Collection & Transport of Clinical Specimens

Sore throat A swab from tonsils or pharynx to be cultured on the day of sampling for B-haemolytic streptococci & C. diphtheriae. If delay is unavoidable transport media should be used; e.g.: Stuart’s or Ames media.

Streptococcal & Staphylococcal Nose & throat swabs are required. The nasal swab should be rubbed gently on the mucosa of both anterior nares.

Meningococcal carriers A nasopharyngeal swab must be seeded immediately on warm blood agar or sent in Stuart’s transport medium.

Whooping Nasopharyngeal or pernasal swabs are seeded directly on to Bordet- Gengou The inoculated medium is sent to the lab. as soon as Cough Plate: Directly in front of patient

Enteric fever or P.U.O (a) 1 st. week: (i)Blood culture: Blood is best taken before treatment. (ii) Blood for serology: Clotted blood is taken for agglutination tests. (iii) Feces culture: A small sample of feces (with pus or mucus) is sent in screw- capped bottle & cultured on day of collection.

(b) 2 nd. & subsequent weeks: (i) Blood culture: A positive result becomes progressively less likely. (ii) Faeces culture: as above. (iii) Agglutination test (Widal): 5-10 ml of clotted blood are collected to test for enteric fever & brucellosis. (iv) Urine culture: A clean specimen is sent in sterile, screw- capped bottle for culture on the day of voiding

Tuberculosis (i) Samples of sputum are sent for microscopic examination on 6 consecutive days. They can be collected separately, refrigerated or kept in a cool place & sent together. (ii) Containers need not be sterile if sputum is sent for microscopy only. (iii) Samples of sputum or any other discharge for culture of T.B. must be received on the day of sampling.

(iv) Gastric lavage must either be received within a few hours or be neutralized with alkali & refrigerated. (v) Laryngeal swabs should be received on the day of sampling or the patient sent to the lab. (vi) Urine: 3 morning specimens submitted together to the lab.

Faeces or rectal swabs must be received on the day of sampling. Swabs must not be allowed to dry & moistened before Cary-Blair transport medium is used for stool transport

Pleural effusion For complete examination 2 samples are required one in a sterile bottle for the other in a large sterile jar containing citrate for examination & culture of T.B.

Pus & infected This should arrive as soon as possible Ames transport medium & thioglycolate medium may be Biopsy specimens for culture should be placed in a sterile screw-capped bottle without adding a When actinomycosis or T.B. is suspected & no biopsy is taken,whole inner wound dressing is sent in a large sterile jar.

C.S.F. should be taken with a dry sterilized puncture needle using extremely careful aseptic It should arrive while still warm. Incubate if there is delay.

Swabs should be seeded at the bedside or patient sent to lab. Puerperal Cervical swabs are either cultured within half hour, or placed in Stuarts transport Blood for culture is collected before treatment

Venereal Urethra & cervix are sampled with swabs & placed in Stuarts transport medium; or collected at Fluid from a chancre is collected in a capillary tube & sealed with plasticine & examined as soon as possible for treponemes by D.G. Blood for serology is delivered into a sterile bottle & allowed to clot. A sterile sample is essential for treponemal immobilization test. Patient must not have received antibiotics within the previous 48 hours.

Fresh blood & alkaline urine, still warm, are examined under D.G. microscope for spirochaetes, inoculated into animals & into fluid media for In 2nd week of disease blood is sent for agglutination tests.

Acute lung A sample of sputum for bacterial culture should be received on day of If virus infection is suspected, sputum should be collected into a screw-capped bottle as early as Or freeze & taken to lab. within the next day or two in a special cold box.

Body fluids for antibiotic These should be transmitted to lab. as soon as Postal specimens are not accepted. Viral infections 2 samples of blood are required for One taken immediately & the other days later.

Urinary tract A mid-stream urine is best Genitalia ( specially females) must be washed with soap & water before passing the Catheterization must be Urine is collected in sterile screw-capped bottles & sent as soon as possible for culture on same day. If there is delay, transport in ice & keep in fridge.