(P) Lec 5: Collection, Handling, and Processing Of Specimen Flashcards

1
Q

All parts of the body exposed to the outside environment is inhabited by the
____ and specimens coming from these parts are considered ____.

A

Normal Microbiota
Non-sterile

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2
Q

Consists of non-pathogenic organisms but can be pathogenic once placed outside their normal habitat

A

Normal Micriobiota

Formerly known as normal flora

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3
Q

Specimens coming from body parts not exposed to the outside environment

A

Sterile Specimens

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4
Q

Sterile or Non-sterile Specimen?

✦ Cerebrospinal Fluid (CSF)
✦ Peritoneal Fluid
✦ Pericardial Fluid
✦ Pleural Fluid
✦ Blood
✦ Suprapubic Aspirate (SPA)

A

Sterile

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5
Q

Sterile Specimens

When cultured under normal conditions, there should be ____

A

no growth of microorganisms (absolutely negative)

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6
Q

Specimens coming from body parts exposed to the outside environment

A

Non-sterile Specimen

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7
Q

Sterile or Non-sterile Specimen?

✦ Urine
✦ Stool
✦ Sputum

A

Non-sterile

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8
Q

Normally, urine is ____ in the bladder

A

sterile

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9
Q

Collection via ____ is critical because there might be a possibility of contamination when performed incorrectly

A

midstream clean-catch

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10
Q

When is urine considered sterile?

A

When collected via suprapubic aspiration

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11
Q

What do MDs usually request prior to antibiotic therapy?

A

Culture & Sensitivity

Unless the objective is to monitor the treatment

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12
Q

Why is sepsis and exception to requesting C&S prior to antibiotic therapy?

A

Because administration of first line antimicrobials cannot be delayed

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13
Q

In automated blood culture machines, they have?

A

Antimicrobial Removing Device (ARD)

Blood C&S with ARD (antibiotic is already given but C&S is still requested)

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14
Q

In aseptic collections and sterile containers, there should be no ____

A

Contaminants

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15
Q

In microbiology, ____ will do except for blood culture

A

minimal amounts

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16
Q

In microbiology, minimal amounts will do except for ____

A

blood culture

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17
Q

This is to obtain a higher yield of isolates

A

Acute Stage of the Disease Process

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18
Q

Ideal TAT

A

Processed immediately after collection

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19
Q

Ideal TAT for critical specimens (coming from sterile site)

A

Within 15 mins after collection

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20
Q

Ideal TAT for non-critical (other) specimens

A

within 2 hours after collection

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21
Q

When processing, we should prioritize what type of specimen?

A

Critical

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22
Q

What should you process first?

Stool vs. Urine vs. Blood vs. CSF

A

Blood then CSF

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23
Q

If you are considering that the sample contains
microorganisms that are sensitive to drying, you should process them ____

A

immediately

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24
Q

Collection Methods

Suitable and done ONLY for aerobic organisms

Because the collection method is already exposed to oxygen

A

Cotton Swab (Swab Technique)

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25
Q

Advantage of cotton swab technique?

A

Common, easily available, easy to perform

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26
Q

Disadvantage of cotton swab technique?

A

Toxic to other organisms

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27
Q

If you are suspecting that the isolate is ____ (also sensitive to drying), note that cotton contains fatty acids that are toxic to the organism

A

Neisseria gonorrhoea

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28
Q

If there is no other choice besides cotton, what can you do when the isolate is Neisseria gonorrhoea?

A

Add charcoal so as to neutralize the toxic fatty acids present in the cotton

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29
Q

✦ Made of synthetic fiber, not cotton
✦ Highly absorbent, so the sample will not easily dry out

A

Rayon and Dacron Technique

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30
Q

Disadvantage of Rayon and Dacron?

A

Expensive and may not be readily available

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31
Q

◦ Any extraction can support the growth of aerobic and anaerobic culture, simply because
the method does not allow exposure of the specimen to oxygen
◦ Aerobic and anaerobic culture
◦ Ex: Peritoneal fluid, urine via SPA, wound exudate, blood

A

Needle Aspiration/Extraction

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32
Q

Done by aspirating from a catheter tube

A

Catheterization

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33
Q

Diagnostic Purpose of Blood Specimen

A

To determine bloodstream infection (bacteremia)

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34
Q

What can be determined during blood culture?

A

Presence of bacteria, not the toxin

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35
Q

Usual order of blood specimen

A

2 sets of blood culture (1 for aerobic bottle and 1 for anaerobic bottle)

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36
Q

Why do they order 2 sets of blood culture?

A

To distinguish TRUE pathogen

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37
Q

Media for manual blood culture

A

Brain-Heart Infusion Broth (BHIB) with 0.025% Sodium Polyanethole Sulfonate (SPS) (+/- 1% Gelatin)

38
Q

Best anticoagulant for blood culture despite it being able inhibit some microorganisms

A

SPS

39
Q

Why SPS regarded as the best anticoagulant for blood culture?

A

because of its anticomplement and
antiphagocytic properties; it also neutralizes aminoglycosides

40
Q

Anticoagulant-to-Blood Ratio for Adults

A

1:10

41
Q

Anticoagulant-to-Blood Ratio for Children

A

1:5

42
Q

Positive result indicators for manual blood culture

A

Hemolysis, Turbidity, Pellicle Formation, Bubble Formation

43
Q

Preliminary / Initial Reporting of Results

A

after 24 hrs, 48 hrs, 72 hrs, 5 days, 7 days

44
Q

When the spx tested negative after 24 hours,

A

the initial report would be negative

45
Q

When the spx tested positive after 48 hours,

A

subculture is performed

46
Q

Official report on the isolate is released usually ___

A

after another 3 days (5th day)

47
Q

The final result would be released at the ___

A

7th day

48
Q

T or F: When spx tested positive in a time frame, you do not have to perform a subculture

A

F (you have to)

49
Q

If you see this, study how to do the subculture hehe

A

Go bebi !!

50
Q

TAT for Typhoid Fever

A

7 days

51
Q

TAT for Brucellosis and Endocarditis secondary to HACEK species

A

21 days

52
Q

What are the HACEK species?

A

Haemophilus
Aggregatobacter
Cardiobacter
Eikenella
Kingella kingae

53
Q

These organisms associated with bacterial endocarditis are slow-growers

A

HACEK

54
Q

Principle of Automated Blood Culture

A

Fluorescence-based

55
Q

TAT of Automated Blood Culture

A

5 days

56
Q
  • Normally sterile (inside the bladder)
  • Depending on how it is collected, it can be sterile or nonsterile
A

Urine Specimen

57
Q

Collection Methods for urine specimens

A

Midstream Clean-Catch
Catheterized
Suprapubic Aspiration

58
Q

Diagnostic Purpose of urine specimen

A

Diagnosis of UTI

59
Q

T or F: Only in urine culture that we perform quantitation

A

T

60
Q

Give the formula of CFU

A

CFU = # of Colonies x Loop Factor (calibrated wire loop)

Loop Factors
▪︎ 0.1 mL - 10
▪︎ 0.01 mL - 100
▪︎ 0.001 mL - 1000

61
Q

Urine Specimen

When is the interpretation for >100,000 CFU/mL?

A

Significant

62
Q

Urine Specimen

When is the interpretation for < 50,000 CFU/mL?

A

Negative

63
Q

Urine Specimen

When is the interpretation for Between 50,000 and 100,000 CFU/mL?

A

Borderline or Indeterminate

64
Q

What happens when the urine specimen falls as borderline or indeterminate?

A

You will need to repeat urine culture

65
Q

Critical and sterile Specimen and collected via Lumbar Puncture

A

CSF Specimen

66
Q

Diagnostic Purpose for CSF specimen

A

For the diagnosis of Bacterial Meningitis

67
Q

Media for CSF specimens

A

BAP, CAP, MAC

68
Q

CSF is incubated at what temperature?

A

Room Temperature or Body Temperature

69
Q
  • Polymicrobial in nature; allows isolation of several microorganisms
  • Collected through swabs or aspirations
  • Emits foul odor due to Anaerobes and Facultative Anaerobes (most pathogenic organisms)
A

Wound discharge/abscess specimen

70
Q

Media for Wound discharge/abscess specimens

A

◦ Plating through MAC and BAP
◦ Thioglycollate (Liquid Media)

71
Q

Which media of wound discharge/abscess specimen is this?

✦ Enrichment Broth
✦ Allows the growth of Obligate Aerobes, Facultative Anaerobes, and Microaerophilics

A

Thioglycollate (Liquid Media)

72
Q
  • Contain many enteric organisms (contaminated with normal microbiota)
  • Gram stain is NOT usually done (very seldom, simply because the fecal matter is full of gramnegative organisms)
A

Stool specimen

73
Q

What selective and differential media are being used for stool specimen?

A

✦ MAC - MacConkey Agar
✦ HEA - Hektoen Enteric Agar
✦ EMB - Eosin-Methylene Blue Agar

74
Q

Differential selective media for isolation of Salmonella spp.

A

SSA (Salmonella-Shigella Agar), Selenite F Broth

75
Q

Differential selective media for isolation of Vibrio spp.

A

TCBS (Thiosulfate-Citrate-Bile Salts-Sucrose Agar) and Peptone Water

76
Q
A
77
Q

Includes nasopharyngeal swabs, sputum, bronchial and tracheal aspirate, and nasopharyngeal aspirates

A

Respiratory specimens

78
Q

Respiratory specimens

Gold standard for decontamination

A

Sodium hydroxide

79
Q

Respiratory specimen

Gold standard for digestion

A

N-acteyllcysteine (NaLC)

80
Q

Plating media for respiratory specimens

A

BAP, MAC, CAP

81
Q

Diagnostic purpose for throat swabs

A

Strep Throat, Diptheria, Neisseria infection

82
Q

Plating media for throat swabs

A

BAP, CAP

83
Q

Plating media for Neisseria spp.

A

Modified Thayer Martin Media

84
Q
  • Do Gram Stain (to check for the intracellular presence of Gram-negative coccobacilli)
A

Vaginal, Urethral & Rectal Swabs

85
Q

Media for Vaginal, Urethral & Rectal Swabs

A

CAP
BAP
MTMM (if infection with Neisseria gonorrhoeae is suspected)

86
Q

How many sputum specimen is required for TB culture?

A

Three (1 for culture, 2 for acid-fast staining)

87
Q

Gold standard for TB Culture

A

NaOH (decontamination) and NaLC (digestion)

88
Q

Media for TB Culture

A

◦ Löwenstein-Jensen (LJ) Medium
◦ Middlebrook 7H11/7H10
◦ BACTEC
◦ Gene Xpert

89
Q

This can detect the presence of Mycobacterium tuberculosis in the specimen and determine whether the isolate is Multidrug Resistant

A

Gene Xpert

90
Q

Check niyo table summary ni Wakin and tell him thank you <3

A

Kaldagan niyo na rin hehe