The patient's name and the source of specimen must be on both the requisition and the specimen. A culture is only as accurate as the method used for collection. Outside microorganisms may contaminate a specimen during each phase of handling. This can lead to misleading or erroneous results. Take care at all times to avoid contamination. Submit promptly for optimal recovery of pathogens. Submit in a Sterile leak-proof container at room temperature unless otherwise specified.

Acid Fast Culture

Collect specimen in container and hold at room temperature until courier pickup. No preservative is necessary.

Blood: 10mL for adults or 1.5 mL for children collected aseptically and placed in SPS (Yellow) tubes.

 Sterile Cup

 

Acid Fast Smear

Sputum : 5 to 10 mL of early morning expectorant from a deep cough.

Blood : 10 mL for adults or 1.5 mL for children collected aseptically and placed in SPS (yellow) tubes.

 
 Sterile Cup

 

Anaerobic Culture Be sure specimen is from suitable anaerobic sterile body site or deep body cavity. Send a culture swab immersed in transport media or fluid in syringe with air expelled and needle removed. Submit promptly for optimal recovery of pathogens. Must be received in microbiology laboratory within 24 hours of collection. Collection container should be a Port A Cult Media Vial.  For fluids, a Port-a-Cul fluid transport system may be used instead and is preferred.  Port a Cult Media Vial

 

 

Bacterial Antigen

Body fluids including serum, CSF, and urine may be submitted in a container for testing. Please specify which of the following bacterial antigens need to be tested:

  • Group B Streptococcus
  • E. coli K1
  • Haemophilus influenza
  • Neisseria meningitidis
  • Streptococcus pneumonia

 

 Sterile Cup

 

Blood Culture

Ideally, 20 mL of blood is drawn and split between an aerobic bottle and an anaerobic bottle. For pediatric draws, 1 to 2 mL blood may be submitted in an aerobic bottle. Use the following aseptic technique: 

  • Clean the blood collection site with alcohol.
  • Disinfect the site with iodine and allow to dry 1 to 2 minutes.
  • Clean the diaphragm of the bottles with alcohol.
  • Do not touch the phlebotomy site after disinfection.
  • Draw blood with a sterile syringe and needle.
  • Immediately transfer 20 mL of blood to each bottle.
  • Mix the bottles by inversion to prevent blood from clotting.
  • Remove iodine from the patient's arm with alcohol. 
  • Bottles should be submitted to the laboratory as quickly as possible, preferably within a few hours, but at the longest within 24 hours.

Pediatric bottles available upon request.  Transfer up to 4 mls.

 Blood Culture Bottles

 

Bordetella by PCR

Package with instructions is available upon request.  

 Bortedella Pertussis Collector

 

Chlamydia Culture

A conical centrifuge tube containing viral transport media is provided. Use a swab to collect the specimen. It is broken off into the tube and should be immersed in the liquid media. Refrigerate.

 

 Viral Culture Media

 

Clostridium Difficile DNA

Submit fresh stool specimen in sterile container. Refrigerate. Freeze if specimen will not be received in the lab within 4 days after collection. Cary Blair collection contain also acceptable.

 

 Sterile Cup

Cary-Blair for Stool Collection

 

 

 

CMV

 

All specimens need to be refrigerated as soon possible.

Blood: Draw 10 mL blood aseptically into heparin (green-top) tube.

Urine: Collect random specimen in a sterile container.

Other: Submit sample in viral transport media.

 

 Sterile Cup

 

 

 

Cryptococcal Antigen

 

CSF or blood may be submitted in a sterile container. Refrigerate.

Plain Red or Serum Separator Tube

 SST

 

 

 

Cryptosporidium Stain

 

 

Submit fresh stool specimen in vial containing formalin. Stool should be preserved at room temp in 10% Formalin Gastric Fluid. Transfer to clean leak proof refrigerated container.

 

 Sterile Cup

 

 

 

CSF Culture

 

 

Submit CSF in sterile container. Submit immediately for optimal recovery of pathogens.

 

 Sterile Cup

 

 

 

Fecal Leukocytes

 

 

Submit fresh stool specimen in sterile container without preservative.

 

 Sterile Cup

 

 

 

Fungus Culture

 

 

 

Submit specimens in sterile container. (Skin Scraping, Hair, Nails)

 Sterile Cup

 

 

 

Fungus Culture Blood

 

Blood specimens should be collected aseptically and submitted in Isolator tubes. Appropriate sample size for adults is 10 mL. Pediatric specimens of 1.5 mL are acceptable.

Heparin (green top) Tube or SPS (yellow top) Tube

 

 Sodium-Heparin---Green

 

 

 

Fungus Culture Other

 

 

Submit specimens in sterile container. Swabs are acceptable but not recommended.

 

 Sterile Cup

 

 

 

GC Culture

 

A culture swab with transport media should be submitted. It must be received in the Microbiology laboratory within 24 hours after collection. A Jembec plate is also acceptable. The plate is inoculated by rolling the swab on the agar surface in a Z-pattern. A CO 2 generator capsule is then placed in the space provided. The plate is then sealed in the provided plastic sack. CPLSE does not provide Jembec Plates.

 

 Swab

 

 

 

Gram Stain

 

Smear glass slide with specimen at time of collection and air dry. Always smear slide frosted side up. Label slide in pencil on frosted area with patient's name and source. Culture swabs and specimens submitted in sterile containers can also be submitted for gram stain. Alternately, liquid may be submitted.

 

 Any container can be used.

 

 

Herpes Simplex Culture

 

Use special collection vial and swab. After swabbing the base of the lesion, place swab in viral transport vial. Label with the patient name and date. Refrigerate.

 

 Viral Culture Media

 

 

 

Herpes Simplex Typing

 

 

Body fluid in a sterile container or sterile swab in viral transport media is required. Refrigerate.

 

 Sterile Cup

Sterile Swab

 

 

KOH Preparation

 

Skin scrapings may be submitted in a clean 50 mL screw cap container. A swab of mucus membrane may be submitted. Do not submit specimens crushed between two slides.

 

 Sterile Cup

 

 

Occult Blood Single Screen

 

Hemoccult slides may be submitted. Following the directions on the slide, one side is lifted and stool is smeared in the provided areas.

 

 Occult Blood Cards

 

 

Occult Blood Screen x3

 

Hemoccult slides may be submitted. Following the directions on the slide, one side is lifted and stool is smeared in the provided areas.

 

 Occult Blood Cards (x3)

 

 

 

Rotavirus Screen

 

 

Submit fresh stool specimen in a clean container. Sample must not be contaminated with urine. Refrigerate.

 

 Sterile Cup

 

 

 

Routine Culture

Fluid: Submit in Port-a-cul fluid transport or alternately sterile tube, or syringe with needle removed. Submit immediately to the laboratory.

Swab: Submit a culture swab in transport media. For optimal results, it should be received in the Microbiology laboratory within 24 hours after collection.

Tissue: Submit in a sterile container immersed in a small amount sterile saline. Submit immediately

 

 Port a Cult Media Vial

Swab

Sterile Cup

 

 

 

RSV Screen

 

 

Submit nasal washing collected in a sterile container. Refrigerate.

 

 Sterile Cup

 

 

 

 

Sputum Culture

Submit sputum expectorated by deep cough into a sterile container. For optimal results, it should be received into he Microbiology laboratory within a few hours, but can be delayed no more than 24 hours after collection.

The Adequacy of Sputum Cultures:

At CPL, a gram stain is performed on all sputum cultures reporting bacteria, epithelial cells and inflammatory cells. This information can be used to assess the adequacy of the sputum collection. A specimen containing greater than 10 squamous epithelial cells/low power field suggests oropharyngeal contamination, and the culture will be rejected. Gram stains exhibiting minimal oropharyngeal contamination will be reported with the number of epithelial cells and inflammatory cells, and the culture results will follow.

 

 Sterile Cup

 

 

 

Stool Culture

 

Submit fresh stool specimen uncontaminated by urine in a vial containing Cary Blair transport media. No more than two bacteriology specimens, collected at separate times, are recommended. Two specimens will pick up 99% of bacterial pathogens. Alternately, a stool sample in a sterile cup-refrigerated immediately upon collection and optimally received in the laboratory within 2 hours, is acceptable. If necessary, it can be refrigerated up to 24 hours before receipt in the Microbiology laboratory.

 

 Cary-Blair for Stool Collection

 

 

Streptococcus Culture -
Throat (M650)

 

 

Submit specimen on a culture swab immersed in transport media.

 

 Swab

 

 

Streptococcus B Culture -
Pregnancy

 

 

Submit specimen on a culture swab immersed in transport media.

 

 Swab
 
 
 
 

 

 

Throat Culture, Comprehensive (M100)

 

 

Submit specimen on a dual culture swab immersed in transport media.

 

 Swab

 

 

 

 

 

 

 

Urine Culture

  

Urine placed immediately in blue-top transport tube is strongly preferred. Urine collected in a sterile container is also acceptable if refrigerated immediately after collection. Directions for proper collection:

1. Females should clean the periurethral area with water.

2. Males should clean the glans penis area with water.

3. Allow the initial flow of urine to commence and then collect a midstream portion into a sterile container.

4. Store and submit sealed container refrigerated, or transfer urine immediately to gray-top preservative tube and store/submit refrigerated or at room temperature. Note: If urinalysis is also ordered, an unpreserved sample should be submitted for that test. Susceptibility testing is not routinely performed on voided specimens with mixed urogenital flora or on colony counts below 50,000 CFU/mL unless from a Nursing Home patient or other special circumstance. Unpreserved refrigerated urine must be received within 24 hours of collection. Urine grey top tubes is acceptable up to 48 hours after collection. Urine in blue topped "culture" tubes is acceptable up to 72 hours after collection. 

 Urine Tube for UA and Culture

 

Sterile Cup

 

 

 

Vaginal Culture

 

Specimens should be submitted on a culture swab immersed in transport media. For optimal results, and to rule out Neisseria Gonorrhea, it should be received in the Microbiology laboratory within 24 hours after collection.

 

 Swab

 

Viral Culture

Body fluid in a sterile container or sterile swab immersed in viral transport media is required. Refrigerate.

 

 Sterile Swab

Sterile Cup

 

Wet Prep

Place swab in 0.5 mL saline. To detect Trichomonas, specimen should be examined as soon as possible.

 

 Swab