Lee Memorial Health System Lee County, FL CLINICAL LABORATORY MICROBIOLOGY SPECIMEN COLLECTION MANUAL ACID FAST CULTURE Specimen Type see Specimen Chart ACID FAST STAIN see Specimen Chart Acid Fast stain included. If Acid Fast Stain is positive specimen will be sent to the State Laboratory for Mycobacterium Tuberculosis Direct (MTD). 42 Days if Negative Various Sterile Screw Top Varies by specimen type Wounds may be submitted on a swab. ADENOVIRUS ANTIGEN Stool, Nasopharyngeal Sterile Rev. 04/13 Page 1 of 14
ANAEROBIC CULTURE Specimen Type see Specimen Chart see Specimen Chart Cultures should be held at room temperature. Should be ordered on all deep tissue collections. 7 Days if No Growth. Preliminary Report After 48 Hours BACTERIAL ANTIGEN SCREEN Blood or Urine Red Top or Urine Cup Serum 2 ml Urine 5 ml Urine is not a suitable specimen for Group B Strep testing on infants. 24/7 BLOOD CULTURE Blood Aerobic and Anaerobic Blood Culture Bottles 5-10 ml in each bottle Blood cultures should be obtained consecutively at least 1 minute apart (or over a short timeframe) from different sites if the physician has not specified an interval. Drawing blood at intervals is only indicated when it is necessary to document continuous bacteremia. Pediatric bottles that hold a specimen volume of 0.5 ml - 4 ml should only be used for pediatric patients. Physician may request culture to be held for an extra day. Please add order comment with this request. 5 Days if Negative Rev. 04/13 Page 2 of 14
BODY FLUID CULTURE Various C DIFFICILE, PCR CATH TIP CULTURE Aerobic and Anaerobic Blood Culture Bottles and a sterile 1-10 ml A culturette is not a suitable specimen for a Body Fluid Culture. 5 Days Stool Sterile Cup 1 ml Swabs are not acceptable. If stool specimen is formed, do not send for testing. Testing is recommended once per 7 day period. Various cath tips. (except Foley) Sterile screw cap container 1-3 cm of cath tip Blood Culture collected from the line and peripheral should be collected before the tip is removed. Positive cath tip cultures must be coordinated with positive blood culture results. 2-4 Days CHLAMYDIA DNA PROBE Cervix, Vaginal, Penile, Urine BD Collection Kit Only BD collection kits are acceptable. The following specimens are rejected: overfilled or under filled urine UPT, CT/GC tube without swab, and CT/GC tube with cleaning swab. Monday, Wednesday, Friday 3-5 Days Rev. 04/13 Page 3 of 14
CRYPTOCOCCUS ANTIGEN CSF or Blood CSF Tube or SST 0.5 ml of CSF or 1 ml of Blood A titer will be performed on all positive antigens. Replaces India Ink prep. 1-2 Days CRYPTOSPORIDIUM ANTIGEN Stool Screw top container 1 gram Stool specimens for ova and parasites are not accepted from inpatients after the third hospital day without prior consultation. No more than 2 specimens per patient can be submitted without prior consultation. This test is included in Ova and Parasite Screen. 1-3 Days CYSTIC FIBROSIS RESPIRATORY CULTURE Sputum E COLI 0157 Sterile Screw Cap, Culturette for throat only Order only on patients with a diagnosis of cystic fibrosis. 5 Days Stool Screw Cap 1 gram Rev. 04/13 Page 4 of 14
ENTEROVIRUS RNA, QUAL PCR CSF Sterile 0.7 ml CSF 24/7 FECAL FAT STAIN Stool Screw cap container 1 gram FECAL LEUKOCYTES Stool Screw Cap 1 gram stool 24/7 FERN TEST Vaginal Secretions Call Laboratory Allow amniotic fluid to air dry on a clean glass slide that is free of fingerprints before sending to the laboratory. Do not coverslip. 24/7 Rev. 04/13 Page 5 of 14
GC CULTURE GC DNA PROBE GIARDIA ANTIGEN GRAM STAIN Endocervical, Urethral, Rectal, Conjuntiva, Throat Culturette Cultures should be held at room temperature. 3 Days Endocervical/Urethral BD Collection Kit Only BD collection kits are acceptable. The following specimens are rejected: overfilled or under filled urine UPT, CT/GC tube without swab, and CT/GC tube with cleaning swab. Monday, Wednesday, Friday 1-3 Days Stool Sterile Cup 1 gram Stool specimens for ova and parasites are not accepted from inpatients after the third hospital day without prior consultation. No more than 2 specimens per patient can be submitted without prior consultation. Included in the Ova and Parasite Screen 1-3 Days Culturette, Sterile Various 1-2 Days Rev. 04/13 Page 6 of 14
Group B Strep PCR Vaginal/Rectal collected per CDC Guidelines Culturette All negative Group B Strep PCR will be followed up with a Group B Strep Culture. 24/7 GROUP B STREP SCREEN Vaginal/Rectal Culturette 2 Days H PYLORI ANTIGEN Stool Sterile INFLUENZA A & B ANTIGEN SCREEN Nasopharyngeal swab in UTM, Nasopharyngeal Washing, Nasopharyngeal Aspirate Call laboratory for collection kit. 0.5 ml 24/7 Rev. 04/13 Page 7 of 14
KOH PREP Hair, Skin or Nails Sterile Cup LEGIONELLA ANTIGEN Urine MALARIA SMEAR Urine Cup or Tube 1 ml Blood Lavender 1 ml 24/7 MRSA PCR Nares Culturette 24/7 Rev. 04/13 Page 8 of 14
MRSA SCREEN Axilla, Groin, Nares Culturette 2 Days MYCOLOGY CULTURE Specimen Type See Mycology Specimen Table See Mycology Specimen Table 4 Weeks MYCOBACTERIA DIRECT PROBE Sputum MYCOLOGY STAIN Sterile Screw Cap 5 ml Monday - Saturday 3-5 Days Various Culturette or Sterile Screw Cap 1-2 Days Rev. 04/13 Page 9 of 14
OCCULT BLOOD, GASTRIC Gastric Aspirate, Vomitus Specimen Cup 0.5 ml 24/7 OCCULT BLOOD, STOOL Stool Specimen Cup 24/7 OVA AND PARASITE MICROSCOPIC EXAM Stool Para-Pak Set Available From Laboratory Fill containers fill line indicated on container. Follow directions on Para-Pak collection set. Specimen cannot be contaminated with urine. Stool Specimens for ova and parasites are nto accepted from inpatients after the third hospital day without prior consultation. No more than 2 specimens per patient without piror consultation and no more than 1 specimen per 24 hour periord. This is a comprehensive ova and parasite exam and hsould be specifically requested as such by the ordring physician. This test is recommended if the patient is in one of the following risk categories: *AIDS/Immunocompromised/Immunosuppressed *Residence or a recent immigration from a developing country *Travel to a developing country *Persistent diarrhea: O&P Screen negative Reference Laboratory 4-10 Days Rev. 04/13 Page 10 of 14
OVA AND PARASITE SC (GIARDIA & CRYPTO AGS) Stool O&P Collection Kit available in Laboratory must be filled to appropriate level. Stool specimens for ova and parasite are not accepted from inpatients after the third hospital day without prior consultation. No more than 2 specimens per patient without prior consultation can be submitted. 1-3 Days PERTUSSIS CULTURE Nasalpharyngeal Call lab for collection kit. Refrigerate. Testing method of choice is PCR - See Bordetella Pertussis and Bordetella Parapertussis Detection by Rapid PCR 7-10 Days RESPIRATORY CULTURE Sputum, Tracheal Aspirates, Bronchial Washings, Bronchial Brushes, Bronchial Biopsy, Lung Aspirate, Lung Biopsy, Transtracheal Aspirate Sterile Screw Cap Sputum specimens should be collected in the early morning. No more than 1 sputum specimen should be collection for culture in a 24 hour period. 2 Days RESPIRATORY CULTURE, QUANTATIVE BAL or PBS Sterile screw cup container 5 ml 3 Days RESPIRATORY VIRAL PANEL (RVP) Rev. 04/13 Page 11 of 14
Nasopharyngeal swab in UTM, Bronchial Wash, BAL Call laboratory for collection kit for Nasopharyngeal swab. 0.5 ml (minimum) 24/7 RSV ANTIGEN Nasopharyngeal Swab in UTM, Nasopharyngeal Washing, Nasopharyngeal Aspirate RSV Collection Kit (available from Laboratory) 0.5 ml 24/7 ROTAVIRUS ANTIGEN Stool Sterile Screw Cap or Swab 2 grams of fresh stool If specimen submitted on swab there must be visible stool. 24/7 ROUTINE CULTURE Any body site, aspirate, or pus. Culturette or Sterile 3 Days Rev. 04/13 Page 12 of 14
STOOL CULTURE 2 grams of fresh stool in Cary Blair or visible stool on culturette Cary Blair Collection or Culturette Collect stool without contaminating with urine. Stool specimens for bacterial culture are not accepted after the third hospital day without prior consultation. No more than 2 specimens per patient without prior consultation can be submitted. 3 Days STREPTOCOCCUS PNEUMONIAE AG CSF or Urine STREP SCREEN Sterile Screw Cap 0.5 ml Infection cannot be ruled out since the antigen level may be below the detectable limit. 1-2 Days Throat Dual Swab Culturette same day if positive. Negative samples will be followed up with a culture. 24/7 TISSUE CULTURE (See Note) Any body site tissue or bone, specify body site Tissue in sterile cup 24/7 7 Days Rev. 04/13 Page 13 of 14
URINE CULTURE WET PREP Clean Catch Midstream, Indwelling Catheter, Straigh Catheter, Suprapubic Aspiration, Cysto Boric Acid Collection Tube or Steril Screw Top 1 ml (minimum) Collection method must be indicated for proper culture interpretation. Contamination by organisms normally present in the urethra or on periurethral surfaces can yield misleading urine culture results. 2-3 Days Vaginal Swab, Vaginal Aspirate, Vaginal Washing, Rectal Washing Tube with 0.5 ml saline Collect specimen with a swab and then place into the tube with saline. Dry swabs will be rejected. Do no overfill tube with saline. 24/7 Rev. 04/13 Page 14 of 14