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[MT 6320] Clinical Bacteriology Laboratory > [1S] UNIT 1.3 Specimen Collection & Handling > Flashcards

[1S] UNIT 1.3 Specimen Collection & Handling Flashcards

1
Q

T/F: Collect specimen in the acute phase of the infection. Collect prior to administration of antibiotics

A

T

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2
Q

Swabs are primarily for?

A

Aerobic Bacteria

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3
Q

Aspirates are primarily for?

A

anaerobic bacteria

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4
Q

● Provide exact anatomic site
● Cleanse the area prior to collection
● Collect at the margin (swabs)
● Place material into an appropriate tube/vial

A

Lesions, Wounds, and Abscesses

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5
Q

LESSIONS, WOUNDS AND ABSCESSES

● Swab: _________ ______
● Aspirate: deep wound

A

superficial wounds

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6
Q

TYPES OF SWABS

for Bacterial Culture

A

Dacron, Calcium Alginate, Rayon

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7
Q

TYPES OF SWABS

for Viral Culture

A

use Cotton and Dacron

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8
Q

UPPER RESPIRATORY TRACT SWAB

isolation of Group A Streptococcus

A

Throat Cultures

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9
Q

UPPER RESPIRATORY TRACT SWAB

for diagnosis of pertussis, middle ear infections, carrier state of S. aureus

A

Nasopharyngeal Cultures

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10
Q

SWABS

Gonococcal urethritis, vaginosis, vaginitis

A

Urogenital Swabs

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11
Q

T/F: Swabs should be collected in duplicates

A

T

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12
Q

Preferred for urine collection

A

Clean catch midstream

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13
Q

for diagnosis of lower respiratory tract infections (bacterial pneumonia, PTB)

A

Sputum

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14
Q

SPUTUM

○ Proper collection: _____ ml
○ Expectorated
○ Induced
○ Gastric contents (children)

A

5-10

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15
Q

SPUTUM

○ Collect 2 specimens of sputum
○ Other specimens: transtracheal aspirate, BAL, bronchial washings

A

For Pulmonary Tuberculosis

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16
Q

SPUTUM

Early morning specimen

A

For other infections

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17
Q

T/F: Prior to culture and sputum examination, pre-examine the submitted sputum.

A

T

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18
Q

SPUTUM

Microscopic Examination: Gram Stain Bartlett’s Classification
● ___ leukocytes/LPF
● ___ epithelial cells/LPF

A

> 25
<10

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19
Q

is the specimen of choice for the diagnosis of gastrointestinal pathogens.

A

Stool

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20
Q

T/F: Rectal swabs may be used if stool is present on the swab during sample collection

A

T

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21
Q

○ diagnosis of fever of unknown origin (FUO)
○ Septicemia, Bacteremia, Typhoid Fever, SBE
○ Collection: Venipuncture
○ Aerobic and Anaerobic

A

Blood

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22
Q

T/F: Septicemia, Bacteremia, Typhoid Fever, SBE Collect before and right after fever spike; 2-3 cultures placed an hour apart

A

T

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23
Q

Blood:Media Ratio

A

1:10

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24
Q

BLOOD

● Media of Choice:
● Anticoagulant:

A

Broth (BHI, TSB, Biphasic Media, Thioglycollate Broth)
SPS (0.025-0.030%); other anticoagulants – heparin

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25
Q

● Includes the abdominal fluid, amniotic fluid, ascitic fluid, bile, synovial fluid, pleural fluid, pericardial fluid
● Collected by needle aspiration
● Disinfect the site prior to aspiration

A

Body Fluids

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26
Q

T/F: Body fluids should be placed immediately in culture media

A

T

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27
Q

Use of Gastric Tubes such as Levine and Rehfuss Tubes

A

Gastric Specimens

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28
Q

Diagnosis of Meningitis or Meningoencephalitis

A

CSF

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29
Q

Diagnosis of Meningitis or Meningoencephalitis

A

CSF

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30
Q

Collection for CSF

A

> /=1ml Lumbar Tap (3rd-4th Lumbar Vertebra)

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31
Q

3 sterile tubes for CSF collection

A

Tube 1 = chemistry and immunology testing.
Tube 2 = microbiology testing.
Tube 3 = hematology testing.

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32
Q

T/F: Aspirates should be placed in a container with tight lid or in an aerobic transport system

A

F; anaerobic

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33
Q

PRESERVATION, STORAGE AND TRANSPORT

Ideally and preferably up to how many hours should a specimen be transported?

A

○ Ideally: 30 minutes
○ Preferably up to 2hours

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34
Q

PRESERVATION, STORAGE AND TRANSPORT

T/F: If not transported immediately, specimens must be added with preservatives, anticoagulants or placed in transport/culture media

A

T

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35
Q

PRESERVATION, STORAGE AND TRANSPORT

Preservatives

A

○ Boric Acid
○ Refrigeration

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36
Q

PRESERVATION, STORAGE AND TRANSPORT

maintains viability
○ Cary Blair
○ Stuart’s or Amie’s
○ JEMBEC Media

A

Transport Media/Holding Media

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37
Q

PRESERVATION, STORAGE AND TRANSPORT

0.025% - 0.03% Sodium polyanethol sulfonate (LIQUOID)

A

Anticoagulants

38
Q

PRESERVATION, STORAGE AND TRANSPORT

● Antiphagocytic, anticomplementary
● May inhibit some antimicrobials (aminoglycosides)
● May inhibit certain bacteria such as Neisseria, Gardnerella vaginalis, Streptobacillus moniliformis and Peptostreptococcus anaerobius

A

0.025% - 0.03% Sodium polyanethol sulfonate (LIQUOID)

39
Q

STORAGE APPLICATION

catheter tips, CSF for viruses, outer ear swab, unpreserved feces and urine, feces (for isolation of Clostridioides difficile toxin), sputum, swabs

A

Refrigerator temperature (4 degree Celsius)

40
Q

STORAGE APPLICATION

CSF for bacteria, abscess, lesion, wound, body fluids, inner ear, preserved urine and stool, nasal specimens, tissues

A

Ambient/Room temperature (22 degree Celsius)

41
Q

STORAGE APPLICATION

CSF

A

Body temperature (37 degree Celsius)

42
Q

STORAGE APPLICATION

Serum for Serology (-20C); long term storage (-70C)

A

Freezer temperature (-20 or – 70 degree Celsius)

43
Q

SPECIMEN COLLECTION / REJECTION GUIDELINES

T/F: Requisition and specimen label must match

44
Q

CRITERIA FOR SPECIMEN REJECTION

prone to contamination and may dilute out the pathogen because of the normal flora

A

Twenty-four-hour sputum collections

45
Q

SPECIMEN COLLECTION / REJECTION GUIDELINES

T/F: Re-collect specimens that do not meet criteria when possible and whose procedures for collection are not difficult or invasive for the patient

46
Q

SPECIMEN COLLECTION / REJECTION GUIDELINES

T/F: Document why the specimen was rejected and communicate to the individual who collected the specimen why it was rejected

47
Q

SPECIMEN COLLECTION / REJECTION GUIDELINES

T/F: Try not to reject specimens that are difficult to collect, such as CSF or surgical biopsies

48
Q

SPECIMEN COLLECTION / REJECTION GUIDELINES

T/F: Set up cultures when the situation cannot be resolved, do not comment concerns on the report and how the results may be affected

A

F; comment concerns

49
Q

SPECIMEN COLLECTION / REJECTION GUIDELINES

T/F: Communicate to and educate hospital personnel who collect speciments through laboratory directives, manuals, and other forms of communication.

50
Q

CRITERIA FOR SPECIMEN REJECTION

T/F: One swab for many requests, such as aerobes, anaerobes, and fungi

51
Q

CRITERIA FOR SPECIMEN REJECTION

may present a biohazard and be contaminated

A

Leaking containers

52
Q

CRITERIA FOR SPECIMEN REJECTION

T/F:
● Nonsterile or contaminated containers
● Culture or agar plates that are overgrown and dry except for specific mycology requests
● Specimens contaminated with dyes, oils, or chemicals
● Formalin in any specimen

53
Q

CRITERIA FOR SPECIMEN REJECTION: ANAEROBIC

T/F:
● Gastric washes
● Feces, except for Clostridiu difficile and Clostridium perfringes

54
Q

CRITERIA FOR SPECIMEN REJECTION: ANAEROBIC

T/F:
● Throat, nares, or oropharyngeal specimens
● Most swabs, including superficial skin swabs

55
Q

CRITERIA FOR SPECIMEN REJECTION: ANAEROBIC

T/F: Midstream urine

56
Q

SPECIMEN PRIORITY

Amniotic fluid, blood, brain, CSF, heart valve, pericardial fluid

A

LEVEL 1: Critical/Invasive

57
Q

SPECIMEN PRIORITY

Bloody fluids, bone, wound drainage

A

LEVEL 2: Unpreserved

58
Q

SPECIMEN PRIORITY

feces, sputum, tissue

A

LEVEL 2: Unpreserved

59
Q

SPECIMEN PRIORITY

feces, sputum, tissue

A

LEVEL 2: Unpreserved

60
Q

SPECIMEN PRIORITY

heart valve, pericardial fluid

A

LEVEL 1: Critical/Invasive

61
Q

SPECIMEN PRIORITY

Catheter tip, urine, tissue for quantification

A

LEVEL 3: Quantitation Required

62
Q

SPECIMEN PRIORITY

Feces in preservative, urine in preservative, swabs in holding medium

A

LEVEL 4: Preserved

63
Q

SPECIMEN COLLECTION AND PROCESSING

○ Gross appearance and physical appearance
○ Determine specimen adequacy and quality

A

Macroscopic Observation

64
Q

SPECIMEN COLLECTION AND PROCESSING

○ Useful and rapid information
○ Specimen Quality
○ Infectious Process Indication
○ Guide

A

Microscopic Observation

65
Q

Done prior to inoculation
○ Homogenization
○ Concentration
○ Filtration
○ Decontamination
○ Vortex

A

Specimen Preparation

66
Q

PRIMARY ISOLATION MEDIA

Isolation of gram(+) and gram(-) abaerobes

A

Anaerobic phenylethyl alcohol agar

67
Q

PRIMARY ISOLATION MEDIA

Isolation of gram(-) anaerobes

A

Anaerobic kanamycin-vancomycin agar

68
Q

PRIMARY ISOLATION MEDIA

Isolation of Bordetella pertussis

A

Bordet-Gengou media

69
Q

PRIMARY ISOLATION MEDIA

Enrichment used to isolate Legionella

A

Buffered charcoal yeast extract (BCYE)

70
Q

PRIMARY ISOLATION MEDIA

Isolation of Campylobacter; Brucella agar and sheep blood with antibiotics

A

Campy blood agar

71
Q

PRIMARY ISOLATION MEDIA

Enriched, nonselective medium to isolate fastidious organisms, such as Neisseria and Haemophilus

A

Chocolate agar

72
Q

PRIMARY ISOLATION MEDIA

Isolation of Yersinia species

A

Cefsulodin-Irgasan-novobiocin agar

73
Q

PRIMARY ISOLATION MEDIA

Isolation of gram(+) bacteria

A

Colistin-nalidixic acid agar

74
Q

PRIMARY ISOLATION MEDIA

Differential: isolation of gram(-) bacilli and differentiation of lactose fermenters from non-lactose fermenters

A

Eosin-methylene blue agar

75
Q

PRIMARY ISOLATION MEDIA

Differential: isolation of gram(-) bacilli and differentiation of lactose fermenters from non-lactose fermenters

A

Eosin-methylene blue agar

76
Q

PRIMARY ISOLATION MEDIA

Enrichment broth to enhance recovery of stool pathogens and inhibit normal flora coliforms

A

Gram(-) broth

77
Q

PRIMARY ISOLATION MEDIA

Selective: isolation of stool pathogens through inhibition of normal flora coliforms

A

Hektoen enteric agar

78
Q

PRIMARY ISOLATION MEDIA

Primary isolation medium for Mycobacterium

A

Lowenstein-Jensen

79
Q

INCUBATION CONDITIONS

Usual incubation time for most bacteria; AFB

A

18-24 hours at 37C

80
Q

INCUBATION CONDITIONS

Pseudomonas aeruginosa, Campylobacter jejuni

81
Q

INCUBATION CONDITIONS

Listeria monocytogenes and Yersinia enterocolitica

A

4C (Cold enrichment medium)

82
Q

INCUBATION CONDITIONS

Aerobic bacteria eg. P. aeruginosa

A

Ambient air (21% oxygen)

83
Q

INCUBATION CONDITIONS

Anaerobic eg. Fusobacterium, Bacteroides, Clostridium

A

Use of anaerobic jars such as Gas-Pak, Brewer Jar, Glove Box method, Biobag System

84
Q

INCUBATION CONDITIONS

Enterics

A

Facultative anaerobes

85
Q

INCUBATION CONDITIONS

Capnophiles

A

Capnophiles (growth in 5-10% carbon dioxide; Use of Candle Jar

86
Q

INCUBATION CONDITIONS

Microaerophiles eg. Campylobacter jejuni, Helicobacter pylori

A

Reduced oxygen (5-6%)

87
Q

INCUBATION TIME

Aerobic Bacteria

A

21% Oxygen, 0.03% CO2

88
Q

INCUBATION TIME

Anaerobe

89
Q

INCUBATION TIME

Capnophiles

A

5-10% CO2; 15% Oxygen

90
Q

INCUBATION TIME

Microaerophiles

A

5-6% Oxygen

91
Q

Critical Results that should be reported immediately

A

Panic Values

[MT 6320] Clinical Bacteriology Laboratory (15 decks)

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