1. Cerebrospinal fluid Culture + Body Fluid Culture

2. 2 Aim of the test  Diagnosis of the bacteria or fungal meningitis by microscopic examination and culture with identification and susceptibility test of the isolated organism.

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5. 5 Specimen processing  Media : 2 Blood Agar Chocolate Agar MacConkey Agar Fluid Thioglycollate

6. 6 Culturing procedure  As a general rule in CSF and body fluid specimens for culture Centrifuge clear specimen and inoculate plates and do staining from sediments. Turbid specimens may not be centrifuged.

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8. 8 Result reporting  Results of the microscopy and all positive cultures of CSF are reported immediately to the treating physician.  Negative bacterial results are sent out 72 hours after the CSF is received.

9. 9 Turn around time  Gram stain result is reported within 30 minutes of specimen receipt  Positive Culture results = 3- 5 days  Negative Culture results = 2-3 day

10. 10 Additional information  Several antigen detection methods are available for capsular antigen of H. influenzae, N. meningitidis, S. pneumoniae and Group B streptococci in CSF which showed specificity and sensitivity of about 90-97%.  The routine culture for CSF does not include all organisms mentioned in the above table.

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12. 12 Body Fluid Culture  This means: Culture of Body Fluid such as peritoneal, pericardial, plural, ascitic, synovial.  Aim of the test Isolate and identify pathogenic organisms from normally sterile body fluids and perform sensitivity test

13. 13  Types of specimen  Aseptically aspirated body fluid (e.g.,, synovial, peritoneal fluid, pericardial fluid, and pleural fluid ).

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18. 18 Patient preparing  Swab skin over the site of puncture with 2% tincture of iodine in concentric circles.  Iodine should remain in contact with skin for at least 1 minute prior to puncture to ensure complete antisepsis.

19. 19 Specimen collection  Contamination with normal flora from skin, rectum, vaginal tract, or other body surfaces should be avoided.  Indicate the specific source and pertinent clinical history on the request form.  Body fluids should be treated as CSF specimens and should processed immediately.

20. 20 Specimen processing  Media Blood Agar (2 plates) Chocolate Agar, MacConkey Agar Thioglycollate broth

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22. 22 Result reporting  Report Gram stain finding as an initial report.  Report the isolated pathogen and its sensitivity pattern as a final report.  Turn around time: Gram stain and wet mount results should be available 1 hour after specimen receipt. Isolation of a possible pathogen can be expected after 2-3 days. Negative culture will be reported out 1-2 days after the receipt of the specimen.

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