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Specimen Collection

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Bacteriology, Mycology , and Mycobacteriology Specimen Collection Guidelines^a

Specimen Type	Collection Guidelines Device and/or minimum vol		Time and Temp Local Courier Transport ^b or local storage		Replica limits	Comments
Hair: dermatophytosis	1. With forceps, collect at least 10-12 affected hairs with the base of the shaft intact. 2. Place in a clean tube or container.	Clean container, 10 hairs	< 24 h, RT	1/day/site		Collect scalp scales, if present, along with scrapings of active borders of lesions. Note any antifungal therapy taken recently.
Nail: dermatophytosis	1. Wipe the nail with 70% alcohol using gauze (not cotton). 2. Clip away a generous portion of the affected area and collect material or debris from under the nail. 3. Place material in a container.	Clean container Enough scrapings to cover the head of a thumb tack.	< 24 h, RT		1 day
Pilonidal cyst	See Abscess
Respiratory, lower: Bronchoalveolar lavage, bronchial brush or wash, tracheal aspirate	1. Place aspirate or washing in a sputum trap. 2. Place brush in a sterile container with saline.	Sterile container, > 1 ml	< 2 h, RT	< 24 h, 4^oC	1/day
Sputum, expectorate	1. Collect the specimen under the direct supervision of a nurse or physician. 2. Have the patient rinse or gargle with water to remove superficial flora. 3. Instruct the patient to cough deeply to produce a lower respiratory specimen (not postnasal fluid). Collect in a sterile container.	Sterile container, > 1 ml Minimum amounts: bacteria, > 1 ml; fungi, 3-5 ml; mycobacteria, 5- 10 ml; parasites, 3-5 ml	< 2 h, RT	< 24 h, 4^oC	1/day	For pediatric patients unable to produce a specimen, a respiratory therapist should collect a specimen via suction. The best specimen should have < 10 squamous cells per 100 x field.
Sputum, induced	1. Have the patient rinse mouth with water after brushing the gums and tongue. 2. With the aid of a nebulizer, have the patient inhale ~ 25 ml of 3-10% sterile saline. 3. Collect the induced sputum in a sterile container.	Sterile container	< 2 h, RT	< 24 h, RT	1/day	Histoplasma capsulatum and Blastomyces dermatitidis survive for only short periods of time once a specimen is obtained. Fungal recovery is primarily for Cryptococcus spp. and some filamentous fungi; other yeasts rarely cause lower respiratory tract infection.
Respiratory, upper: Oral	1. Remove oral secretins and debris from the surface of the lesion with swab and discard swab. 2. Using a second swab, vigorously sample the lesion, avoiding any areas of normal tissue.	Aerobic swab transport	< 2 h, RT	< 24 h, RT	1/day	Discourage sampling of superficial tissue for bacterial evaluation. Tissue biopsy or needle aspirates are the specimens of choice.