U1 LAB: SPECIMEN COLLECTION AND HANDLING Flashcards
T/F: Specimen should be collected prior to administration of antibiotics.
True
Specimen collection should be done in what phase?
Acute phase (Early phase)
What is the result when specimen collection is done after administration of antibiotics?
False negative result
Specimens should be properly labeled with:
- Name
- Birthday
- Date & Time of collection
- Anatomic site
Specimens should be accompanied by a?
laboratory request
CS stands for?
Culture & Sensitivity
ARD stands for?
Antibiotic Removal Device
These may be possible contaminants
Normal flora
Blood is considered as a?
sterile site
What must you do when the blood culture is positive?
Report immediately (there should be no bacteria in blood)
Bacteria that is Gram + which is mistaken for Anthrax
Bacillus
Examples of anatomic site
Wound discharge, swab
The use of sterile leak proof containers must be observed in all body fluids except for?
stool
What are primarily used for aerobic bacteria?
Swabs
What are primarily used for anaerobic bacteria?
Aspirates
Where should you collect lesions, wounds, and abscesses?
at the margin (swabs)
Swabs are collected in?
superficial wounds
Aspirates are collected in?
deep wounds
This is a transport medium to maintain the viability of organisms.
Tube/vial
This is appropriate for the recovery of aerobic organisms
Swabs
Types of Swabs
for Bacterial Culture
Dacron, Calcium, Alginate, Rayon
Types of Swabs
for Viral Culture
Cotton and Dacron
This has fatty acids that have antibacterial properties.
Cotton
Types of Swabs
Nasopharyngeal swab
flexible swabs
The shaft of the swab must be made up of?
plastic or wooden material
This part of the swab absorbs the fatty acid.
Charcoal (black)
T/F: You can place back the swab in its cover to prevent drying.
True
Upper Respiratory Tract for swab
- Throat cultures
- Nasopharyngeal cultures
- Nasal
Throat cultures isolate what bacteria?
Group A Streptococcus (S. pyogenes)
Nasopharyngeal cultures are used to diagnose?
Pertussis, middle ear infections
Nasopharyngeal cultures are used to see carrier states of?
- Staphylococcus aureus
- Neisseria meningitidis
- Haemophilus influenzae
Urogenital swabs are used to diagnosis?
Gonococcal urethritis, Vaginosis, Vaginitis
Other than the URT, swabs can also be used in the?
External ear, eyes
Minimum swabs
2
2 swabs are for?
- Direct Microscopy (Gram Staining)
- Culture & Sensitivity
If there is only one swab, who will decide what test it should be used for?
Physician
UTIs stand for?
Urinary Tract Infections
This connects the kidney to the bladder.
Ureter
UTIs are more prone to who, and why?
Females, have shorter urethra
UTIs include?
- Cystitis
- Urethritis
- Pyelonephritis (kidney)
- Pyelitis
- Glomerulonephritis
This refers to the inflammation of the bladder.
Cystitis
Etiologic agents in Urine specimens (PEKPEKS)
- Escherichia coli
Gram -
- Enterics (Proteus, Enterobacter, Klebsiella)
- Pseudomonas aeruginosa
Gram +
- Enterococcus faecalis
- Staphylococcus aureus
- Staphylococcus saphrophyticus
What is the preferred urine specimen?
Clean catch midstream
First portion of the urine contains organisms from the?
Urethra
Which etiologic agent in urine appears as bluish/greenish?
Pseudomonas aeruginosa
Other urine collection methods
- Straight catheterized urine
- Suprapubic aspirates
- Cytoscopy
This refers to the method in which the syringe is directly punctured in the bladder.
Suprapubic aspiration
What urine should be avoided?
Random voided urine, Foley catheters
Best urine specimens
- First morning (concentrated)
- Clean Catch Midstream
Urine from a newborn is collected through a?
plastic bag
CFU stands for?
Colony Forming Unit
What value is indicative of UTI?
> 100,000 CFU/ml
This is used for quantitative procedure, and has measurements in its loop (diameter)
Calibrated loop
This is used for diagnosis of lower respiratory tract infections.
Sputum
Examples of LRT infections
Bacterial pneumonia, PTB
Recommended volume for sputum
5-10ml
Collection of sputum is done through:
- Expectorated
- Induced
- Gastric contents (children)
Recommended number of sputum specimens
2
Other specimens for PTB:
- Transtracheal aspirate
- Bronchoalveolar lavage (BAL)
- Bronchial washings
T/F: Bronchoalveolar lavage is done by the medical technologist.
False
Physician ang gagawa
What specimen may be used for other sputum-related infections?
Early morning specimen
What stain is used in microscopic examination for sputum?
Gram Stain
This refers to the values of acceptable sputum.
Bartlett’s Classification
Bartlett’s Classification
> 25 WBCs/LPF
<10 Epithelial cells/LPF
LPF stands for?
Low power field
Specimen of choice for diagnosis of gastrointestinal pathogens
Stool
This can be used if stool is present on swab during collection.
Rectal Swab
Stool pathogens
- Campylobacter jejuni
- Salmonella
- Shigella
- Escherichia coli (EHEC, ETEC, EPEC, EIEC)
- Vibrio
- Yersinia enterocolitica
- Listeria monocytogenes
- Clostridium difficile
- Mycobacterium avium complex (MAC)
Strains of E. coli as stool pathogens
- EHEC (Hemorrhagic)
- ETEC (Toxigenic)
- EPEC (Pathogenic)
- EIEC (Invasive)
This refers to the normal flora of stool and carries no infection.
Escherichia coli
T/F: Identification of E. coli in water analysis is often caused by fecal contamination.
True
This specimen is used to determine fever of unknown origin.
Blood
Blood is used for the diagnosis of the following:
- Fever of unknown origin (FUO)
- Septicemia
- Bacteremia
- Typhoid Fever
- Subacute Bacterial Endocarditis (SBE)
Collection of blood must be done when?
before and right after fever spike (to isolate organism), an hour apart
If culture bottle is not possible to be used, aspirate using what?
syringe
Collection of blood must be done where and when?
2 to 3 different sights (left/right arm/foot) within 24 hours
Disinfecting with venipuncture is done with?
70% alcohol, iodine/clorhexidine
Volume of blood collection in adults
20ml
Volume of blood collection in pediatrics
1-20 (1-5ml)
Blood to media ratio
1:10
Media of choice for blood
Broth, Isolator system
Types of broth
- Brain heart infusion (BHI)
- Tryptic soy broth (TSB)
- Biphasic media
- Thioglycollate Broth
This media contains both agar and broth.
Biphasic Media
What percent of SPS is recommended?
0.025 to 0.030%
Mainly used anticoagulant for blood
Sodium polyanetholsulfonate (SPS)
Other anticoagulants for blood
- Heparin
- Sodium amylosulfate
- Sodium citrate
This anticoagulant is used for mycobacteria cultivation.
Heparin
T/F: EDTA inhibits growth of microorganisms.
True
This property refers to inhibition of growth.
Bacteriostatic
This property refers to killing of organisms.
Bacteriocidal
Body Fluids include
- Abdominal fluid
- Amniotic fluid
- Ascitic fluid
- Bile
- Synovial fluid
- Pleural fluid
- Pericardial fluid
Body fluids are collected by?
needle aspiration
Body fluids must be placed in culture media?
immediately
What gastric tubes must be used for gastric specimens?
Levine and Rehfuss
CSF stands for?
Cerebrospinal Fluid
CSF is used for diagnosis of?
Meningitis or Menincoencephalitis
Agents of Meningitis
- Haemophilus influenzae
- Neisseria meningitidis
- Streptococcus pneumoniae
- Streptococcus agalactiae
- Listeria
Collection of CSF
Lumbar Tap (3rd-4th Lumbar Vertebra)
How many tubes can be collected for CSF?
3-4
What tube for CSF is used in microbiology?
2nd tube or 4th tube
If there is only 1 CSF tube, where should it be used?
CS (Microbiology)
Volume of CSF
> /= 1mL
Tissue specimens are collected thru?
Biopsy
Two types of Biopsy
Excisional and Incisional
This refers to biopsy wherein the whole lesion is removed.
Excisional
This refers to biopsy wherein only a portion of the lesion is removed.
Incisional
Aspirates must be placed in a container with tight lid or in an?
anaerobic transport system
Ideal time for specimen transport
30 minutes
Two common preservatives
Boric Acid, Refrigeration
This is used to preserve urine when there are delays
Boric Acid
In cold temperatures
Yersinia enterocolitica
This is an antiphagocytic, anticomplementary anticoagulant
SPS
T/F: SPS may inhibit aminoglycosides.
True
SPS inhibits bacteria such as?
- Neisseria
- Gardnerella vaginalis
- Streptobacillus moniliformis
- Peptostreptococcus anaerobius
Refrigerator temp at 4 degrees
- Catheter tips
- CSF FOR VIRUSES
- Outer ear swab
- Unpreserved feces and urine
- Feces (C. diffinale)
- Sputum, swabs
Ambient / Room temp at 22 degrees
- CSF FOR BACTERIA
- Abscess, lesion, wound
- Body fluid
- Inner ear
- Preserved urine and stool
- Nasal specimens
- Tissues
Body temperature (37 degrees)
- Normal CSF
Freezer temperature (-20 or -70 degrees)
- 20: serum for Serology
- 70: long term storage
QNS stands for?
Quantity not sufficient
This refers to dead organisms collected.
Fixed specimens
Specimen Priority
Level 1 (Critical/Invasive)
- CSF
- aminiotic fluid
- blood
- pericardial fluid
Specimen Priority
Level 2 (Unpreserved)
- Feces
- Sputum
- Tissue
Specimen Priority
Level 3 (Quantitation required)
- Urine
- Tissue for quantification
Specimen Priority
Level 4 (Preserved)
- Feces and urine in preservative
- Swabs in holding/transport medium
Specimen Priority
Level 5 (Batch processing)
- Sputum
- AFB Culture
Incubation condition
18-24 hours at 37 degrees
for most bacteria, AFB
Incubation condition
4 degrees (Cold enrichment medium)
- Listeria monocytogenes
- Yersinia enterocolitica
Incubation condition
5-10% Carbon Dioxide (15% O2), candle jar
Capnophiles
Incubation condition
takes months
Mycobacteria
Incubation condition
Aerobic bacteria
21% O2, 0.03% CO2
Incubation condition
Anaerobe
0% O2
Incubation condition
Microaerophiles
5-6% or 5-10% O2
