SPECIMEN COLLECTION AND CULTIVATION OF VIRUSES Flashcards
- Specimen collection depends on the ____, ____
- In the requisition, the ____ and ____ should be included.
- Must be collected as early as possible after the onset of symptomatic disease
____ -interfere with nucleic acid based tests, recovery of some enveloped viruses, and fluorescent-antibody test
SPECIMEN COLLECTION FOR VIROLOGY
- specific disease syndrome, viral agents
suspected
- specimen type
- suspected virus
- Calcium alginate swabs
SUCCESSFUL LABORATORY INVESTIGATIONS
✓Collection of adequate and appropriate specimens
✓Sufficient documentation
✓Biosafety and decontamination
✓Correct packaging
✓Rapid transport
✓Choice of a laboratory that can accurately perform the tests
✓Timely communication of results
Specialized medium used to transport and store viral samples
VIRAL TRANSPORT MEDIUM (VTM)
Buffering Agents
Phosphate-Buffered saline: pH stability
and osmotic balance
▪Hanks’ balanced salt solution (HBSS):
mixture of salts and nutrients
Stabilizers
Glycerol: preservation of viral particles
▪Protein Stabilizers: bovine serum albumin
to stabilize the viral particles
Antimicrobial Agents
Antibiotics: penicillin, streptomycin,
gentamicin
▪Antifungal agents: amphotericin B
Throat swabs
1
2
3
Enteroviruses , Adenoviruses, HSV
Nasopharyngeal swab or aspirate
1
2
3
RSV , Influenza, Parainfluenza
Nasal Specimen
Rhinovirus
-____ are superior to swabs
-Swabs should be made of __,___,___,__
-Often are contaminated with bacteria.
> Contaminants may be removed by concentrating the sample through
___
THROAT, NASOPHARYNGEAL SWAB OR ASPIRATE
- aspirate
-polyester, Dacron, or rayon with plastic oraluminum shafts
- centrifugation
- Hold tongue away with tongue depressor
- Locate areas of inflammation and
exudate in ____, tonsillar region of throat behind uvula - Avoid swabbing ___; do not touch tongue
- Rub area back and forth with cotton or ___ swab
THROAT SWAB : POSTERIOR PHARYNGEAL SWAB
- posterior pharynx
- soft palate
- Dacron
1 Tilt head backwards
2 Insert _____ into nostril and back
to nasopharynx
3 Leave in place a few seconds
4 Withdraw slowly; rotating motion
NASOPHARYNGEAL SWAB
- flexible fine-shafted polyester swab
- Tilt head slightly backward
- Instill ___of VTM /sterile normal
saline into one nostril - Use ____
- Insert ___ in nostril and
aspirate the secretion gently by
suction in each nostril
NASOPHARYNGEAL ASPIRATE
- 1-1.5 ml
-aspiration trap
- silicon catheter
Specimen for detecting viruses that infect the lower respiratory tract( ___ and___)
Should be centrifuged to remove contaminating materials
>Not necessary if sample are for ____ and ____
BRONCHIAL AND BRONCHOALVEOLAR WASHES
- (Influenza and Adenoviruses)
- antigen
- nucleic acid testing
RECTAL SWABS AND STOOL is Used to detect __,__,___
- Rotavirus, enteric adenoviruses (serotypes 40 and 41), and enteroviruses.
preferable for rotavirus and enteric adenovirus testing.
Stool
___ - acceptable for detecting enteroviruses in patients suspected of having an enteroviral disease, such as ___
Rectal swabs
- aseptic meningitis
Due to bacterial contamination in ____, centrifugation, filtration or both are
necessary for cell cultures for the recovery of viral agents
Storage: ____
stool
- 4°C or -15°C (Ag detection and PCR)
Urine is for detection of __,__,__,__,__,__
Improved recovery: at least ___ from clean catch first morning urine
Interference of urine __ and ___ may affect viral replication
>Urine is centrifuged or filtered to remove contaminants and neutralizing pH with____
- CMV, Mumps, Rubella and Measles Virus,
Polyomavirus and Adenovirus - 10mL
- pH and bacteria
- 7.5% solution of sodium bicarbonate
- Detection of HSV or VZV may require a ___ if PCR testing is not available
> are prepared by carefully unroofing the
vesicle.
Tzanck smear
___, ___,____ , and in rare cases ___ or ___ can be detected in vesicular lesions of the skin and mucous membranes.
>Once the vesicle has ____ , detection of the virus is difficult
- Enteroviruses, HSV, VZV
- CMV or pox viruses
- ulcerated or crusted
STERILE BODY FLUIDS OTHER THAN BLOOD
-may contain ___, __,___,___,____
- Collected aseptically by the physician and sent to the laboratory forprocessing
-Must not be diluted with VTM-causes___
- Specimens contaminated with blood may inhibit viral cultivation due to presence of ___
- CSF and pericardial and pleural fluids, Amniotic Fluid
- enteroviruses, HSV, VZV, influenza viruses, or CMV
- false negative results
- antibodies
Amniotic Fluid
1
2
3
.Delay in processing: Storage at refrigerated temp for ___ or ___ if longer
congenital CMV, VZV and parvovirus B19
- 48hrs or -70°C
Viral culture of blood is used primarily to detect __; however, __,__,__,__ occasionally may be encountered
CMV
- HSV, VZV, enteroviruses and adenovirus
___ of anticoagulated blood collected in a whole blood tube is needed
- __,__,___ anticoagulated blood is acceptable for CMV detection
5-10 mL
- Heparinized, citrated, or ethylene diaminetetraacetic acid (EDTA)
__ and __ should be used for samples collected for nucleic acid testing, because other anticoagulants may interfere with the enzyme functions required for PCR amplification.
Serum may be used for ___ and ____
EDTA and Citrated blood
- serologic tests and nucleic acid assays
For BONE MARROW
__ or __ anticoagulants are acceptable for culture
__ and ___ for nucleic acid testing
Heparin or EDTA
EDTA and ACD
Useful for detecting viruses that commonly infect the lungs (___,___,__,__), brain (___), and gastrointestinal tract (__).
Collected during surgical procedures.
- ___ is preferred for nucleic acid assays, but __ and ___ may be used after removal of the paraffin (deparaffinization) and extraction
Tissue
- CMV, influenza virus, adenovirus, sin nombre virus
- HSV
- CMV
- Fresh TISSUE
- formalin-fixed and paraffin-embedded tissues
GENITAL SPECIMENS
Detection of __ and __
Must be place in appropriate VTM
HSV and HPV
should be used for ulcerations and placed in
appropriate viral transport media.
Genital swabs
may be collected using a swab or brush and
placed in viral transport media.
Some manufactured __ or ___ are appropriate for nucleic acid testing
Cervical specimens
- endocervical or liquid-based cytology devices
__ and ___ specimens may be needed to detect
antibody to specific viruses
- Acute specimens should be collected as soon as possible after the
appearance of symptoms
Acute and convalescent serum
is collected a minimum of 2 to 3 weeks after the acute specimen
Convalescent specimen
Appropriate specimen is ___ of serum collected by venipuncture.
3 to 5 mL
Throat and Nasopharynx
Respiratory:
1 Adenoviruses Y
2 Parainfluenza virus Y
3 Influenza virus W
4 Respiratory syncytial virus W
5 Metapneumovirus W
6 SARS coronavirus W
nasal:+++ in respiratory
Rhinoviruses y
(other:serum) in respiratory
Sin nombre virus sp, s
Dermatologic and mucous membrane vesicular
Throat and Nasopharynx
Stool
Vesicle fluid or scrapping
Entero virus S F
Dermatologic and mucous membrane vesicular
Vesicle fluid or scrapping
Herpes simplex virus Y
Moknkeypox Y
Dermatologic and mucous membrane vesicular
Throat and Nasopharynx
Vesicle fluid or scrapping
Varicella zoster virus Y
Dermatologic and mucous membrane Exanthematous
Throat and Nasopharynx
Stool
Enterovirus S
Dermatologic and mucous membrane Exanthematous
Throat and Nasopharynx
Urine
Serum
Measles Y
Dermatologic and mucous membrane Exanthematous
Urine
Serum
Rubella Y
Dermatologic and mucous membrane Exanthematous
Serum
Amniotic fluid
Parvoviirus Y
Dermatologic and mucous membrane Pustular/Nodular
Tissue
Molluscum contagiosum, orf Y
Dermatologic and mucous membrane Pustular/Nodular
Tissue/ cells, thin prep
Warts Y
Dermatologic and mucous membrane Pustular/Nodular
cervical
Papillomavirus
Meningoencephalitis/encephalitis
CSF and Serum
Arboviruses S, F
Meningoencephalitis/encephalitis
Throat and Nasopharynx
CSF
Urine
Enteroviruses S, F
Meningoencephalitis/encephalitis
CSF
Brain biopsy
Herpes simplex virus Y
Meningoencephalitis/encephalitis
Serum
Lymphocytic choriomeningitis Y
Mumps virus Y
Meningoencephalitis/encephalitis
Brain biopsy
HIV Y
Polyomavirus (JC virus) Y
Meningoencephalitis/encephalitis
Corneal cels, brain
Rabies virus
Gastrointestinal dse
Stool
Adenoviruses (serotypes 40-41) Y
Noroviruses S
Rotavirus W, SP
Myocarditis, Pericarditis, and Pleurodynia
Throat and nasopharynx
csf
pericardial fluid
CoxsackieB S, F
Hemorrhagic fevers
Tissue, respiratory secretions and serum
Ebola/Malburg viruses Y