Specimen collection

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Specimen collection

  1. 1.  Proper collection of specimens is important to maximize the outcome of laboratory tests for the diagnosis of infectious diseases A variety of laboratory tests can be performed to make a presumptive or definitive diagnosis so that therapy can begin.
  2. 2. TYPES OF SPECIMENCOLLECTION
  3. 3. Blood Culture Normally a sterile body fluid. Specimens obtained by venipuncture are preferred over sampling from vascular catheters unless testing for a central line infection. Timing is determined by the patients clinical condition and should be indicated by the ordering clinician.
  4. 4.  Usually collection is spaced over 24 hours. Aseptic technique is essential to avoid contaminating the specimen with organisms colonizing the skin. Cleanse the venipuncture site with 2% chlorhexidine gluconate or povidone-iodine and allow to dry. In case of allergy, use 70% alcohol.
  5. 5.  The diaphragm tops of the culture bottles are not sterile and must be wiped with alcohol before injection of blood.
  6. 6. Urine Culture Normally a sterile body fluid. A clean-catch midstream urine collection provides the best method for obtaining a specimen to detect a UTI Patients who are catheterized should have the specimen withdrawn using a sterile syringe from the catheter sampling port
  7. 7.  Urine specimens must be transported to the laboratory promptly. If not cultured within 30 mins of collection, urine must be refrigerated and cultured within 24 hrs. Clean-catch midstream urine specimens that have more than 100,000 colonies of bacteria per mL of urine may be indicative of infection. Other types of urine specimens may be collected, such as a straight in-and-out catheter specimen or suprapubic bladder drainage
  8. 8. Stool Culture Obtained to culture organisms that are not part of the normal bowel flora (eg, salmonella, shigella, rotavirus) Patient should defecate into a sterilized container or bedpan. Stool specimens should not contain urine or water from the toilet bowl. Stool specimens can also be obtained directly from the rectum using a sterile swab.
  9. 9. Sputum Culture Specimen needs to be from the lower respiratory tract, not oropharyngeal secretions. The laboratory will perform a Gram stain on all sputum specimens to determine if they are representative of pulmonary secretions. A specimen containing a majority of cells from squamous epithelium will be rejected.
  10. 10.  The most common method of collection is expectoration from a cooperative patient with a productive cough Early morning is the optimal time to collect sputum specimens. A sputum specimen can be collected in a sputum trap from patients who have artificial airways and require suctioning.
  11. 11.  If a patient cannot produce sputum, sputum induction using an aerosol nebulizer may assist with loosening thickened secretions. Bronchoscopy may be required to obtain sputum if induction fails.
  12. 12. Wound Culture Specimens are cultured for aerobic and anaerobic organisms. Using a sterile swab supplied by the laboratory, collect as much exudate as possible from the advancing margin of the lesion
  13. 13.  Avoid swabbing surrounding skin. Place the swab immediately in appropriate transport culture tube and take to the laboratory. Label with the specific anatomic site.
  14. 14. Throat Culture Use a tongue depressor to hold the tongue down. Carefully yet firmly rub swab over areas of exudate or over the tonsils and posterior pharynx, avoiding the cheeks, teeth, and gums. Insert swab into packet and follow directions for handling the transport medium.

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