The patient's name and the source of specimen must be on both the requisition and the specimen. A culture is only as accurate as the method used for collection. Outside microorganisms may contaminate a specimen during each phase of handling. This can lead to misleading or erroneous results. Take care at all times to avoid contamination. Submit promptly for optimal recovery of pathogens. Submit in a leak-proof container at room temperature unless otherwise specified.

 

CODE

NAME

SPECIMEN REQUIREMENTS

 

 

 

6070

Acid Fast Culture

 

(and/or)

Collect specimen in container and hold at room temperature until courier pickup. No preservative is necessary.

 

6071

Acid Fast Smear

Sputum : 5 to 10 mL of early morning expectorant from a deep cough.

Blood : 10 mL for adults or 1.5 mL for children collected aseptically and placed in SPS (yellow) tubes.

 

6010

Anaerobic Culture

Be sure specimen is from suitable anaerobic sterile body site or deep body cavity. Send a culture swab immersed in transport media or fluid in syringe with air expelled and needle removed. Submit promptly for optimal recovery of pathogens.

 

6095

Autoclave Ampule

The test ampule is placed in the center of an autoclave load. It should be submitted for testing with an unautoclaved ampule marked as a control.

 

6083

Bacterial Antigen

Body fluids including serum, CSF, and urine may be submitted in a container for testing. Please specify which of the following bacterial antigens need to be tested:

  • Group B Streptococcus
  • E. coli K1
  • Haemophilus influenzae
  • Neisseria meningitidis
  • Streptococcus pneumoniae

 

6013

 

 

 

 

 

 

 

 

 

 

 

Blood Culture

Ideally, 20 mL of blood is drawn and split between an aerobic bottle and an anaerobic bottle. For pediatric draws, 1 to 2 mL blood may be submitted in an aerobic bottle. Use the following aseptic technique:

 

  • Clean the blood collection site with alcohol.
  • Disinfect the site with iodine and allow to dry 1 to 2 minutes.
  • Clean the diaphragm of the bottles with alcohol.
  • Do not touch the phlebotomy site after disinfection.
  • Draw blood with a sterile syringe and needle.
  • Immediately transfer 20 mL of blood to each bottle.
  • Mix the bottles by inversion to prevent blood from clotting.
  • Remove iodine from the patient's arm with alcohol.

 

6090

Bordetella by PCR

Package with instructions is available upon request. Sent to the Texas Department of Health for processing unless otherwise requested.

 

6066

Chlamydia Culture

A conical centrifuge tube containing viral transport media is provided. Use a swab to collect the specimen. It is broken off into the tube and should be immersed in the liquid media. Refrigerate.

 

6025

Clostridium difficile Culture

 

Submit fresh stool specimen in sterile container.

 

6135

Clostridium difficile Toxin

Submit fresh stool specimen in sterile container. Refrigerate.

 

6067

CMV

All specimens need to be refrigerated as soon possible.

Blood: Draw 10 mL blood aseptically into heparin (green-top) tube.

Urine: Collect random specimen in a sterile container.

 

Other: Submit sample in viral transport media.

 

3600

Cryptococcal Antigen

CSF or blood may be submitted in a sterile container. Refrigerate.

 

7050

Cryptosporidium Stain

Submit fresh stool specimen in vial containing formalin.

 

6037

CSF Culture

Submit CSF in sterile container. Submit promptly for optimal recovery of pathogens.

 

7020

Fecal Leukocytes

Submit fresh stool specimen in sterile container or fresh stool in vial containing formalin.

 

6075

Fungus Culture

(skin, hair, nails)

 

Submit specimens in sterile container.

6074

Fungus Culture Blood

Blood specimens should be collected aseptically and submitted in Isolator tubes. Appropriate sample size for adults is 10 mL. Pediatric specimens of 1.5 mL are acceptable.

 

6077

Fungus Culture Other

Submit specimens in sterile container. Swabs are acceptable but not recommended.

 

6031

GC Culture

A culture swab with transport media may be submitted. A Jembec plate is also acceptable. The plate is inoculated by rolling the swab on the agar surface in a Z-pattern. A CO 2 generator capsule is then placed in the space provided. The plate is then sealed in the provided plastic sack.

 

 

6106

Gram Stain

Smear glass slide with specimen at time of collection and air dry. Always smear slide frosted side up. Label slide in pencil on frosted area with patient's name and source. Culture swabs and specimens submitted in sterile containers can also be submitted for gram stain.

 

6501

Group A Strep Rapid

Use dual culture swabs and be sure to inoculate both swabs.

 

6061

Group A Strep Rapid Reflex

Use dual culture swabs and be sure to inoculate both swabs. If the screen is negative, a culture will be done with the remaining swab.

 

6069

Herpes Simplex Culture

Use special collection vial and swab. After swabbing the base of the lesion, place swab in viral transport vial. Label with the patient name and date. Refrigerate.

 

6068

Herpes Simplex Typing

Body fluid in a sterile container or sterile swab in viral transport media is required. Refrigerate.

 

6110

KOH Preparation

Skin scrapings may be submitted in a clean 50 mL screw cap container. A swab of mucus membrane may be submitted. Do not submit specimens crushed between two slides.

 

7010

Occult Blood Single Screen

Hemoccult slides may be submitted. Following the directions on the slide, one side is lifted and stool is smeared in the provided areas.

 

7015

Occult Blood Screen x3

Hemoccult slides may be submitted. Following the directions on the slide, one side is lifted and stool is smeared in the provided areas.

 

7017

Medicare Occult Blood

Hemoccult slides may be submitted. Following the directions on the slide, one side is lifted and stool is smeared in the provided areas.

 

7000

Ova & Parasite

Submit fresh stool specimen in stool preservative vials (one formalin and one PVA vial). Fecal leukocytes can be performed with this specimen. No more than three parasitology specimens are recommended. Three O & P specimens will pick up 99% of parasitic pathogens.

7030

Pinworm Slide

Plastic paddle specimens are preferred. Clear tape may be acceptable but is not recommended. Collect first thing in the morning by gently pressing the sticky side of the paddle against the anus. Frosted tape cannot be used.

 

 

6160

Pneumocystis carinii

Submit biopsy, sputum or bronchial washings in sterile container.

 

6145

Rotavirus Screen

Submit fresh stool specimen in a clean container. Sample must not be contaminated with urine. Refrigerate.

 

6007

Routine Culture

Fluid: Submit in sterile tube or syringe with needle removed.

 

Swab: Submit a culture swab in transport media.

 

Tissue: Submit in a sterile container immersed in a small amount sterile saline.

 

6039

RSV Screen

Submit nasal washing collected in a sterile container. Refrigerate.

 

6040

Sputum Culture

Submit sputum expectorated by deep cough into a sterile container.

   

The Adequacy of Sputum Cultures:

At CPL, a gram stain is performed on all sputum cultures reporting bacteria, epithelial cells and inflammatory cells. This information can be used to assess the adequacy of the sputum collection. A specimen containing greater than 10 squamous epithelial cells/low power field suggests oropharyngeal contamination, and the gram stain will be reported as "possible oropharyngeal contamination". Gram stains exhibiting minimal oropharyngeal contamination will be reported with the number of epithelial cells and inflammatory cells. Because recollection may be difficult or may delay clinical evaluation, CPL does not cancel the sputum culture in cases of possible oral cavity contamination, unless the client communicates with the microbiology department. If the client feels the collection was inadequate based on the gram stain report, a recollection should be considered.

 

6042

Stool Culture

Submit fresh stool specimen uncontaminated by urine in a vial containing Cary Blair transport media. No more than two bacteriology specimens are recommended. Two specimens will pick up 99% of bacterial pathogens.

 

6047

Streptococcus Culture -

Throat

Submit specimen on a culture swab immersed in transport media.

 

6079

Streptococcus B Culture -

Pregnancy

Submit specimen on a culture swab immersed in transport media.

 

6046

Throat Culture

Submit specimen on a dual culture swab immersed in transport media.

 

6049

Urine Culture

Urine placed in gray-top transport tube is preferred. Urine collected in sterile container is also acceptable. Directions for proper collection:

1. Females should clean the periurethral area with water.

2. Males should clean the glans penis area with water.

3. Allow the initial flow of urine to commence and then collect a midstream portion into a sterile container.

4. Submit sealed container refrigerated or transfer urine to gray-top preservative tube at room temperature. Note: If urinalysis is also ordered, an unpreserved sample should be submitted for that test. Susceptibility testing is not routinely performed on voided specimens with mixed urogenital flora or on colony counts below 10,000 CFU/mL.

 

6052

Vaginal Culture

Specimens should be submitted on a culture swab immersed in transport media.

 

6065

Viral Culture

Body fluid in a sterile container or sterile swab immersed in viral transport media is required. Refrigerate.

 

6105

Wet Prep

Place swab in 0.5 mL saline. To detect Trichomonas, specimen should be examined as soon as possible.