenous tissue

See Abscess

Discourage sampling of surface or superficial tissue; tissue biopsy or aspirates are preferred.

Gastric: wash or lavage

Collect early in the morning before patients eat and while they are still in bed.

1.  Introduce a nasogastric tube orally or nasally into the stomach.

2.  Perform lavage with 25-50 ml. of chilled, sterile, distilled water.

3.  Recover sample and place it in a leakproof, sterile container.

4.  Before removing the tube, release suction and clamp it.

Sterile, leakproof container.

< 15 min, RT

< 24 h, 4^oC

1/day

The specimen must be processed promptly since mycobacteria die rapidly in gastric washings.

Genital (female):

    Amniotic

1.  Aspirate via amniocentesis, cesarean section, or intrauterine catheter.

Anaerobic transport system, > 1 ml

< 15 min, RT

< 24 h, RT

None

Swabbing or aspiration of vaginal membrane is not acceptable because of the potential for culture contamination by commensal vaginal flora.

     Bartholin

1.  Disinfect skin with a iodine preparation.

2.  Aspirate fluid from ducts.

Anaerobic transport system

> 1 ml

< 2 h, RT

< 24 h, RT

1/day

     Cervical

1.  Visualize the cervix using a speculum without lubricant.

2.  Remove mucus and secretions from the cervix with a swab and discard the swab.

3.  Firmly, yet gently, sample the endo-cervical canal with a newly obtained sterile swab.

Aerobic swab transport

GC Selective plate

< 2 h, RT

< 24 h, RT

1/day

See information on virus and chlamydia collection and transport needs.

Neisseria gonorrhoeae is found in exudates, whereas chlamydiae infect specific cells.

     Cul-de-sac

Submit aspirate or fluid

Anaerobic transport system > 1 ml

< 2 h, RT

< 24 h, RT

1/day