Microbiology - Mycobacteriology
Specimen Collection
Clearly label each specimen with patient's name and fill out DHHS form #1247 completely. The following data items are essential to our computerized record handling system: patient name, patient Social Security Number, date of birth, submitter Social Security Number or Federal Tax Number, Medicaid number, if eligible, submitter return address and phone number, county code, specimen collection date and specimen source. Without these data, specimen records cannot be entered in the computer, nor can a report of results be printed. Other data are required for follow-up and for statistical purposes. For more complete information regarding the computerized record system, contact the Microbiology unit at (919) 733-7367.
Sputum
A series of three specimens is recommended. Collect in the early morning on consecutive days. A volume of 5 to 10 ml is adequate for each specimen. Induced (or nebulized) sputum specimens are usually very watery, and unless indicated on the requisition form, may be mistaken for saliva, which is an inappropriate specimen. Sputum swabs are unsatisfactory. Do not use any transport medium. Use Sputum mailer or equivalent that meets safety requirements.
Bronchoalveolar Lavage Fluids and Bronchial Washings
Collect at least 5 ml in a sterile container. Avoid contaminating bronchoscope with tap water. Saprophytic mycobacteria may produce false-positive culture or smear results. Frequently, bronchoscopy causes the patient to produce sputum naturally for several days after the procedure, and specimens collected a day or two after bronchoscopy enhance detection of mycobacteria. Use Sputum mailer or equivalent that meets safety requirements.
Gastric lavages
Collect 5 to 10 ml of fluid in a sterile container without a preservative, either early in the morning or eight hours after eating or drug therapy. A series of three specimens is recommended. Neutralize as soon as possible with 100 mg of sodium carbonate powder (Na2CO3). Do not use any transport medium. Use Sputum mailer or equivalent that meets safety requirements.
Tissue
Collect 1g of tissue, if possible, aseptically. Select a caseous portion, if available. Do not immerse the specimen in saline (or other fluid) or wrap in gauze. Freezing decreases yield. A sterile container with a small amount of sterile water or sterile saline (to keep the specimen moist) is acceptable. Do not use any transport medium, preservative or fixative. Use Sputum mailer or equivalent that meets safety requirements.
Urine
Collect catheterized or mid-stream urine voided in early morning. A minimum of 40ml is recommended. Submit a series of three specimens, taken on three different days. Twenty-four hour cumulative specimens are unsatisfactory. Do not use any transport medium. Use Sputum mailer or equivalent that meets safety requirements.
Blood and Bone Marrow
Collect 5-10 mL for blood and as much as possible for bone marrow in a sterile tube containing heparin (green top) or sodium polyanetholsulfonate (SPS-yellow top). Blood collected in EDTA or blood that is coagulated is not acceptable. Use Sputum mailer or equivalent that meets safety requirements.
Feces
Only fecal specimens from confirmed or suspected AIDS or other immunocompromised patients will be accepted. Collect approximately 1 gram feces and send in a 50 mL conical sputum mailer. Use Sputum mailer or equivalent that meets safety requirements.
Body Fluids (CSF, pleural, peritoneal, pericardial, etc.)
Collect aseptically following proper procedure for type of specimen. Collect as much as possible (10-15ml minimum) in a sterile container. The recommendation for CSF is at least 2ml. Bloody specimens may be anticoagulated with SPS or heparin. Please phone prior to submission if you have any questions. Do not use any transport medium. Use sputum mailer or equivalent that meets safety requirements.
Abscess Contents, Aspirated Fluid, Skin Lesions, Wounds
Aspirate as much material as possible into a syringe with a luer tip cap. If the volume is insufficient for aspiration by syringe, collect the specimen on a swab and place in transport medium (Amies or Stuart’s). For cutaneous lesions, aspirate material from under the margin of the lesion. Dry swabs are not acceptable. Use Sputum mailer or equivalent that meets safety requirements.
Reference Specimens
Select organisms or subcultures which show good growth and appear in pure culture. Label the media with the patient's name and wrap carefully, securing screw cap with tape. If media is liquid pack with enough absorbent material to absorb the entire contents in case of breakage or leakage. Do not seal cap with paraffin, as it may contaminate culture and interfere with processing. Do not wrap DHHS form #1247 around culture tube, but place in outer container of culture mailer. Use Microbiology Culture Mailer or equivalent that meets safety requirements.
Sputum or Microbiology culture mailers are available from the laboratory mailroom and can be ordered on-line at https://slphreporting.ncpublichealth.com/labportal/
Relevant Links:
See also:
- About Microbiology
- Botulism
- Bordetella Pertussis
- Enteric Bacteriology
- Foodborne Illness
- Cholera
- Legionella
- Mycobacteriology
- Mycology
- Neisseria Gonorrhoeae
- Norovirus
- Parasitology
- Special & Atypical Bacteriology
