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1. Sample collection in clinical microbiology
Dr. Ajit Kumar Singh
(MD Laboratory Medicine)
PGT 1st year
Guided by
Dr. Subhranshu Mandal
M.B.B.S. M.D (Microbiology)
Specialist Microbiologist
CHITTRANJAN NATIONAL CANCER INSTITUTE , KOLKATA

2. Sample collection in clinical microbiology
COLLECTION, TRANSPORT AND ASPETIC TECHNIQUE
“SPECIMEN COLLECTION IN MICROBIOLOGY TO ISOLATE AND IDENTIFY
THE CAUSATIVE AGENTS FORMS BACK BONE OF THE INVESTIGATIVE
PROCEDURES”
Specimen collection is a prior procedure towards a better diagnosis.
Collection should be of a quality, that means; right specimen, collected at right
time and transported at a right way to the right laboratory.
Collection should be from a right patient.
Handling ensures right collection and quality of specimen as specified by
standard operating procedure.

3. Hospital Emergency codes
• RED- (FIRE) code red shall be activated in case of fire,
flames, smoke and unusual heat
• ORANGE- in case of hazardous materials spillage
• YELLOW- in case of suspected or actual disaster
• BLUE- (cardiac arrest) code blue is the term used to alert
the code blue team(resuscitation team) to an area where
a person has had a cardiac arrest
• PINK- (child abduction) in case of suspected & actual
infant or child abduction
• VIOLET- (security emergency) a combative person with
weapons or active shooter and hostage situation
• BLACK- in case of bomb threat or discovery of suspicious
devices

4. How is an emergency code is announced and terminate
Alert category
Specific code description
Location
Activation ??
1.Security alert (alert category)
2.Code violet (specific code
description )
3.Room number. 555(location)
Termination ??
Security alert code violet room
number 555 clear

5. Spill management
Spill management of blood and body fluids :-
Bring the spill kit to the site of spillage , wear
appropriate ppe (gloves and gown)
Put no entry sign board near the spill area
If spillage is small (<10 ml)
If spillage is large (>10 ml)

6. General collection criteria
o Start collection of specimens for all cultures before starting an Antibiotic
o If patient have had antibiotics, if antimicrobial agent is already started then
the best time of collection is just before the next dose of antimicrobial agent
o Avoid contamination from indigenous flora (normal flora), whenever possible
to ensure a sample representative of the infections process.
o Collect samples from appropriate time and site with aseptic technique.
o Completely filled requisition form
o Collect adequate volumes; insufficient material may yield false-negative
results.
o Prompt delivery to laboratory
o Safety of patient and medical staff

7. Needle stick injury prevention and management
An occupational exposure
o Percutaneous injury (needle stick injury ) or other sharp
injury
o Splash injury
Agents transmitted : - HIV , HCV , HIV
Infectious specimens for NSI :- potentially infectious body
fluids include
Blood , genital secretions all body fluids
Prevention of needle stick injury
o Never recap needles
o Disposal after use

8. Post exposure management
Steps of post exposure
management : -
o First aid
o Report to designated nodal
center
o Take first dose of pep hiv
o Testing of bbvs
o Decision on pep for hiv and
hbv
o Documentation and
recording of exposure
o Informed consent and
counseling
o Follow – up testing of hcws
o Precautions during the
follow up period

9. Risk of infection and management of needle stick injury
pathogen Risk of infection from a known positive
person
Step in management If source is not positive
HIV 0.3 % o Wash the area immediately
o Determine status of patient’s
infection
o Start PEP
o In case of HCV there is no PEP
o Only local cleaning
o No treatment
HBV 6 to 30 %
HCV 1.8 %
HBV protocol : - HCW has been vaccinate for HBV and antibody titer is > 10 mlU/ml requires no treatment
If titer is <10mlu/ml or HCW is no vaccinated then hepatitis b immunoglobulin HBIG is administered , immediately
along with the full course of HB vaccine
If the source is unknown , HBIG and a full course of HB vaccine are administered
HIV protocol : - the course is a four week regimen of two drugs – zidovudine and lamivudine , if the person tests
negative , no pep is required.

10. CONTAINERS FOR SAMPLE COLLECTION
o Leak-proof
o Unbreakable
o Sterile and dry
containers should be
sterilized either by
moist heat or by dry
heat or by radiation but
never by disinfectant or
antiseptic.

11. AN IDEAL SPECIMEN FORM
o Patient’s name……………
o Age/ sex…. Address ….
o Medical record number…
o IP/OP no …..
o Date and time of collection
o Ward
o Specimen type
o Diagnosis, and test requested
o Nature of specimen
o Doctor/staff ….. signature

12. Blood collection bottle :
Bd bactec : includes resin containing medium
Bact/alert : supplemented with bhi broth containg activated
charcoal particles
Ratio -
Patientblood: culture media(1:5)
Fluid : includes sterile body fluids
(CSF, pleural fluid , peritoneal, fluid , asctic fluid , synovial fluid)
Universal container :
Without anti-coagulant :
With ant-coagulant :- By addition of 0.3 ml of 20% solution
Sodium citrate to the container prior to autoclaving

13. For urine : -
Sterile wide mouth container
For sputum : -
Clean , sterile , wide – mouthed disposable
containers
For faeces : -
Universal container spoon attached to the
inside of the Screw cap
Volume : - 1 tea spoon (5 ml )
Swab : -
Swab suitable for taking specimen of exudates
from the throat nostril ear skin wounds and
other accessible lesions consist of a sterile
pledget of absorbent material

14. Cotton swab :-not preferred for
culture as contain fatty acid
Dacron or rayon polyester :-better
choice
Flocked swabs : newer , numerous
microscopic folds
Calcium alginate swabs: for
nasopharyeal secretions , especially
for chlamydias

15. LABEL HIGH RISK SPECIMENS
o Sputum with suspected tuberculosis
o Fecal samples suspected with cholera, typhoid, anthrax ?
o Serum when suspected with HIV/ HBV/HCV, infections

16. REJECTION CRITERIA
oUnlabeled or mislabeled specimens
oUse of improper transport medium
oExcessive transport time
oImproper temperature during transport or storage
oImproper collection site for test requested
oSpecimen leakage out of transport container

17. SELF PROTECTION
o A few ways to make sure your role in the collection process
is carried out with efficiency, orderliness and safety
o All specimens should be presumed to contain transmissible
agents and therefore should be collected and handled using
standard precautions.
o Use of gloves, gown, mask, and protective eyewear when
there is a risk of coming in contact with the specimen
o In my institution’s clinical laboratories, a special area is
designed for processing clinical samples for culture

18. EQUIPMENT NEEDED
o Chlorhexidine swabs /alcohol swabs
o Collection tubes
o Gloves (sterile &nonsterile)
o Tourniquet
o Sterile gauze pad
o Adhesive strip or tape
o Self-sticking patient labels
o Plastic zip lock specimen bags
o Hand towel or absorbent pad
o Slides

19. SPECIMENS
For isolation and diagnosis of micro-organism
following specimen collected in microbiology
laboratory
These are:
o Throat swab
o Sputum
o Urine
o Stool
o Rectal swab
o Vaginal swab
o Cerebral spinal fluid

20. SAMPLE COLLECTION OF RESPIRATORY TRACT
o Collection of specimen in the case of RTI poses a number of
problems because , there is enormous commensal flora that
colonizes this respiratory tract
o Therefore, the specimen collection is very crucial and
specially in case of viral infections of respiratory tract
o One has to avoid contamination of the specimens.

21. UPPER RESPIRATORY TRACT
1.Oral swab : -
Remove the oral secretions or debris from the surface of lesion with
swab and discard
Using 2nd swab , vigorously specimen the lesion avoiding any areas of
normal tissue
2.Nasal swab : -
Use swab moistened with sterile saline
Insert approx. 2cm into nares
Rotate swab against nasal mucosa

22. UPPER RESPIRATORY TRACT
Nasopharyngeal : -
o Swabs : to collect nasopharyngeal cells,
all mucus is removed, small flexible
nasopharyngeal swab is inserted along
the nasal septum to the posterior pharynx
rotate slowly for 5 sec. Against the
mucosa several times
o Aspirate : is collected with a plastic tube
attached to 10 ml syringe or suction
catheter
o Washings : is obtained with a rubber
suction bulb by instilling and withdrawing
3-7 ml of sterile buffer saline

23. UPPER RESPIRATORY TRACT
THROAT SWAB
Swabs – two throat swabs should be collected – one for direct
microscopic examination and another for culture
Sterile cotton, darcon or calcium alginate tipped swabs
For 8 hrs before swabing, must not be treated with antibiotic and mouth
gargle
In good light, collect as much exudate as possible from tonsils,
posterior pharyngeal wall or other inflamed sites
Swab rubbed with rotation over one tonsillar area then arch of soft
palate and uvula the other tonsillar area and finally posterior
pharyngeal wall
Contamination from oral flora should be avoided

24. Pseudomembrane over tonsils
Pseudomembrane on tonsils
(Bull neck)
Two dacron swabs are collected from the
lesion under vision using a tongue depressor
The area under the visible membrane should
be sampled

25. transport
If can’t be delivered within 1 hour, refrigerate at 4 degree alternatively
can be stored in tube with silica gel and transported.
Moist swab- can be cultured up to 4 hrs. Group A Streptococci - highly
resistant to desiccations.
(Survive in dry swab for 48-72hrs) - can be placed in glassine paper
envelopes for transport

26. LOWER RESPIRATORY TRACT INFECTION
PUTUM COLLECTION
Proper patient instruction
Food should not have been ingested for 1-2 h prior to
expectoration
The mouth should be rinsed with saline or water
Patient should breathe and cough deeply
Patient should expectorate into a wide mouth container
Transport container immediately to lab

27. SPUTUM
Material from lower respiratory tract infection, most commonly sent specimen for
bacteriological examination is sputum (mixture of bronchial washing and
inflammatory exudate) coughed up into mouth and expectorated
Bacterial infection- purulent containing green or yellow material with mucus
Saliva- relatively clear and watery
Collected in clean, dry, wide mouthed, leak- proof container, preferably early morning
sample
Record - Color , Consistency , Amount , Odor
Document date & time sent to lab.

28. Apart from sputum , endotracheal aspirate or
bronchoalveolar lavage
may also be collected from the lower respiratory tract
If the patient is on a ventilator or intubated , a non -
bronchoscopic lavage or BAL sample may be collected to
diagnose VAP
Specimens for virus isolation are transported in virus
transport medium
(VTM)

29. INDUCED SPUTUM
Patients who are unable to produce sputum.
patient to breath aerosolized droplets of a solution of 15%
sodium chloride and 10% glycerin for approximately 10
minute
Avoid the need for a more invasive procedures, such as
bronchoscopy or needle aspiration etc.

30. URINE COLLECTION METHODS
Clean catch mid-stream urine specimen
Requirements - sterile, dry, wide mouth leak proof
bottle
Early morning (midstream) first urine sample
Instructions
Male patients: should wash the genital organ with
clean water
Female patients: should cleanse the area around
urethral opening with clean water
After drying the area, midstream urine is collected

31. URINE COLLECTION METHODS
Method : - Give patient a sterile, dry and wide-necked, leak proof
container, instruct to collect about 20 ml of midstream urine
sample with as little contamination as possible.
By removing the cap bottle and after discarding the initial portion
of urine, required amount of urine sample is collected. (If possible,
the first morning sample as it the most concentrated)
Label the container with date, name, unique number of patient and
time of collection
Deliver the sample with request form to lab as soon as possible. If
not possible, can be stored at 2-8oc for 24 hrs.
Add 0.1g/10ml boric acid powder to preserve the specimen

32. URINE SPECIMEN WITH SUSPECTED RENAL TUBERCULOSIS
• REQUIREMENTS : - Clean, dry, leak
proof and sufficiently large to collect
entire specimen
• Collection : - early morning entire urine
specimen for three successive days can
be stored at 4oc until all three urine
specimen are collected
• Or 24 hours urine specimen container
should be of 3 liter capacity

33. CATHETERIZED URINE SPECIMENS
Wash hands, done apron, prepare equipment.
Apply alcohol hand rub.
Once sufficient urine has collected in the tube,
wipe the sampling port with an alcohol-
impregnated swab.
Allow to dry.
Stableising the tube below the sampling port,
insert the needle into the port at an angle of 45.
Aspirate the required amount of urine and Inject
urine into sterile specimen container.
Wipe the sampling port with an alcohol-
impregnated swab and allow to dry.
Unclamp the catheter tubing as required.
Dispose of waste, remove apron, wash hands
thoroughly.
Complete documentation.
Dispatch the specimen to the laboratory.

34. PEDIATRIC urine SPECIMEN
Supra-pubic aspiration:
Ask assistant to hold infant supine
with legs extended
Ask parent to be ready to catch
urine if the patient voids
Wipe the skin with an alcohol swab
Insertion point:
Midline , Lower abdominal crease
Insert needle perpendicular to the
skin, aspirating gently as you
advance the needle.
Thus obtained urine, remove needle
and squirt urine into sterile urine
jar.

35. INVASIVE METHODS
Bladder washout
Intravenous pyelography
Micturating cystography
Urethrescopy
Ureteric catheterization
Renal biopsy

36. COLLECTION OF UROGENITAL SPECIMEN
Specimen required for diagnosis of gonorrhoea
Female patients : -
Smear of mucopus from cervix and urethra
Swab of urethral discharge in amies transport media
or inoculated directly in selective media
Male patients : -
Smear of urethral discharge
Swab of urethral discharge in amies transport media
or inoculated directly in selective media

37. Collection of urethral specimen
Patient should not have passed urine preferably for 2 hrs before
sample collection , cotton swab treated with charcoal, calcium
alginate ( Not for HSV, gonococci, chlamydia and mycoplasma ) and
dacron tipped swab
Urethral swab- swab is inserted about 2 cm into urethra and
rotated gently. (Mainly for chlamydia)
Collect a sample of pus : -
Contamination from indigenous commensal flora should be avoided
Transport rapidly and ambient temperature conditions
Make a smear for gram stain and process for culture

38. Collection of cervical specimen
Insert vaginal speculum
Cleanse cervix with swab moistened with sterile
physiological saline
Pass sterile cotton swab into endocervical canal and
gently rotate
Insert swab in amies transport medium
Make a smear for staining

39. Collection of vaginal specimen
Collect vaginal discharge in sterile cotton swab
Insert into amies transport media
Make smear for staining
Wet preparation is helpful for protozoal parasites and fungi
Report the appearance of discharge : -
Yellow green purulent- t. Vaginalis
White discharge (ph <4.5)- c. Albicans
Grey offensive (ph> 4.5)- g. Vaginalis

40. Collection of other urogenital specimens
Syphilis : -
Wearing rubber gloves, cleanse area around ulcer with
physiological saline
Collect serous exudate on cover glass and invert on glass slid
Transfer immediately for DGI

41. COLLECTION OF GIT TRACT SPECIMEN
Faeces for microbiological examination should be collected during
acute stage, preferably before antimicrobial treatment
Fresh specimen is preferred to rectal swab and faecal swab
Rectal swab : - if not possible to obtain stool sample
Collection of stool sample , 2 small wooden stick and suitable
clean, dry, disinfectant free bedpan or wide- necked, leak proof
container
Specimen should contain at least 5 g of faeces
Sample containing blood, mucus or pus is better
Shouldn’t contaminated with urine
Should be transferred to lab within 2 hrs
If not possible, a small amount of faecal specimen (with mucus,
blood and epithelial if present) should be collected 2-3 swabs
Transport in cary-blair, stuart or amies media

42. COLLECTION OF RECTAL SWAB
Moisten a cotton swab with sterile water
Insert swab through rectal sphincter, rotate and withdraw
Examine swab for faecal staining
Place swab in sterile tube containing cotton lug or screw-
cap if processed within 2 hrs
If need to kept for longer period- place in transport medium

43. Collection of wound specimen
Best collected at time of incission or drainage
Special care to avoid contamination from skin commensals
swab
Collect sample aseptically and transfer to amies transport
media or sterile container
Aspirates:
Discharging pus and granules (if present) in sterile leak proof
container

44. DETECTION OF BACTEREMIA
Specimen collection
Preparation of site : - first vein is chosen - if patient has an existing
IV line, blood should be drawn bellow existing line
Antisepsis : - 70% alcohol and tincture of iodine
Method : - choose the vein to be drawn - using 70% alcohol,
cleanse aprox 5cm in diameter - apply 2% tincture of iodine (or
porividine iodine) or 1 to 2% chlorhexidine in ever widening circle -
allow to dry the skin for at least 1 minute - insert the needle into
the vein and withdraw blood

45. Specimen volume
Adults : -
Low number of CFU
Collection of 10 to 20 ml of blood per culture increase yield
of 3.2% for each ml of blood cultured.
Children : -
For infants and children, only 1 to 5 ml of blood is drawn
High levels of bacteremia in some infants

46. NUMBER OF BLOOD CULTURES
If the volume adequate : - 2-3 blood culture is sufficient
Endocarditis : - sample are collected before antimicrobial
therapy
a single blood culture pos. 90-95% -second blood culture at
least 98%
Received prior antibiotics therapy : - 3 blood collections of
10-20 ml each an additional blood culture or 2 on second day.
Bacteremic pts : - 80 to 92 % by 1st blood culture , 90 to 99%
by 2nd blood culture , 99.6% by 3rd blood culture

47. ANTICOAGULATION
Blood drawn for culture must not be clotted - heparin, EDTA
and citrate inhibit bacterial growth not used
Sodium polyanethol sulfonate : - 0.025 to 0.03% dilution
Largest feasible vol. Of blood (10ml) with the smallest
amount of media - still encourage the growth of bacteria and
dilute antibacterial components of blood

48. BLOOD CULTURE MEDIA
Diversity of bacteria - equally various types of culture media -
commonly used : - nutrient broth - trypticase soya broth - BHI
broth - supplimented peptone water - thioglycolate broth etc
ADDITIVES
Cell wall deficient bacteria need osmotic stabilizers eg.
Sucrose, mannitol or sorbose - penicillinase to inactivate
penicillin -recent years, use of resins to inactivate antibiotics

49. FLUIDS
Cerebrospinal fluid , Pleural fluid , Peritoneal fluid , Joint
fluid
COLLECTION AND TRANSPORT:
After aspiration
Aseptically dispense
2-3ml into dry, sterile and screw-cap tube or bottle
9ml into screw cap tube or bottle with 1 ml tri- sodium
citrate 3% w/v and mix well.
Label and deliver to lab as soon as possible

50. CEREBROSPINAL FLUID
Procedure - Lumbar puncture
Pt lies in L lateral decub position, knees to chest
Aim for the l3-l4 or l4-l5 intervertebral space
Posterior iliac crest as marker for l4-l5 space
Prep/drape lower back in sterile fashion...Lidocaine
Insert lp needle pointing towards umbilicus with the bevel up
Obtain opening pressure

51. PRESERVATION OF CSF
It is important when there is delay in transportation of
specimens to laboratory do not keep in refrigerator, which
tends to kill H. Influenza
If delay is anticipated
Leave at room temperature.

52. Laboratory diagnosis
Specimen obtained after careful preparation of skin site Anaerobes
survive long time in tissue
A small amount of non-bacteriostatic saline can be added to keep
specimen moist
Legionella spp. may be inhibited by saline
Formaldehyde fixed tissue is not suitable for recovery of organism
Grinding may destroy some organism including fungal cells .
So mince the larger tissue to culture
As surgical specimen are obtained at great risk and expense, save a
portion of original tissue in refrigerator or at -70oC

53. Sample collection:
usually performed by medical officer
Bone marrow aspiration :
For diagnosis of certain diseases eg. brucellosis, histoplasmosis,
blastomycosis, tuberculosis and leishmaniasis
Bone biopsy :
Small piece of infected bone- for diagnosis of etiologic agent of
osteomyelitis

54. LOWER RESPIRATORY TRACT INFECTIONS
Acute bronchitis
Chronic bronchitis
Pneumonia:-
Typical pneumonia
Atypical pneumonia
Community acquired pneumonia
Hospital acquired pneumonia
Others - Lobar pneumonia - Bronchopneumonia -Aspiration
pneumonia -Pneumonia in the immunocompromised host

55. SPUTUM SPECIMENS
3 major types for : -
.Culture and sensitivity
.Acid fast bacilli
3 consecutive, early am
.Cytology
Abnormal lung cancer by cell type
3 early am

56. URINARY TRACT INFECTION
Microbial invasion of any tissue of
urinary tract from the renal cortex
to urethral meatus.
infection of prostate and epididymis
is also included.
2nd commonest site of infection
after respiratory tract

57. CHARECTERIA FOR URINARY TRACT INFECTION
Frequency
Urgency
Dysuria
Hematuria
Fever
Cloudy
burning micturition
lower abdominal pain
bacteriuria
pyuria

58. URINARY TRACT INFECTION
CYSTITIS: gram negative bacilli: escherichia coli, klebsiella spp., proteus
spp., enterobacter spp., citrobacter spp., Providencia
spp,morganella,acinatobacter,pseudomonas etc  gram positive cocci:
staphylococcus aureus, coaggulase negative staphylococci,
enterococcus faecalis etc
PROSTATITIS: gram negative bacilli: E. Coli, haemophilus influenzae  gram
positive bacilli: corynebacterium spp
Urethritis: gram negative bacilli: escherichia coli, gram positive cocci:
streptococcus spp., coagulase negative staphylococci  gram negative
cocci: neisseria gonorrhoeae  others: trichomonas vaginalis

59. GENITAL TRACT INFECTION
Genital ulceration
Urethral discharge
Abnormal vaginal discharge
Asymptomatic infection

60. SEXUAL TRANSMITTED DISEASE
Genital ulcers:- earliest clue and common
manifestation
Painless ulcers  treponema pallidum---------syphilis
Chlamydia trachomatis-----lymhogranuloma venerum
Calimatobacterium granulomatis--------donovanosis
Painful ulcers  haemophillus ducrei-----------chancroid
Herpes simplex virus types 1 & 2 ------herpes genitellis

61. Vaginal Discharge
Trichomonas vaginalis
Candida albicans
Gardnerella vaginalis and
other anaerobes
Asymptomatic : -
N. gonorrhoeae
C. trachomatis
HIV, HBV,CMV

62. Genital discharge
Gonococcal urethritis: -
Neisseria gonorrhoeae
Non-gonococcal
urethritis: -
C. trachomatis
Ureaplasma urealyticum
Mycoplasma genitalium
Acintobacter spps.
Bacteroides
Candida albicans

63. GASTROINTESTINAL INFECTION
Microorganism that cause GI infections :-
Invasion - shigella spp. Eiec e. Histolytica, B. Coli, yersinia
spp. Etc.
Toxin production enterotoxin - V. Cholerae, shigella
dysenteriae type 1, ETEC, salmonella, aeromonas spp.
clostridium spp. Etc.
Cytotoxin- shigella spp. EHEC etc.
Neurotoxin- C. Botulinum, S. Aureus, B. Cereus etc.

64. DEFINITION
Bacteremia - presence of viable bacteria in the blood stream
Sepsis :- bacteremia associated with an inflammatory
response from the body (systemic inflammatory response
syndrome- rapid breathing , low blood pressure and fever
etc.)
Microorganism present in circulating blood- continuously,
intermittently or transiently
Serious immediate consequences- shock, multiple organ
failure, DIC, and death

65. Bacteria commonly isolated from blood cultures
Salmonella spp. , Escherichia spp.
Klebsiella spp. , Enterobacter spp.
Proteus spp. , Pseudomonas spp.
Acinitobacter spp. , Anaerobic bacteria such as
Bacteroides and Clostridium spp.
Coagulase negative staphylococci
Staphylococcus aureus , Viridians streptococci
Enterococci spp. , Beta- hemolytic streptococci
Streptococcus pneumoniae

66. CLINICAL MANIFESTATIONS
Septicemia:-
Bacteria and their products causing harm to host
Signs and symptoms of septicemia :-
Fever , hypothermia , chills , hyperventilation and
subsequent respiratory alkalosis , skin lesions , change in
mental status and diarrhea
Septic shock syndrome :- fever, acute respiratory distress,
renal failure, intravascular coagulation, and tissue
destruction

67. Organisms commonly associated with bloodstream invasion
from extravascular sites of infection.
Organism Extravascular site of infection :-
Haemophilus influenzae type b Meningitis, epiglotitis,
periorbital region Streptococcus pneumoniae Meningitis,
sometimes lung Neisseria meningitidis meninges Brucella
spp Reticuloendothelial system Salmonella typhi Small
intestine, lymphnodes of intestine, RE system Listeria
meninges

68. LOWER RESPIRATORY TRACT
lower respiratory tract (trachea, bronchi & lungs) – normally
free from microorganisms
Immunocompromized - organism from throat may invade
Inhaled pathogens- Mycobacterium diptheriae Bordetella
pertusis Mycoplasma pneumoniae Chlamydia Influenza
viruses etc.

69. Specimen
• Bronchial washing and lavage, sputum etc.
• Blood sample for serology, serum stored at refrigerator until
processing
• Transportation : - for virus detection, should be transported
immediately
• Specimen should be placed in viral transport media and
transported in ice box

70. SPUTUM COLLECTION
May be delegated
Cough effectively
Mucus from bronchus
Not Saliva

71. WOUND INFECTIONS
Wound infection can occur as a
complication of surgery, trauma, bites or
diseases
Postoperative infections: infection from
patient’s own normal flora or organism
present in environment
Depends on site of wound etc.
Appendectomy or lower GIT surgery –
E. Coli, streptococci, bactereoides,
clostridium and other anaerobes