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BACTERIOLOGY > Specimen collection and Handling > Flashcards

Specimen collection and Handling Flashcards

1
Q

Specimen Collection Timing

A

Collect during ACUTE/EARLY PHASE OF ILLNESS (2-3 days for viral infection). Collect before administration of antibiotic, antifungal, or antiviral.

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2
Q

Specimen Storage

A

Collect and store specimen in STERILE SCREW-CAP CONTAINER except for STOOL

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3
Q

Swab Use - General

A

POOR specimen if aspirate or biopsy can be obtained

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4
Q

Swab Use - Appropriate

A

nasal/nasopharyngeal, oropharyngeal, eyes, ears, or genitals

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5
Q

Swab Use - Not Appropriate

A

NOT FOR ANAEROBES AND FUNGI

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6
Q

Swab Shaft - Toxic to Chlamydia and Mycoplasma

A

Wooden

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7
Q

Swab Shaft - Used usually in a calcium alginate-tipped swab

A

Aluminum

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8
Q

Swab Shaft - General purpose shaft for bacteria and viruses

A

Plastic

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9
Q

Swab Tip - General use for bacteria and viruses

A

Dacron

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10
Q

Swab Tip - Excellent collection and release of samples

A

Rayon

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11
Q

Swab Tip - Toxic to Neisseria (unless with charcoal)

A

Cotton

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12
Q

Swab Tip - Toxic to enveloped virus & Neisseria, interferes with PCR methods

A

Calcium alginate

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13
Q

Swab Design - Can trap organisms, leading to decreased recovery/sensitivity

A

Woven/Traditional

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14
Q

Swab Design - Uses Nylon fibers for enhanced uptake and release of microbes

A

Flocked

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15
Q

Enhancing Microbe Recovery

A

Place swab in 0.5-1.0 mL of sterile broth/saline and vortex it

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16
Q

Specimen Transport - Container

A

Leak-proof plastic bag with separation for paperwork; has BIOHAZARD label

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17
Q

Specimen Transport - Time Frame

A

Transport within 2 hours to the lab, except sterile specimens (within 15 minutes)

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18
Q

SARS-CoV-2 Transport Medium

A

3mL of viral transport medium (VTM), Amies transport medium, phosphate buffered saline, or sterile saline

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19
Q

Bacteria Susceptible to Air Exposure

A

Anaerobes

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20
Q

Bacteria Susceptible to Temperature Changes

A

Neisseria meningitidis

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21
Q

Bacteria Susceptible to pH Changes

A

Shigella

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22
Q

Bacteria Susceptible to Glycerol

A

Vibrio

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23
Q

Shipment - Arrangement of Container

A

Sample > Primary container > Absorbent > Secondary container > Dry ice/Liq. nitrogen > Outer/Tertiary container

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24
Q

Shipment - Category A

A

Substances/microbes capable of permanent disability or life-threatening

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25
Q

Shipment - Category B

A

Substances/microbe incapable of permanent disability or life-threatening on its current form

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26
Q

Preservation - Urine

A

Use BORIC ACID (bacteriostatic for 3 days)

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27
Q

Preservation - For Parasites

A

Don’t use formalin or Polyvinyl alcohol (PVA)

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28
Q

Preservation - Stuart/Amies Medium

A

Contains charcoal to neutralize fatty acid toxic to bacteria with pili

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29
Q

Preservation - Anticoagulants

A

Prevent clotting in blood, bone marrow, synovial fluid

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30
Q

Preservation - SPS (Sodium Polyanethol Sulfonate)

A

0.025-0.050% concentration, anticoagulant, anticomplement, antiphagocytic

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31
Q

Preservation - SPS - Function

A

Neutralizes aminoglycoside, neutralize with 1% gelatin

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32
Q

Preservation - SPS - Anaerobe Sensitivity

A

0.025% concentration preferred for some anaerobes and Neisseria

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33
Q

Preservation - Heparin

A

Can be used for viral culture and Mycobacterium culture, inhibits some gram-positive bacteria and yeasts

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34
Q

Preservation - Unused Anticoagulants

A

Citrate, EDTA, and others – should never be used

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35
Q

Preparation - Plating

A

Sterile specimens are plated directly into the culture media

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36
Q

Preparation - Centrifuge

A

> 1 mL of fluid samples centrifuged at 3000 g for 20 minutes

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37
Q

Preparation - Tissue Homogenization

A

Tissues may be homogenized using a tissue grinder (disadvantages: destroys fungi)

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38
Q

Specimen for Abscess, Lesion, Wound, Ulcer container

A

Swab in Amie’s or Stuart’s medium

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39
Q

Common Isolates Abscess, Lesion, Wound, Ulcer - Macule

A

Dermatophytes, T. pallidum

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40
Q

Common Isolates -Abscess, Lesion, Wound, Ulcer Papule

A

HPV, S. aureus, Pox

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41
Q

Common Isolates -Abscess, Lesion, Wound, Ulcer Nodule

A

C. diphtheriae, Sporothrix, M. marinum

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42
Q

Common Isolates - Abscess, Lesion, Wound, Ulcer Pustule

A

Candida, Herpes, N. gonorrhoeae, S. aureus, VZV

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43
Q

Common Isolates - Abscess, Lesion, Wound, Ulcer Bulla

A

C. perfringens, HSV, S. aureus, V. vulnificus

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44
Q

Common Isolates - Abscess, Lesion, Wound, Ulcer Ulcer

A

B. anthracis, H. ducreyi, T. pallidum

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45
Q

Blood - Adult Volume

A

≥ 20mL/set

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46
Q

Blood - Pediatric Volume

A

1-20mL/set

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47
Q

Blood - Culture Bottle

A

Both aerobic and anaerobic

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48
Q

Blood - When to Draw

A

During febrile episodes, 2-3 sets per 24 hours, Do not draw >4 sets in 24 hours

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49
Q

ARD (Antimicrobial Removal Device) - Manual

A

1:10 blood to broth ratio, Growth detected in pellicle/turbidity/hemolysis/bubbles

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50
Q

ARD - Automated

A

1:5 blood to broth ratio, Growth detected by BacT/Alert (5 days TAT)

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51
Q

Common Blood Isolates

A

Staphylococcus aureus, E. coli, Staphylococcus epidermidis, Enterococcus, B-hemolytic streptococci, Candida albicans, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae, Proteus, Bacteroides, Clostridium

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52
Q

Bone Marrow - Culture Bottle

A

May use blood culture bottle if volume is sufficient

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53
Q

Common Bone Marrow Isolates

A

Brucella, Histoplasma

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54
Q

Amniotic, Peritoneal, Pericardial, Pleural Fluids container

A

Sterile screw cap or blood culture bottle, Transport within 15 minutes at room temperature

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55
Q

Common Fluid Isolates - Pericardial

A

Coxsackie, Adenovirus, Influenza

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56
Q

Common Fluid Isolates - Arthritis

A

S. aureus, Streptococci, H. influenzae, Bacteroides, N. gonorrhoeae, Candida, Cryptococcus

57
Q

CSF/Spinal Fluid - Transport Temperature

A

22-25°C, delayed testing at 20-24°C or 35°C

58
Q

CSF/Spinal Fluid - Viral Studies

A

Transport at 4°C, Transport within 15 minutes at room temperature

59
Q

CSF/Spinal Fluid - Direct Examination

A

India ink and Gram stain

60
Q

CSF Collection - Number of Bottles

A

3 or more bottles collected: 2nd bottle → Micro, if only 1 bottle collected: Micro (1st) → Hema (2nd) → Chem/Serology (3rd)

61
Q

CSF - Cytocentrifugation

A

Use acridine orange for best sensitivity and organism recovery

62
Q

Meningitis - Newborn

A

S. agalactiae, E. coli

63
Q

Meningitis - Children

A

H. influenzae

64
Q

Meningitis - Adult

A

N. meningitidis

65
Q

Meningitis - Geriatric

A

S. pneumoniae

66
Q

Meningitis - Immunocompromised

A

L. monocytogenes

67
Q

Meningitis/Encephalitis - Additional Causes

A

P. cantonensis, N. fowleri, Acanthamoeba, Coxsackie, HIV, T. solium, Toxoplasma

68
Q

Ear Specimen - Transport Container

A

Sterile screw cap container

69
Q

Ear Specimen - Anaerobic Transporter

A

Inner ear aspirate

70
Q

Otitis Externa - Acute

A

S. aureus, S. pyogenes, P. aeruginosa (Swimmer’s ear/Acute diffuse otitis externa)

71
Q

Otitis Externa - Chronic

A

P. aeruginosa, Anaerobes

72
Q

Otitis Media - Acute

A

S. pneumoniae, H. influenzae, M. catarrhalis, S. pyogenes, RSV, Influenza virus, coronavirus, enterovirus, rhinovirus

73
Q

Otitis Media - Chronic

A

Anaerobes (Bacteroides, Fusobacterium, Prevotella, Porphyromonas, Peptostreptococcus)

74
Q

Eye Conjunctiva or Corneal Scraping - Transport Method

A

Direct inoculation to BAP and CAP

75
Q

Eye Conjunctiva or Corneal Scraping - Transport Time

A

Transport within 15 mins at room temperature

76
Q

Corneal Scraping - Incubation

A

28°C in SDA

77
Q

Common Eye Isolates

A

Chlamydia trachomatis, Acanthamoeba, Herpes simplex virus

78
Q

Gastric Wash or Lavage - Transport Time

A

Transport within 15 mins at room temperature

79
Q

Gastric Aspirates - Indications

A

Infants or AFB, process within 4 hours or neutralize with 10% sodium carbonate

80
Q

Common Gastric Isolates

A

Campylobacter jejuni, Helicobacter pylori, Mycobacterium tuberculosis, Ascaris larvae

81
Q

Rectal Swab - Transport Medium

A

Enteric transport medium

82
Q

Rectal Swab - Inoculation Method

A

Insert 1-1.5 cm deep, feces visible on swab, inoculate in enteric media

83
Q

Common Rectal Swab Isolates

A

Pathogenic Enterobacteria, Vibrio, Campylobacter, Helicobacter, Parasites (stool sample), Norwalk, Rotavirus, C. difficile

84
Q

Urine - Best Collection Method

A

Mid-stream clean catch (Ambulatory/Outpatient/Non-invasive)

85
Q

Urine - Catheterized Collection Method

A

Non-Ambulatory/In-Patient/Invasive, Clean urethra with soap and water, collect remainder after first 15mL

86
Q

Urine - Suprapubic Aspiration

A

For Anaerobic culture, disinfect skin first

87
Q

Common Urine Isolates

A

Escherichia coli (UPEC), Klebsiella, Staphylococcus saprophyticus, Enterococci, Proteus, Pseudomonas, Candida, Acinetobacter

88
Q

Urine - Quantitative Counting

A

1 µL Loop (1 colony x 1000 = CFU/mL), 10 µL Loop (1 colony x 100 = CFU/mL)

89
Q

Urethra - Collection Method

A

Swab in Amie’s or Stuart’s medium, collect 1 hour after patient has urinated

90
Q

Urethra - Direct Smear

A

Gram stain

91
Q

Urethra - Collection Time

A

Do not refrigerate, collect if >1 hour after urination

92
Q

Common Urethral Isolates

A

N. gonorrhoeae, Chlamydia trachomatis, Ureaplasma, Mycoplasma

93
Q

Cervix - Collection Method

A

Swab in Amie’s or Stuart’s medium, Remove mucus before collection

94
Q

Cervix - Collection Instructions

A

Do NOT use lubricant on speculum, Swab deeply into endocervical canal

95
Q

Cervix - Swab Material

A

Do NOT use wooden shaft or Calcium alginate swab

96
Q

Common Cervix Isolates

A

N. gonorrhoeae, C. trachomatis, Ureaplasma

97
Q

Vagina - Collection Method

A

Swab in Amie’s or Stuart’s medium, Remove exudate

98
Q

Vagina - Collection Instructions

A

Swab secretions and mucous membrane

99
Q

Vagina - Bacterial Vaginosis Diagnosis

A

Culture is not recommended

100
Q

Vagina - Group B Streptococcus Screening

A

Use LIM broth

101
Q

Common Vagina Isolates

A

Lactobacillus, G. vaginalis, Mobiluncus, S. agalactiae

102
Q

Prostate - Collection Method

A

Swab in Amie’s or Stuart’s medium, Clean urethral meatus with soap and water

103
Q

Prostate - Collection Instructions

A

Massage prostate through rectum and swab the secretions, Plate immediately

104
Q

Common Prostate Isolates

A

E. coli, other enteric organisms, P. aeruginosa, Mycoplasma genitalium

105
Q

IUD - Collection Method

A

Sterile screw cap container, Disinfect skin before removal

106
Q

IUD - Transport Instructions

A

Transport within 15 mins at room temperature, Plate immediately

107
Q

Common IUD Isolates

A

Actinomyces infections

108
Q

IV Catheter - Collection Method

A

Sterile screw cap container, Disinfect skin with alcohol before removal

109
Q

IV Catheter - Collection Instructions

A

Do not accept foley catheters, Roll segment back and forth for 4x using sterile forceps

110
Q

IV Catheter - Quantitative Culture

A

≥ 15 colonies are significant

111
Q

Common IV Catheter Isolates

A

S. epidermidis, S. aureus, other CONS, Enterobacteria, P. aeruginosa, Candida, Corynebacterium

112
Q

Nasopharyngeal Swab - Collection Method

A

Swab in Amie’s or Stuart’s medium, Rotate the swab for 5 seconds

113
Q

Nasopharyngeal Swab - Transport Instructions

A

Transport within 15 mins if no transport media, or within 2 hours at 20-24°C

114
Q

Common Nasopharyngeal Isolates

A

B. pertussis, SARS-CoV, H. influenzae, N. meningitidis, Rhinovirus, Coronavirus, Adenovirus, Influenza, Klebsiella ozaenae

115
Q

Nasal Swab - Collection Method

A

Swab in Amie’s/Stuart’s, Premoisten with sterile saline, insert 1-2 cm into nares and rotate

116
Q

Common Nasal Isolate

A

MRSA screening

117
Q

Throat Swab - Collection Method

A

Sterile screw cap, Clean genitals with soap and water

118
Q

Common Throat Isolates

A

S. pyogenes (Grp A Streptococcus), Pharyngitis – S. pyogenes, Group C/G streptococcus, Arcanobacterium, Fusobacterium, N. gonorrhoeae, Corynebacterium ulceran

119
Q

Sputum - Collection Method

A

Sterile screw cap, Brush teeth then rinse or gargle with water

120
Q

Sputum - Aerosol-induced Sample

A

Use 15% NaCl or 10% glycerin

121
Q

Common Sputum Isolates

A

M. tuberculosis, Corynebacterium, Mycoplasma pneumoniae, Chlamydia trachomatis, Chlamydia pneumoniae, Bordetella pertussis, Legionella, Pneumocystis, Nocardia, Histoplasma, Coccidioides, RSV, Coronavirus, Influenza/Parainfluenza

122
Q

Tissue - Collection Method

A

Anaerobic transporter, Disinfect skin, Do not allow the specimen to dry, May need to be homogenized

123
Q

Common Tissue Isolates

A

Anaerobes, Gram-negative bacilli, Gram-positive organisms, Fungi

124
Q

Specimen Transport for Viruses, Chlamydia, Mycoplasma

A

Transport in appropriate media at 4°C (ice pack or liquid nitrogen)

125
Q

Transport Time for Majority of Samples

A

Transport within 2 hours at room temperature

126
Q

Exceptions to Transport Time

A

Normally sterile samples (within 15 minutes), gastric biopsy (within 1 hour)

127
Q

Specimen Storage at Room Temperature (20-24°C)

A

Hair, Nails, Skin scraping for fungi (<2 hrs)

128
Q

Specimen Storage Up to 24 Hours at Room Temperature

A

Abscess, lesion, wound, pustule, ulcer, Nasopharyngeal swab, Oropharyngeal swab, Sterile body fluids (Peritoneal, Pleural, Pericardial), Inner ear sample, Eye samples (Conjunctiva, Cornea, Vitreous fluid), Rectal swab, Genital samples (cervix, vagina, cul-de-sac, prostate, Urethral swab), Bone marrow, Tissues, Preserved stool (in holding media), Preserved urine (in holding media), CSF (or at 35°C)

129
Q

Specimen Storage at 4°C (Refrigerator Temperature) Up to 48 Hours

A

Feces for Clostridium difficile (culture or molecular)

130
Q

Specimen Storage at 4°C (Refrigerator Temperature) Up to 24 Hours

A

Feces for E. coli O157:H7, Outer ear sample, Gastric aspirate/biopsy, Respiratory samples (BAL, Bronchial washing, Sputum), Unpreserved/Fresh urine, Unpreserved/Fresh stool

131
Q

Specimen Storage at 4°C (Refrigerator Temperature) Up to 2 Hours

A

IV catheters, Pins

132
Q

Specimen Storage at 35°C (Incubator Temperature) Within 6 Hours

A

CSF

133
Q

Specimen Storage Upon Receipt at the Lab

A

Blood, Sterile body fluids in blood culture bottle

134
Q

Level 1 Immediate Critical/Invasive Specimen

A

Amniotic fluid, Blood, Heart valve, Brain, CSF

135
Q

Level 2 Unpreserved Specimen

A

Body fluids (not listed in Level 1), Bone, Wound Drainage, Feces, Sputum, Tissue

136
Q

Level 3 Quantitation Required Specimen

A

Catheter tip, Urine (midstream/suprapubic/catheterized)

137
Q

Level 4 Preserved Specimen

A

Preserved Urine, Preserved Stool, Swabs in holding/transport medium

138
Q

Rejected Samples - Criteria

A

Non-matching label and requisition, Specimen transported at wrong temperature or wrong media, QNS, Leaking sample, Exceeds 2-hour transport, Preserved with fixative (formalin), Swabs for anaerobic culture, Calcium alginate swab for molecular assay, Dried sample/swab, Foley catheter tip

BACTERIOLOGY (49 decks)

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