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Guidelines for Specimen Collection and Submission: Mycobacteriology (AFB) Collection, Transport, and Storage

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Specimen Guidelines Table of Contents | Mycobacteriology/Mycology home

 

Guidelines for Specimen Collection and Submission: Mycobacteriology (AFB) Collection, Transport, and Storage

Specimen type (reference): Abscess - General

Collection guidelines: Remove surface exudate by wiping with sterile saline or 70% alcohol. Collect fluid abscess material with Luer tip syringe and/or remove tissue aseptically.

Transport device and/or minimum vol.:   Fluid abscess material should be submitted in a sterile leak-proof container such as a sterile 50 ml conical tube.  Tissue should be submitted in 2 to 3 ml sterile saline in a sterile leak-proof container such as a sterile 50 ml conical tube. Do not transport specimen in culturette or in transport medium.

Transport time and temp:  As soon as possible; Ambient

Storage time:  If transport is delayed for more than one hour, refrigerate specimen.

Replica limits:  1/day/source

Comments: Tissue or fluid is preferred.  A swab is discouraged unless it is the only specimen available; submit swabs in 2 to 3 ml sterile saline.  Swabs submitted in transport medium or culturette tube are unacceptable.  Do not freeze or preserve tissue.

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Specimen type (reference):  Abscess - Open

Collection guidelines: Aspirate if possible.  Aspirate material from under the margin of the lesion/abscess.  Remove tissue aseptically.

Transport device and/or minimum vol.:  Fluid abscess material should be submitted in a sterile leak-proof container such as a sterile 50 ml conical tube.  Tissue should be submitted in 2 to 3 ml sterile saline in a sterile leak-proof container such as a sterile 50 ml conical tube. Do not transport specimen in culturette or in transport medium.

Transport time and temp:  As soon as possible; Ambient

Storage time:  If transport is delayed for more than one hour, refrigerate specimen.

Replica limits: 1/day/source

Comments: Tissue or fluid is preferred.  A swab is discouraged unless it is the only specimen available; submit swabs in 2 to 3 ml sterile saline.  Swabs submitted in transport medium or culturette tube are unacceptable.  Do not freeze or preserve tissue.

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Specimen type (reference): Blood

Collection guidelines: Palpate vein before disinfection of venipucture site. Disinfection of venipuncture site: 
1.  Cleanse site with 70% alcohol  
2.  Swab concentrically, starting at the center with an iodine preparation 
3.  Allow the iodine to dry 
4. Do no palpate vein at this point without sterile glove 
5. Collect blood; mix contents of blood collection tube after collecting.
6. After venipucture, remove iodine from the skin with alcohol 

Transport device and/or minimum vol.:  10 ml Yellow top collectors preferred (must contain SPS only); minimum volume is 1 ml.

Transport time and temp: As soon as possible; Ambient

Storage time:  RT. Do not refrigerate or freeze blood specimens

Replica limits: 1/day

Comments:

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Specimen type (reference): Bone Marrow aspirate

Collection guidelines: Prepare puncture site as for surgical incision.

Transport device and/or minimum vol.:  Submit in sterile leak-proof container such as sterile 50 ml conical tube.

Transport time and temp: As soon as possible; Ambient

Storage time: RT.  Do not refrigerate or freeze blood specimens

Replica limits: 1/day

Comments:

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Specimen type (reference): Cellulitis, aspirate from area of 

Collection guidelines: 1. Cleanse site by wiping with sterile saline or 70% alcohol.
2. Aspirate the area of maximum inflammation (commonly the center rather than the leading edge) 
with a needle and syringe; irrigation with a small amount of sterile saline may be necessary
3.  Aspirate saline into syringe, and expel into sterile leak-proof container such as a sterile 50 ml conical tube

Transport device and/or minimum vol.: Sterile leak-proof container such as a sterile 50 ml conical tube

Transport time and temp:  As soon as possible; Ambient

Storage time:

Replica limits: 1/day

Comments: A swab is discouraged unless it is the only specimen available; submit swabs in 2 to 3 ml sterile saline.  Swabs submitted in transport medium or culturette tube are unacceptable. 

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Specimen type (reference): CSF

Collection guidelines: 1.  Disinfect site with iodine preparation

Transport device and/or minimum vol.: Sterile leak-proof container such as 50 ml conical tube.  Minimum amt required:  2-3 ml

Transport time and temp: As soon as possible; Ambient

Storage time: RT.  Do not refrigerate or freeze CSF specimen.

Replica limits: None

Comments:

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Specimen type (reference): Eye (exudates) 

Collection guidelines:  Aspirate if possible.  Collect material in Luer tip syringe.

Transport device and/or minimum vol:  Exudate should be submitted in a sterile leak-proof container such as a sterile 50 ml conical tube.

Transport time and temp: As soon as possible; Ambient

Storage time:   If transport is delayed for more than one hour, refrigerate specimen

Replica limits: None

Comments:

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Specimen type (reference): Eye - Corneal scrapings 

Collection guidelines: 1.  Specimen collected by ophthalmologist
2.  Using sterile spatula, scrape ulcers or lesions, and inoculate scraping directly onto medium 

Transport device and/or minimum vol.: Direct culture inoculations:  BHI with 10% sheep blood agar plate or chocolate agar plates 

Transport time and temp: As soon as possible; Ambient

Storage time: 

Replica limits: None

Comments: Please notify supervisor at 512-458-7342 prior to shipping this specimen type.  Fungal isolation media should also be included but fungal isolation test is not available at TDSHS without prior approval.

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Specimen type (reference): Feces

Collection guidelines: Pass specimen directly into a sterile leak-proof container.  Do not use holding medium or transport medium.

Transport device and/or minimum vol.: Sterile, leak-proof, container such as a 50 ml conical tube; minimum volume is 1 gm.

Transport time and temp: Unpreserved; As soon as possible; Ambient. 

Storage time: If transport is delayed for more than one hour, refrigerate specimen

Replica limits: 1/day

Comments: Do not submit rectal swabs for mycobacterial culture.  Do not freeze specimen.

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Specimen type (reference): Fluids: abdominal, amniotic, ascites, bile, joint, paracentesis, pericardial, peritoneal, pleural, synovial, thoracentesis 

Collection guidelines: 1.  Disinfect overlying skin with alcohol or iodine preparation
2.  Obtain specimen via percutaneous needle aspiration or surgery 
3.  Always submit as much fluid as possible; never submit a swab dipped in fluid

Transport device and/or minimum vol.: Sterile leak-proof container such as a 50 ml conical tube; Minimum volume is 10-15 ml.

Transport time and temp: As soon as possible; Ambient

Storage time:

Replica limits: None

Comments:  Maximum volume recommended is 15 ml.  Bloody specimens can be collected and submitted in 10 ml Yellow top blood collection tube.

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Specimen type (reference): Gastric Wash or lavage for mycobacteria

Collection guidelines: Collect in early morning before patients eat and while they are still in bed.
1.Introduce a nasogastric tube into the stomach
2. Perform lavage with 25-50 ml of chilled, sterile distilled water  
3. Recover sample and place in a leak-proof, sterile container

Transport device and/or minimum vol.: Sterile, leak-proof container such as sterile 50 ml conical tube ; minimum volume is 5-10 mL.

Transport time and temp: Neutralize within 1 h of collection, transport as soon as possible; Ambient

Storage time:

Replica limits:1/day on three consecutive days

Comments: The specimen must be processed promptly, since mycobacteria die rapidly in gastric washings. Neutralize with 100 mg sodium carbonate.   Maximum volume of specimen recommended is 15 ml.

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Specimen type (reference): Endometrial tissue

Collection guidelines: 1.  Collect tissue aseptically during endometrial biopsy procedure.

Transport device and/or minimum vol.:  Sterile leak-proof container; if dry, add up to 5 ml sterile saline for transport.

Transport time and temp: Ambient

Storage time: RT

Replica limits:1/day

Comments:  Do not freeze or preserve tissue specimen.

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Specimen type (reference): Vaginal Secretions

Collection guidelines: 1.  Wipe away old secretions and discharge 
2.  Obtain secretions from the mucosal membrane of the vaginal wall with a sterile pipette 

Transport device and/or minimum vol.:  Submit secretions in sterile leak-proof container; do not use transport medium.

Transport time and temp: As soon as possible; Ambient

Storage time: If transport is delayed for more than one hour, refrigerate specimen

Replica limits:1/day

Comments:  A swab is discouraged unless it is the only specimen available; submit swabs in 2 to 3 ml sterile saline.  Swabs submitted in transport medium or culturette tube are unacceptable

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Specimen type (reference): Skin lesion

Collection guidelines: 1.  Cleanse with sterile saline, and remove lesion's surface with a sterile scalpel blade
2.  Allow transudate to accumulate 
3.  While pressing the base of the lesion, collect transudate with sterile syringe.  Please contents of syringe in sterile leak-proof container.  
4.  If tissue is collected, place tissue in sterile leak-proof container and add 2 to 3 ml sterile saline for transport.

Transport device and/or minimum vol.:  Sterile leak-proof container such as a sterile 50 ml conical tube

Transport time and temp: As soon as possible; Ambient

Storage time: If transport is delayed for more than one hour, refrigerate specimen

Replica limits:1/day

Comments:  A swab is discouraged unless it is the only specimen available; submit swabs in 2 to 3 ml sterile saline.  Swabs submitted in transport medium or culturette tube are unacceptable

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Specimen type (reference): Respiratory, lower Bronchoalveolar lavage, brush or wash, endotracheal aspirate, transtracheal aspirate

Collection guidelines: 1.  Collect washing or aspirate in a sputum trap
2.  Place brush in sterile leak-proof container with up to 5 ml of saline

Transport device and/or minimum vol.: Sterile container such as a sterile 50 ml conical tube; minimum volume is 3 ml

Transport time and temp: As soon as possible; Ambient

Storage time: If transport is delayed for more than one hour, refrigerate specimen

Replica limits:1/day

Comments:

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Specimen type (reference): Sputum, expectorated 

Collection guidelines: 1.  Collect specimen under the direct supervision of a nurse or physician 
2.  Have patient rinse or gargle with water to remove excess oral flora. 
3.  Instruct patient to cough deeply to produce a lower respiratory specimen (not postnasal fluid)
4.  Collect in a sterile container

Transport device and/or minimum vol.: Sterile container such as 50 ml conical tube;  minimum volume is  3 ml

Transport time and temp: As soon as possible; Ambient

Storage time: If transport is delayed for more than one hour, refrigerate specimen

Replica limits:1/day on 3 consecutive days

Comments:  Early morning sputum specimen is preferred.   Do not pool sputum specimens.

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Specimen type (reference): Sputum, induced 

Collection guidelines: 1.  Have patient rinse mouth with water after brushing gums and tongue
2.  With the aid of a nebulizer, have patients inhale approximately 25 ml of 3-10% sterile saline 
3.  Collect in a sterile leak-proof container

Transport device and/or minimum vol.: Sterile leak-proof container such as a 50 ml conical tube; minimum volume is 3 ml

Transport time and temp: As soon as possible; Ambient

Storage time: If transport is delayed for more than one hour, refrigerate specimen

Replica limits:1/day on three consecutive days

Comments: Same as above for sputum, expectorated.

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Specimen type (reference): Tissue/lymph node

Collection guidelines: Collected during surgery or cutaneous biopsy procedure

Transport device and/or minimum vol.: Sterile leak-proof container such as sterile 50 ml conical tube

Transport time and temp: As soon as possible; Ambient

Storage time:

Replica limits:1/day

Comments: Always submit as much tissue as possible. Add 2 to 3 ml sterile saline to tissue for transport.

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Specimen type (reference): Urine Female, midstream 

Collection guidelines: 1.  While holding the labia apart, begin voiding 
2.  After several milliliters has passed, collect a midstream portion without stopping the flow of urine
3.  The midstream portion is used for bacterial culture

Transport device and/or minimum vol.: Sterile, leak-proof container such as sterile 50 ml conical tube; minimum volume is 10-15 ml.  Prefer up to 40 ml.

Transport time and temp: As soon as possible; Ambient

Storage time: If transport is delayed for more than one hour, refrigerate specimen

Replica limits:1/day on 3 consecutive days.

Comments: First morning specimen should be collected.   Do not pool urine specimens.

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Specimen type (reference): Urine, Male, midstream

Collection guidelines: 1.  While holding foreskin retracted, begin voiding 
2.  After several milliliters has passed, collect a midstream portion without stopping the flow of urine  
3.  The midstream portion is used for culture

Transport device and/or minimum vol.: Sterile, leak-proof container such as sterile 50 ml conical tube; minimum volume is 10-15 ml.  Prefer up to 40 ml.

Transport time and temp: As soon as possible; Ambient

Storage time: If transport is delayed for more than one hour, refrigerate specimen

Replica limits: 1/day on 3 consecutive days

Comments: First morning specimen should be collected.   Do not pool urine specimens

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Specimen type (reference): Straight catheter

Collection guidelines: Thoroughly cleanse the urethral opening with soap and water
2.  Rinse area with wet gauzepads 
3.  Aseptically, insert catheter into the bladder
4.  After allowing approximately 15 ml to pass, collect urine to be submitted in a sterile container

Transport device and/or minimum vol.: Sterile, leak-proof container such as sterile 50 ml conical tube; minimum volume is 10-15 ml.  Prefer up to 40 ml.

Transport time and temp: As soon as possible; Ambient

Storage time:

Replica limits: 1/day on 3 consecutive days

Comments: First morning specimen should be collected.   Do not pool urine specimens

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Specimen type (reference): Indwelling catheter or suprapubic tap

Collection guidelines: 1.  Disinfect the catheter collection port with 70% alcohol 
2.  Use needle and syringe to aseptically collect 5-20 ml of urine
3.  For suprapubic tap, use Luer tip syringe to collect as much as possible.
4.  Transfer to a sterile tube or container

Transport device and/or minimum vol.: Sterile leak-proof container such as sterile 50 ml conical tube; minimum volume is 10-15 ml

Transport time and temp: As soon as possible; Ambient

Storage time:

Replica limits:

Comments:

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Specimen type (reference): Wound (See Abscess)

 

Last updated February 20, 2014