Guidelines for Specimen Collection and Submission: Mycobacteriology (AFB) Collection, Transport, and Storage
Quick Links
- Abscess General
- Abscess - Open
- Body Fluid - abdominal, amniotic, ascites, bile, joint, paracentesis, pericardial, peritoneal, pleural, synovial, thoracentesis
- Cellulitis, aspirate from area of
- Cerebrospinal Fluid (CSF) Analysis
- Endometrial Tissue
- Eye - Corneal Scrapings
- Eye - Exudate
- Feces
- Fistula (See Abscess)
- Gastric Wash or lavage for mycobacteria
- Respiratory, lower Bronchoalveolar lavage, brush or wash, endotracheal aspirate, transtracheal aspirate
- Skin Lesion
- Sputum, Expectorated
- Sputum, Induced
- Tissue / Lymph Node
- Vaginal Secretions
- Wound (See Abscess)
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. If transport is delayed for more than one hour, refrigerate specimen
Transport time and temp: As soon as possible; Overnight shipment on cold pack is recommended.
Storage time: Refrigerate, but do not freeze specimen
Replica limits: 1/day/source
Comments: Tissue (at least 1 gram, if possible) 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.
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; Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen.
Storage time: Refrigerate but do not freeze specimen
Replica limits: 1/day/source
Comments: Tissue (at least 1 gram, if possible) 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.
Specimen Type (Reference): Body Fluids: abdominal, amniotic, ascites, bile, joint, paracentesis, pericardial, peritoneal, pleural, synovial, thoracentesis
Collection guidelines: Palpate vein before disinfection of venipucture site. Disinfection of venipuncture site:
- Disinfect overlying skin with alcohol or iodine preparation
- Obtain specimen via percutaneous needle aspiration or surgery
- 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 temperature: As soon as possible; Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen.
Storage time: Refrigerate but do not freeze specimen
Replica limits: None
Comments: Maximum volume recommended is 15 ml
Specimen Type (Reference): Cellulitis, aspirate from area of
Collection guidelines:
- Cleanse site by wiping with sterile saline or 70% alcohol.
- 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
- 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 temperature: As soon as possible; Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen.
Storage time: Refrigerate, but do not freeze specimen
Replica limits: 1/day
Transport time and temp: As soon as possible; Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen.
Specimen Type (Reference): Cerebrospinal Fluid (CSF) Analysis
Collection guidelines: 1. Disinfect site with iodine preparation
Transport device and/or minimum volume: 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: Room Temperature. Do not refrigerate or freeze CSF specimen.
Replica limits: None
Comments: None
Specimen Type (Reference): Endometrial Tissue
Collection guidelines: 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: Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen.
Storage time: Refrigerate, but do not freeze specimen.
Replica limits: 1/day
Comments: Do not freeze or preserve tissue specimen.
Specimen Type (Reference): Eye - Corneal Scrapings
Collection guidelines:
- Specimen collected by ophthalmologist
- 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; Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen.
Storage time: Refrigerate but do not freeze specimen
Replica limits: None
Comments: None
Specimen Type (Reference): Eye (exudates)
Collection guidelines: Aspirate if possible. Collect material in Luer tip syringe.
Transport device and/or minimum volume: Exudate should be submitted in a sterile leak-proof container such as a sterile 50 ml conical tube.
Transport time and temperature: As soon as possible; Overnight shipment on cold pack is recommended.. If transport is delayed for more than one hour, refrigerate specimen
Storage time: Refrigerate but do not freeze specimen
Replica limits: None
Comments: None
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 volume: Sterile, leak-proof, container such as a 50 ml conical tube; minimum volume is 1 gram.
Transport time and temp: Unpreserved; As soon as possible; Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen
Storage time: Refrigerate but do not freeze specimen
Replica limits: 1/Day
Comments: Do not submit rectal swabs for mycobacterial culture.
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.
- Introduce a nasogastric tube into the stomach
- Perform lavage with 25-50 ml of chilled, sterile distilled water
- 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: NA
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.
Specimen Type (Reference): Respiratory, lower bronchoalveolar lavage, brush or wash, endotracheal aspirate, transtracheal aspirate
Collection guidelines:
- Collect washing or aspirate in a sputum trap
- Place brush in sterile leak-proof container with up to 5 ml of saline
Transport device and/or minimum volume: Sterile container such as a sterile 50 ml conical tube; minimum volume is 3 ml
Transport time and temperature: As soon as possible; Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen
Storage time: Refrigerate but do not freeze specimen
Replica limits: 1/day
Comments: None
Specimen Type (Reference): Skin Lesion
Collection guidelines:
- Cleanse with sterile saline, and remove lesion's surface with a sterile scalpel blade
- Allow transudate to accumulate
- While pressing the base of the lesion, collect transudate with sterile syringe. Place contents of syringe in sterile leak-proof container.
- 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 volume: Sterile leak-proof container such as a sterile 50 ml conical tube.
Transport time and temperature: As soon as possible; Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen.
Storage time: Refrigerate but do not freeze 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
Specimen Type (Reference): Sputum, Expectorated
Collection guidelines:
- Collect specimen under the direct supervision of a nurse or physician
- Have patient rinse or gargle with water to remove excess oral flora.
- Instruct patient to cough deeply to produce a lower respiratory specimen (not postnasal fluid)
- Collect in a sterile container
Transport device and/or minimum volume: Sterile container such as 50 ml conical tube; minimum volume is 3 ml
Transport time and temperature: As soon as possible; Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen
Storage time: Refrigerate but do not freeze specimen
Replica limits: For diagnosis, at least three consecutive sputum specimens are needed, each collected in 8- to 24-hour intervals, with at least one being an early morning specimen.
Comments: Early morning sputum specimen is preferred. Do not pool sputum specimens.
Specimen Type (Reference): Sputum, Induced
Collection guidelines:
- Have patient rinse mouth with water after brushing gums and tongue
- With the aid of a nebulizer, have patients inhale approximately 25 ml of 3-10% sterile saline
- 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; Overnight shipment on cold pack is recommended.. If transport is delayed for more than one hour, refrigerate specimen
Storage time: Refrigerate but do not freeze specimen
Replica limits: For diagnosis, at least three consecutive sputum specimens are needed, each collected in 8- to 24-hour intervals, with at least one being an early morning specimen.
Comments: Same as above for sputum, expectorated.
Specimen Type (Reference): Tissue / Lymph Node
Collection guidelines: Aseptically 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; Overnight shipment on cold pack is recommended. If transport is delayed for more than one hour, refrigerate specimen.
Storage time: NA
Replica limits: 1/day
Comments: Always submit as much tissue as possible. Add 2 to 3 ml sterile saline to tissue for transport.
Specimen Type (Reference): Vaginal Secretions
Collection guidelines:
- Wipe away old secretions and discharge
- Obtain secretions from the mucosal membrane of the vaginal wall with a sterile pipette
Transport device and/or minimum volume: Submit secretions in sterile leak-proof container; do not use transport medium.
Transport time and temperature: As soon as possible; Overnight shipment on cold pack is recommended.. If transport is delayed for more than one hour, refrigerate specimen
Storage time: Refrigerate but do not freeze 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.