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Specimen Collection and Processing

This document discusses guidelines for specimen collection and processing in a clinical microbiology laboratory. It covers basic principles of specimen collection including correct collection procedures and labeling. It also discusses preservation, storage and transport of specimens, as well as receipt and processing in the laboratory. This includes prioritizing specimens, examining them microscopically and growing cultures using various media and incubation techniques. The final sections cover non-routine specimens and communicating laboratory findings.

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Firman Setiawan Moehan
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1K views19 pages

Specimen Collection and Processing

This document discusses guidelines for specimen collection and processing in a clinical microbiology laboratory. It covers basic principles of specimen collection including correct collection procedures and labeling. It also discusses preservation, storage and transport of specimens, as well as receipt and processing in the laboratory. This includes prioritizing specimens, examining them microscopically and growing cultures using various media and incubation techniques. The final sections cover non-routine specimens and communicating laboratory findings.

Uploaded by

Firman Setiawan Moehan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Specimen Collection and

Processing
Firman Setiawan, dr.
Clinical Microbiology

BASIC PRINCIPLES OF
SPECIMEN COLLECTION
Fundamentals
Collection Procedures
Patient-Collected Specimens
Labeling and Requisitions
Safety

PRESERVATION, STORAGE,
AND TRANSPORT OF
SPECIMENS
Specimen Storage
Preservatives
Anticoagulants
Holding or Transport Media
Shipping Infectious Substances

SPECIMEN RECEIPT AN
PROCESSING
Specimen Priority
Unacceptable Specimens and
Specimen Rejection
Macroscopic Observation
Microscopic Observation
Primary Inoculation
Specimen Preparation
Isolation Techniques
Incubation

CULTURE WORKUP
Nonroutine Specimens
COMMUNICATION OF
ABORATORY FINDINGS

BASIC PRINCIPLES OF SPECIMEN


COLLECTION
A major goal of the microbiology
laboratory is to aid in the
diagnosis of infectious diseases.
Appropriate specimen selection,
collection, and transportation are
critical if laboratory results are used
to provide information that
establishes a diagnosis and
successful treatment.

Gambar bagan pro analitik dan post


analitik

fundamentals
The following basic principles of specimen collection are
fundamental to ensuring appropriate specimen management:
1. Before antibiotics are administered
2. Acute phase of the infection.
3. Select the correct anatomic site
4. Collect the specimen using the proper technique
And supplies with minimal contamination from normal biota (normal
flora).

5. Collect the appropriate quantity of specimen.


6. Package the specimen in a container designed
to maintain the viability of the organisms and avoid hazards that
result from leakage.

7. Label the specimen accurately


with the specific anatomic site and the patient information.

8. Transport the specimen to the laboratory promptly


or make provisions to store the specimen in an environment that will
not degrade the suspected organism(s)

Specimen Collection
Guidelines
Specimen

Patient
Preparation

Container/Minimum Quantity

Blood culture

Disinfect skin
with alcohol and
iodine

Blood culture media set (aerobic


and anaerobic bottles) or
Vacutainer tube with SPS/adults 20
mL per set; children 5 to 10 mL
per set

Body fluids

Disinfect skin
before needle
aspiration

Sterile, screw-cap tube or


anaerobic transport system/1 mL

Disinfect skin
before removal

Sterile, screw-cap container

(abdominal,
amniotic,
ascites, bile, joint,
pericardial,
pleural)

Catheter tips,
IV
(Foley catheters
not cultured)

Cerebrospinal
fluid

Disinfect skin
Sterile, screw-cap tube/bacteria 1
before aspiration mL, fungi 2 mL, AFB 2 mL,

Specimen Collection
Guidelines
Specimen

Patient
Preparation

Container/Minimum Quantity

Lesion/wound/abscess
Superficial

Wipe area with


sterile saline,
Swab along
outer edge

Swab transport system

Deep

Wipe area with


alcohol 70%,
Aspirate with
needle and
syringe

Anaerobic transport system

Disinfect skin;
do not allow
tissue to dry
out; if
necessary,
moisten with

Anaerobic transport system or


sterile screw-cap
container
Urine

Tissue

Specimen Collection
Guidelines
Specimen

Patient Preparation

Container/Minimum
Quantity

Urine
Clean-catch Clean external genitalia;
midstream begin voiding and after
several mL have passed;
collect midstream without
stopping flow of urine

Sterile, screw-cap
container or urine
transport kit 2-3 mL

Catheter Clean urethral area, insert Sterile, screw-cap


catheter, and allow first 15 container or urine
mL to pass; then collect
transport kit
remainder
Indwelling Disinfect catheter
catheter collection port, aspirate 510 mL with needle and
syringe
Suprapubic Disinfect skin, aspirate

Sterile, screw-cap
container or urine
transport kit
Sterile, screw-cap

Specimen Collection
Guidelines
Specimen

Patient Preparation

Container/Minimum
Quantity

Respiratory tract: upper


Nasal Insert premoistened swab
with sterile saline 1 inch
into nares
Nasopharynx Insert flexible swab
through nose into
posterior nasopharynx,
rotate for 5 sec

Swab transport system

Swab transport system


or direct inoculation to
media

Throat Swab posterior pharynx,


Swab transport system
tonsils, and inflamed areas
Respiratory tract: lower : bronchial
specimens
Sputum Rinse mouth or gargle
with water, instruct to
cough deeply into

Sterile, screw-cap
container

Specimen Collection
Guidelines
Specimen

Patient Preparation

Container/Minimum
Quantity

Ear
Inner Clean ear canal with mild
soap, aspirate fluid with
needle if eardrum intact;
use swab if eardrum
ruptured

Sterile, screw-cap tube or


anaerobic transport
system

Outer Remove debris or crust


Swab transport system
from ear canal with salinemoistened swab; rotate
swab in outer canal
Eye
Conjunctiva Sample both eyes; use
Swab transport system
separate swabs moistened
with sterile saline
Corneal Instill local anesthetic,

Agar available at bedside

Specimen Collection
Guidelines
Specimen

Patient Preparation

Container/Minimum
Quantity

Genitalia
Cervix/vagina Remove mucus before
collection; do not use
lubricant on speculum;
swab endocervical canal
or vaginal mucosa

Swab transport system


or JEMBEC transport
system

Urethra Flexible swab inserted 2-4 Swab transport system


cm into urethra for 2-3 sec or JEMBEC transport
or collect discharge
system
Feces

Collect directly into


container, avoid
contamination with urine

Clean, leakproof
container or enteric
transport system

Fungal
scrapings

Wipe nails or skin with


alcohol
Hair:10-12 hairs with shaft

Clean, screw-cap
container

Hair/nails/skin

Patient-Collected specimens
urine, sputum, and stool.
written using simple language and
pictures
assistance from medical personnel
following thorough instructions.
printed instructions in multiple
languages to a collection device does
not ensure that patients will read
them or understand them.

PRESERVATION, STORAGE, AND


TRANSPORT OF SPECIMENS

SPECIMEN RECEIPT AND


PROCESSING
specimen Priority
critical nature of the
specimen or potential for
specimen degradation
1. Level 1 specimens are
classified as critical
because they represent
a potentially lifethreatening illness and
are from
2. Level 2 specimens are
unprotected and may
quickly degrade or have
overgrowth of
contaminating flora.
3. Level 3 specimens
require quantitation.
4. Level 4 specimens are
those that arrive in the

BAP,Sheep blood agar;


CHOC,chocolate agar;
MAC,MacConkey agar;
EMB,eosin-methylene blue agar;
ANA,anaerobic culture media (anaerobic blood agar, Bacteroides bile esculin
agar, kanamycin-vancomycin laked blood agar, anaerobic CNA or PEA,
phenylethyl alcohol agar);
THIO,thioglycollate broth;
TM,ThayerMartin or other Neisseria-selective agar;
CSF, cerebrospinal fluid;
CNA, Columbia Colistin-Nalidixic acid agar;
HE, Hektoen-enteric agar;
XLD, xylose-lysinedeoxycholate agar;
CAMPY, Campylobacter-selective blood agar;
SMAC,sorbitol-MacConkey agar;;
IUD,intrauterine device.

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