Collection & Handling

of Clinical Specimens
JAN NHEILLE LOCSON
Instructor
 Topic Outline

1 2 3 4 5
Safety and Collection from Transport Media selection Specimen
General Guidelines various sites and Incubation rejection

2 Collection & Handling 2022

 Safety and General Guidelines
• A properly collected specimen is absolutely crucial to quality
diagnostic information and patient care.

Universal precautions are followed during the collection and

handling process.

1. Persons collecting or handling specimens should wear gloves and laboratory gown.
2. Eye protection should also be worn if splashing is a potential hazard.
3. Accidents or injuries must be reported immediately.

3 Collection & Handling 2022

 1 Collect the specimen in the acute phase of infection and
before the administration of antibiotics or antimicrobials.

Appropriate collection devices and containers should be

2 used and must be sterile. Aseptic technique is required.

Collect specimen using proper technique with minimal

General Guidelines 3 contamination from normal flora. Collect appropriate
quantity of specimen.
How to ensure appropriate
specimen management?
Package the specimen in a container that is designed to
maintain the viability of organisms and avoid hazards
4 that result from leakage.

Label the specimen accurately.

• Patient’s identification
5 • Date and time of collection
• Source of specimen
 Specimen

SWAB
SWAB TISSUE
TISSUE FLUID
FLUID

• Wound abscess in a • Collected on bedside • Blood • Sputum

superficial cut by a doctor. • Urine • Other body
• Must be sterile • CSF fluids

5 Collection & Handling 2022

 Collection
• Specimen should be collected in a
sterile state (except stool)
• Swabs are not recommended since
they easily dry up and are easily
contaminated
• Lesions, wounds, and abscesses –
the exact anatomic site must be
provided.

Presentation title 6
 Collection from Various Sites

a) 2-3 cultures should be collected at random times during a

Blood b)
24-hour period.
Skin is disinfected with 70% alcohol, followed by iodine.

Cerebrospinal a) Collected aseptically by a physician.

b) Processed immediately and not exposed to refrigeration or
Fluid heat.

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 Collection from Various Sites

Body Fluids a) Collected by a physician with a needle and syringe.

Abscess aspirates or exudates, as well as b) Collected in a sterile screw-capped container.
synovial, pericardial, and pleural fluid.

a) Midstream clean-catch is the most common collection

method.
Urine b) Catheterized urine specimens usually have less normal
flora contamination.

8 Collection & Handling 2022

 Collection from Various Sites

a) Collected in a clean, leakproof, wide-mouthed container

with a tight-fitting lid.
Stool b) Stool specimens should never be taken from the toilet and
should not be contaminated with urine.

a) Early morning specimens are best.

Sputum b) Expectorated specimens from a deep cough should be
collected into a sterile specimen cup.

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 Collection from Various Sites

a) The tongue should be depressed before swabbing between

Throat b)
the tonsillar pillars and behind the uvula.
The cheek, tongue, and teeth should not be touched.

a) A flexible wire nasopharyngeal swab should be gently

Nasopharynx inserted through the nose into the posterior nasopharynx,
rotated, and then removed.

10 Collection & Handling 2022

 Collection from Various Sites

MEN:
Genital tract a) Exudates may be expressed from the urethral orifice or a
small-diameter swab may be inserted 3 to 4 cm into the
urethra.

WOMEN:
a) Cervical specimens are obtained by a physician with the
a a) A flexible
aid wire nasopharyngeal swab should be gently
of a speculum.
b) inserted through
Lubricants, whichthe
maynose
be into the
lethal toposterior
Neisserianasopharynx,
gonorrhoeae,
rotated,
should notand
bethen
usedremoved.
on the speculum.

11 Collection & Handling 2022

 Patient-collected Specimen

URINE
URINE STOOL
STOOL SPUTUM
SPUTUM

• Midstream clean catch • For examination of GIT • First morning sputum

• Take note if female pathogen is preferred
patients are currently • Rectal swab must • Method of collection is
on their menstrual show feces expectoration
cycle. • Bacterial infection – 3 • For C&S, Acid Fast
• Urine C&S specimens for 3 days Staining, and Cytology
• Culture = to check if (1 per day) • For the diagnosis of
there is growth of • Parasitic infection – 3 bacterial pneumonia
bacteria specimens for 10 days • Should NOT be saliva
• Sensitivity = to know
which antibiotics are
to detect ova/parasites
effective Note: Stool should not be contaminated
with urine or toilet water.

12 Collection & Handling 2022

 Transport of Specimen
Primary goal of transportation To maintain the specimen as
near to its original stat as possible with minimal deterioration
and to prevent risk to the specimen handler.

• Specimen should be transported to the laboratory within 30

minutes, preferably within 2 hours.

• If transport cannot occur immediately, most specimens can

be held at 2-8°C.
13 Collection & Handling 2022
 Media Selection

Most isolation Chocolate agar is Specialized media Media substitutions

protocols call for the used for fastidious for suspected may be made with
use of blood agar. isolates. specific organisms. acceptable results.

14 Collection & Handling 2022

 Incubation
The normal incubation temperature for bacterial cultures is 35°C to 37 ° C.

AEROBES
aaa ANAEROBES
AAA

• Grows in ambient air • Microorganisms which grow on

• 21% oxygen anaerobic jar chambers with no
• 0.03% carbon dioxide oxygen
• 0% oxygen
• 5 to 10% carbon dioxide
• 80 to 90% nitrogen

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 Incubation

CAPNOPHILES
aaa MICROAEROPHILES
AAA

• Microorganisms which requires • Microorganisms which requires

increased carbon dioxide conc. low concentration of oxygen and
(candle jars) increased carbon dioxide
• 5 to 10% carbon dioxide • 5 to 10% oxygen
• 15% oxygen • 8 to 10% carbon dioxide

Example: H. influenzae, N. gonorrhoeae Example: H. pylori, C. jejuni

16 Collection & Handling 2022

 1 Quantity Not Sufficient (QNS) or inadequate specimens
for number of tests requested

Specimens received in nonsterile or contaminated

2 containers (including those that has leaked out)

Specimen Rejection 3 Specimen submitted in improper container and unlabeled

container
The following situations or
specimen types should be
rejected:
Saliva instead of sputum
4

Excessive delay between specimen collection and arrival

5 in laboratory
 6 Container and request form have different ID's

Specimens placed into formalin

7

Specimen Rejection 8 Stool for ova and parasites with gross barium

The following situations or

specimen types should be
rejected:
Dry swab received for culture
9

Improper specimen for test

10
End of Lesson 3
1. Safety and General Guidelines
2. Collection from Various Sites
3. Transport
4. Media selection and Incubation
5. Specimen Rejection