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Microbiology IPAP 3-17 > Test 4: Specimen Collection and Handling > Flashcards

Test 4: Specimen Collection and Handling Flashcards

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1
Q

For better results of laboratory testing multiple samples should be obtained, what considerations should be made in the collection of fecal, sputum, blood cultures?

A
  • Prior to antimicrobial therapy
  • Stool and Sputum: 1 per day for 3 days
  • Blood Clx: 3 w/in 2hrs
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2
Q

What is the collection time if a culture of a virus is to be considered?

A

Collect within 3 days after onset of symptoms

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3
Q

What is the collection time for immunodiagnostic test of a virus, single sample test (Ag or early Ab)?

A

Collect and test immediately

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4
Q

For an immunodiagnostic comparison test (Ab increase) of a virus, what are the collection times?

A
  • Acute phase serum: within 7 days after onset of symptoms

- Convalescent phase serum 14-21 days after onset of symptoms

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5
Q

What are the transport times for routine, urine, CSF specimen samples?

A
  • Routine: within 2hrs
  • Urine: within 1 hour or refrigerate
  • CSF: Immediately
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6
Q

What are the transport times for specimen samples of Anaerobes?

A

Immediately if not in anaerobic transporter device

-Within 2hrs in device

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7
Q

Urethral Exudate (gonorrhea culture) should be transported within what time frame?

A

immediately, in device

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8
Q

A viral culture needs to be transported to the lab within what time frame?

A

Immediately (lab my freeze and ship)

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9
Q

Blood for immunologic testing (serum separation) should be taken to the lab within what time frame?

A

within 2 hours

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10
Q

A routine lab should be maintained at what temperature?

A

Room temp or refrigerate

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11
Q

If you suspect these, What sample should not refrigerated?

A

Neisseria
Haemophilus
anaerobes

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12
Q

Most viruses are frozen for shipment unless you suspect what diseases?

A

-Rabies
-Respiratory Syncytial Virus
-Parainfluenza viruses
(keep cold w/wet ice)

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13
Q

Serum may be kept for how long?

A
  • Separate from clot
  • Refrigerate: few days
  • Freeze for longer
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14
Q

Name the predominant normal flora of the upper respiratory tract?

A
  • A and G Streptococcus
  • S. Pneumoniae (GPC)
  • Staphylococcus spp. (GPC) (other than S. aureus)
  • Corynebacterium spp. (GPB) (other than C. diphtheriae)
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15
Q

What are the predominant normal flora of the lower respiratory tract, sinuses, and middle ear?

A

NONE

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16
Q

Name the predominant pathogens of the upper respiratory tract?

A
  • Group A Strep: Pharyngitis
  • Strep pneumonia: sinusitis, otitis media
  • Haemophilus influenza (child): epiglottitis, otitis media
  • Staph aureus: nasal folliculitis
  • Flu virus
  • Cold Viruses: Rhinovirus, RSV, Corona Virus
  • Adenovirus
  • Parainfluenza virus (cold-like)
17
Q

What are the predominant pathogens of the lower respiratory tract?

A
  • Strep pneumonia: pneumonia
  • Mycoplasma pneumonia: pneumonia
  • Haemophilus influenza (GNCB): adults
  • Moraxella catarrhalis (GNCB): pneumonia
  • Legionella: pneumonia
  • Chlamydia pneumonia: pneumonia
  • Klebsiella pneumonia: pneumonia
  • Group A strep: lung abscess and pneumonia
  • Staph aureus: lung abscess and pneumonia
  • Mycobacterium tuberculosis
  • Human metapneumovirus: pneumonia
  • Parinfluenze virus: croups, bronchitis (child)
  • Flu virus
  • RSV
  • Adenovirus
18
Q

What is the process for obtaining a throat swab sample?

A

1) Depress tongue w/sterile tongue blade
2) Collect exudate or secretion on dacron swab
3) swab, throat, tonsillar areas, and exudative or inflamed areas
4) Avoid the tongue
5) Place swab in medium and transport w/in 2hrs

19
Q

What is the process for a nasopharyngeal swab?

A

1) Thin-wire swab into nostril to point of resistance
2) rotate
3) transport w/in 2hrs

20
Q

What is the process for a Nasopharyngeal wash?

A

1) 5mL sterile water in sterile rubber bulb
2) tip pt head 70 degrees, insert into nostril and squeeze
3) tip pt head fwd and collect fluid into container
4) Alt., secretions may be aspirated into rubber bulb

21
Q

For collection of sputum you want to collect what?

A

1) First deep cough production (5-10mL) in sterile container
2) 1 specimen per day for 3 days optimal results
3) transport 2hrs
4) special request for myscobacterial, fungal, and viral clx

22
Q

For a sputum collection excessive saliva contamination is unacceptable. What is considered an acceptable sample?

A

More than 25 neutrophils and less than 10 squamous epithelial cells per 10X objective field

23
Q

Thoracentesis collection process?

A

1) direct puncture of chest wall collect pleural fluid

2) Transport immediately in anaerobic transporter regardless of anaerobic and aerobic cultures and gram stains

24
Q

What are the normal flora of the GI tract?

A
  • Bacteroides spp.
  • Enterococcus spp.
  • Enterobacteriaceae: Escherichia coli, citrobacter, proteus, serratia, enterobacter, kelbsiella, providencia
25
Q

What are the predominate pathogens of the GI tract?

A

-Campylobacter jejuni
-Salmonella enteritidis
-Shigella spp.
-Clostridium difficile
-Vibrio Cholerae: Asia, S. and Central America
-Yersinia enterocolitica
-Escherichia coli: traveler’s diarrhea (ETEC), enterohemorrhagic (EHEC)
-Staph aureus: food poisoning
-Clostridium perfringens: food poisoning
-norovirus (Norwalk virus)
-adenovirus
rotavirus (young child)

26
Q

How far should a rectal swab be inserted?

A

2-3 cm

27
Q

What consideration must be made for a pt hospitalized for more than 3 days and admitting diagnosis was not Gastroenteritis if a stool sample is needed?

A
  • Do not perform routine
  • Consult
  • intestinal flora does not represent community acquired bacteria
  • Consider testing for C. difficile
28
Q

What are the normal flora of the skin?

A
  • Staphylococcus spp.
  • Corynebacterium spp. (not C. diphtheriae)
  • Propionibacterium spp.
  • Candida spp.
  • Dermatophytic fungi
29
Q

What are the predominant pathogens of the skin, wounds, and other tissue abscesses?

A
  • Staph aureus
  • Group A Strep
  • E. Coli
  • Pseudomonas aeruginosa, proteus spp. (burns, nosocominal)
  • Other GNB from soil/fecal sources
  • Clostridium spp.
  • Bacteroides spp.
  • Herpes simplex
  • Candida albicans
  • Microsporum. trichophyton and epidermophyton (dermatophytic fungi)
  • Haemophilus, adenovirus (pink eye)
30
Q

For collection and handling of deep abscess, wound, and lesions (anaerobic or aerobic pathogens) what is the procedure?

A

1) Clean surface to kill normal flora
2) Aspirate
3) If suspected anaerobe use transport and get to lab

31
Q

Microscopic examination of a skin scraping for fungi is accomplished via what?

A

KOH and other wet mount in clinic.

-Sent to lab for confirmation

32
Q

What is the normal flora of the genital tract, male and female?

A

Staphylococcus spp.

Corynebacterirum spp.

33
Q

Female genital tract has what other normal flora?

A
  • Various GNB
  • Various anaerobes
  • Streptococci
  • Lactobacillus spp. (GPB) (decreases during bacterial vaginosis)
  • Yeast
34
Q

What are the predominant pathogens of the genital tract?

A 
STD
-Chlamydia trachomatis
-Neisseria gonorrhoeae
-Herpes simplex
-Treponema pallidum
-Trichomonas vaginalis (protozoan) vaginitis
Non-STD
-Candida albicans
-Gardnerella vaginalis (GNB): Bacterial vag. Clue cells
35
Q

What is the lab processing for gonorrhea?

A
  • Gram stain for males
  • PCR typical
  • Females: cervix, anus and throat
  • males: confirmation and proof of cure
36
Q

What is the routine lab processing for chlamydia?

A
  • PCR typical
  • EIA/ELISA sometimes used
  • Gram stain no benefit
  • Special stain from cell culture provides good results

Microbiology IPAP 3-17 (16 decks)

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