These include:

OUTLINE o Urine
I. Overview o Amniotic fluid
II. Non-blood Specimen Labeling and Handling o Cerebrospinal fluid
III. Non-blood Body-Fluid Specimens (11)
o Gastric fluid / Gastric Analysis
A. Urine
o Nasopharyngeal Secretions
B. Amniotic Fluid
o Saliva
C. CSF
o Semen
D. Gastric Fluid / Gastric Analysis
E. Nasopharyngeal Secretions, etc o Serous fluid
IV. Other Non-blood Specimens o Sputum
o Sweat
o Synovial fluid.
I. OVERVIEW ● Its function is to serve as a lubricant so that there could be
● Although blood is the specimen of choice for many laboratory distance between the tissues and surrounding tissues.
tests, various other body substances are also analyzed. ● It also serves to lubricate the various organs.
● The phlebotomist may be involved in obtaining the specimens
(e.g., throat swab collection), test administration (e.g., sweat URINE
chloride collection), instruction (e.g., urine collection), ● Is the most frequently analyzed non-blood body fluid.
processing (accessioning and preparing the specimen for ● It is the focus specimen for clinical microscopy. It is a
testing), or merely labeling or transporting the specimens to the non-invasive collection procedure since you just ask the patient
lab. to void his or her urine.
● This chapter addresses routine and special nonblood ● Urine has been studied since the very beginning of laboratory
specimens and procedures, including the collection and medicine.
handling of urine specimens and other non blood body fluids ● It is readily available, easy to collect, and generally inexpensive
and substances. to test, its analysis can provide information on many of the
● A phlebotomist with a thorough understanding of all aspects of body's major metabolic functions.
nonblood specimen collection helps ensure the quality of the ● Normally, urine is the color yellow. If the urine is mostly
specimens and the accuracy of test results. concentrated, it is described to be dark yellow in color.
● Analysis of urine can aid in.
II. NON-BLOOD SPECIMEN LABELING AND o monitoring wellness,
HANDLING o the diagnosis and treatment of urinary tract infections,
● Proper labeling helps avoid testing delays, which can o the detection and monitoring of metabolic disease,
compromise patient care. Nonblood specimens should be o and determining the effectiveness or complications of
labeled with the same identifying information as blood therapy
specimens. ● Accurate results depend on.
● In addition, since many body fluids are similar in appearance, o collection method
labeling should include the type and/or source of the specimen. o container used
● Because the lid is removed for testing, the label should be o specimen transportation and handling
applied to the container, not the lid, so as to avoid o timeliness of testing
misidentification. If urine is not tested in a timely fashion, this results in
● Nonblood specimens have various handling requirements. The erroneous results.
phlebotomist must be familiar with these requirements to ● If urine is not tested in a timely fashion, this results in erroneous
protect the integrity of the specimen and help ensure accurate results.
test results. ● Inpatient urine specimen collection is typically handled by
● In addition, all body substances are potentially infectious, and nursing personnel.
standard precautions must be observed in handling them. ● Outpatient urine specimen collection is often handled by
phlebotomists.
● The phlebotomist must be able to explain urine collection
III. NON-BLOOD BODY-FLUID SPECIMEN procedures without embarrassing the patient.
● Nonblood body fluids are liquid or semiliquid substances ● If urine specimens are not tested promptly, urine components
produced by the body and found in the intracellular and can change. For example, cellular elements decompose,
interstitial spaces and within various organs (e.g., the bladder) bilirubin breaks down to biliverdin, and bacteria multiply, leading
and body spaces (e.g., joints). to erroneous test results.

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● The type of specimen preferred for many urine tests is the first ● Machines are available that read the strips automatically. The
urine voided (passed naturally from the bladder or urinated) in strip is used once and then discarded.
the morning, because it is the most concentrated.
● However, the type of urine specimen and method of collection MICROSCOPIC ANALYSIS
vary depending on the type of test. ● Microscopic analysis identifies urine components such as
● The most common urine tests, types of specimens, and cells, crystals, and microorganisms by examining a sample of
collection methods follow. urine sediment under a microscope.
COMMON URINE TESTS
● To obtain the sediment, a measured portion of urine is
● Routine Urinalysis (UA) centrifuged in a special plastic tube.
● Urine Culture and Sensitivity ● After centrifugation, the supernatant, or top portion of the
● Urine Cytology Studies specimen, is discarded.
● Urine Drug Screening ● A drop of the remaining sediment is placed either on a
● Urine Glucose and Ketone Testing glass slide and covered with a small square of glass
● Urine Pregnancy Testing called a coverslip or placed in a special chamber.
● It is then examined under the microscope by a laboratory
technologist or technician.
ROUTINE URINALYSIS (UA) ● There are also machines that perform this function. • A random
● is the most commonly requested urine test because it screens specimen is acceptable for routine urinalysis.
for urinary and systemic disorders. ● However, to avoid contamination of the specimen by genital
● It may be ordered as part of a physical examination or at secretions, pubic hair, and bacteria surrounding the urinary
various times during hospitalization. opening, the ideal procedure for collecting a specimen for
● A routine UA typically includes: routine urinalysis is referred to as midstream collection.
o Physical, ● Routine UA specimens should be collected in clear, dry,
o Chemical, chemically clean containers with tight-fitting lids.
o Microscopic analysis of the urine specimen ● If a culture and sensitivity (C&S) is also ordered on the
specimen, the container should be sterile.
PHYSICAL ANALYSIS ● Urine specimens should be transported to the lab promptly.
● involves macroscopic observation and notation of color, clarity, ● Specimens that cannot be transported or analyzed promptly
and odor, as well as measurements of volume and specific can be held at room temperature and protected from light for up
gravity (SG) or osmolality. to 2 hours.
● It is the first step in urinalysis. ● Specimens held longer should be refrigerated.
● (SG and osmolality indicate urine concentration.) ● Specimens that require both UA and C&S testing should be
● Physical analysis can also help explain or confirm chemical and refrigerated if immediate processing is not possible.
microscopic results.
URINE CULTURE AND SENSITIVITY
CHEMICAL ANALYSIS ● A urine culture and sensitivity (C&S) test may be requested
● Can detect: on a patient with symptoms of urinary tract infection (UTI).
o Bacteria, ● The culture involves placing a measured portion of urine on a
o Bilirubin special nutrient medium that encourages the growth of
o blood (red blood cells and hemoglobin) microorganisms, incubating it for 18 to 24 hours, checking
o Glucose it for growth, and identifying any microorganisms that grow.
o Ketones ● If it will not grow, it means that there is negativity for that
o Leukocytes specific microorganism.
o Nitrite ● If a microorganism is identified, a sensitivity or antibiotic
o Protein susceptibility test is performed to determine which antibiotics
o and urobilinogen will be effective against the microorganism.
o measure pH and ● Urine for C&S testing must be collected in a sterile
o specific gravity. container, following midstream clean-catch procedures to
● Analysis is commonly performed using a plastic reagent strip ensure that the specimen is free of contaminating matter
(often called a dipstick) that contains pads impregnated with from the external genital areas.
test reagents.
● Each test has its own pad. The strip is dipped into the PHYSICAL ANALYSIS
urine and color reactions that take place on the pads are ● Cytology studies on urine are performed to:
compared to a color chart, which is usually found on the label of o detect cancer
the reagent strip container. o cytomegalovirus
● Allow the urinary strip to stand for 30 seconds to 2
o and other viral and inflammatory diseases of the bladder
minutes, depending on the reagent type.
and other structures of the urinary system.
● Special timing, which is not the same for all tests, is
● Cells from the lining of the urinary tract are readily shed into the
involved in reading the results, which are reported in the
urine, and a smear containing them can easily be prepared
manner indicated on the color chart.
from urinary sediment or filtrate.
● Results are typically reported using the terms trace, 1+, 2+, and
so on to indicate the degree of a positive result, and negative
(neg) or (–) when no reaction is noted.

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● The smear is stained by the Papanicolaou (PAP) method
and examined under a microscope for the presence of
abnormal cells.
● A fresh clean-catch specimen is required for the test.
● Ideally, the specimen should be examined as soon after
collection as possible.
● If a delay is unavoidable, the specimen can be preserved by the
addition of an equal volume of 50% alcohol.
URINE DRUG SCREENING
● Urine drug screening is performed to detect:
o Illicit use of recreational drugs,
o Use of anabolic steroids to enhance performance in sports,
o and unwarranted use of prescription drugs;
● It is also used to monitor therapeutic drug use in order to
minimize withdrawal symptoms and to confirm a diagnosis of
drug overdose.
● With the exception of alcohol, urine à is preferred for drug
screening, since many drugs can be detected in urine but
not blood.
● Screening tests are typically performed in groups based on
drug classifications or families.
● A random sample in a chemically clean, covered container
is required for the test.
● Specimens containing blood cells or having a high or low urine
pH (highly alkaline or highly acid) or a low specific gravity will
yield erroneous results and will require recollection of the
specimen.
URINE GLUCOSE AND KETONE TESTING
● Urine reagent test strips are also used to screen for
diabetes and monitor glucose and ketone levels in diabetics.
● The body breaks down carbohydrates to supply itself with
glucose.
● Ketones à are created when the body breaks down fat for
energy because the diet is deficient in carbohydrates or when
the body does not metabolize glucose properly.
● The testing of urine ketone levels can be used to
diagnose diabetic ketoacidosis and help differentiate between
diabetic and nondiabetic coma.
● Results are read by comparing color changes on the test strip
to a color chart.
URINE PREGNANCY TESTING
● Pregnancy can be confirmed by testing urine for the
presence of human chorionic gonadotropin (HCG). a hormone
produced by cells within the developing placenta, that
appears in serum and urine approximately 8 to 10 days after
conception, or fertilization.
● Although a random urine specimen can be used for
testing, the first morning specimen is preferred because it
is typically more concentrated and would therefore have the
highest HCG concentration.
OTHER URINE TESTS
● Numerous chemistry tests—including:
o electrophoresis,
o tests for heavy metals (e.g., copper and lead),
o myoglobin clearance,
o creatinine clearance, and
o porphyrins—can be performed on urine specimens
● Many of these tests require a pooled timed specimen, such as a
24-hour collection.
PMLS Handling and Processing of Non-Blood Specimens for Laboratory Testing
TYPES OF URINE SPECIMENS
RANDOM
● Random urine specimens can be collected at any time.
● They are used primarily for routine urinalysis and screening
tests.
● Random refers only to the timing of the specimen and not the
method of collection.
FIRST MORNING / 8-HOUR SPECIMEN
● A first morning or 8-hour urine specimen (also called a first
voided, overnight, or early morning specimen) is usually
collected immediately upon awakening in the morning after
approximately 8 hours of sleep.
● This type of specimen normally has a higher specific
gravity, which means that it is more concentrated than a random
specimen.
● For this reason, first morning specimens are often
requested to confirm results of random specimens and
specimens with low specific gravity.
FASTING
● A fasting specimen is typically used for glucose monitoring.
● It differs from a first morning specimen in that the
specimen is the second specimen voided after a period of
fasting.
● This helps assure that the specimen will not be affected by food
consumed prior to fasting.
TIMED
● Some tests require individual urine specimens collected at
specific times.
● Others require the collection and pooling of urine throughout
a specific time period. Some of the most frequently
encountered timed urine tests are as follows.
TIMED URINE SPECIMENS
TOLERANCE TEST SPECIMEN
● Tolerance tests typically require collection of urine at
specific times.
● The traditional standard glucose tolerance test (GTT) requires
individual urine specimens collected serially at specific times
that correspond with the timing of blood collection, such as
fasting, 1/2 hour, 1 hour, and so on.
● Timing of the specimens is important in the interpretation of test
results.
● For this reason, the specimens must be collected as close to
the requested time as possible, and the label of the
specimen should include the time of collection and the
type of specimen (e.g., fasting, 1/2 hour).
2-HOUR POSTPRANDIAL SPECIMEN
● A 2-hour postprandial (PP) specimen is collected 2 hours
after a meal and tested for glucose.
● It is primarily used to monitor the insulin therapy of patients
with diabetes mellitus.
● The patient is instructed to avoid it shortly before consuming a
normal meal and to collect a specimen 2 hours later.
● Results are often compared with glucose results on fasting
urine and fasting blood specimens.
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24-HOUR SPECIMEN
● A 24-hour urine specimen is collected to allow quantitative
analysis of a urine analyte.
● Collection and pooling of all urine voided in the 24-hour period
is critical.
● The best time to begin a 24-hour collection is when the patient
wakes in the morning, typically between 6 and 8 A.M.
● Collection of the specimen requires a large, clean,
preferably wide-mouth container capable of holding several
liters.
● A special collection device that fits over the toilet and
looks somewhat like an upside-down hat is sometimes
provided to the patient to make collection of the specimen
easier.
● Only after hitting the 24-hour mark will you be allowed to
analyze the analyte being measured for the 24-hour urine.
● Some 24-hour specimens require the addition of a
preservative prior to collection.
● Others, such as creatinine clearance, must be kept
refrigerated throughout the collection period.
● Information on proper handling of the specimen can be
obtained by consulting the laboratory procedure manual.
● The label of the specimen, in addition to standard patient
identification, must state that the specimen is a 24-hour
specimen, the type of preservative added to the container
(if applicable), and any precautions associated with it, as some
preservatives can burn the skin.
● A urine creatinine clearance test also requires collection of
a blood creatinine specimen, which is ideally collected at the
midpoint of urine collection (i.e., 12 hours into urine collection).
URINE COLLECTION
● Regular Voided Specimen
● Midstream Specimen
● Midstream Clean-Catch Specimen
● Catheterized Specimen
● Suprapubic Aspiration
● Pediatric Urine Collection
AMNIOTIC FLUID
● Is the clear, almost colorless to pale-yellow fluid that fills the
membrane (amnion or amniotic sac) that surrounds and
cushions a fetus in the uterus.
● It is preferably collected after 15 weeks of gestation
(pregnancy) and is obtained by a physician using a
procedure called transabdominal amniocentesis.
● The procedure, which is typically performed with ultrasound
guidance, involves inserting a needle through the mother’s
abdominal wall into the uterus and aspirating approximately 10
mL of fluid from the amniotic sac.
● Amniotic fluid can be analyzed to:
o detect genetic disorders such as Down’s syndrome,
o identify hemolytic disease resulting from blood
incompatibility between the mother and fetus,
o and determine gestational age.
● However, the most common reasons for testing amniotic fluid
are to detect problems in fetal development (particularly
neural tube defects such as spina bifida) and assess fetal
lung maturity.
● Genetic disorders can be detected by chromosome studies
done on fetal cells removed from the fluid, although the
procedure has for the most part been replaced by studies
PMLS Handling and Processing of Non-Blood Specimens for Laboratory Testing
on chorionic villi or placental tissue because it can be
obtained earlier in the gestational period than amniotic fluid.
● Hemolytic disease can be detected by measuring bilirubin
levels.
● Although ultrasonography has become the accepted means
of estimating gestational age, amniotic fluid creatinine levels
have also been used to estimate gestational age because
these levels are related to fetal muscle mass.
● Problems in fetal development can be detected by
measuring alpha-fetoprotein (AFP) à an antigen normally
present in the human fetus that is also found in amniotic fluid
and maternal serum. (a tumor marker)
● Abnormal AFP levels may indicate problems in fetal
development such as neural tube defects or the potential for
Down’s syndrome.
● AFP testing is initially performed on maternal serum, and
abnormal results are confirmed by amniotic fluid AFP
testing.
● Because normal AFP levels are different in each week of
gestation, it is important that the gestational age of the
fetus be included on the specimen label.
CEREBROSPINAL FLUID
● Cerebrospinal fluid (CSF) à is a clear, colorless liquid that
surrounds the brain and spinal cord.
● CSF has many of the same constituents as blood plasma.
• Specimens are obtained by a physician; most often
through lumbar puncture (spinal tap).
● The primary reason for collecting CSF is to diagnose
meningitis.
● It is also used to diagnose other disorders such as brain
abscess, CNS cancer, and multiple sclerosis.
● Routine tests performed on spinal fluid include cell counts,
chloride, glucose, and total protein. Other tests are
performed if indicated.
● CSF is generally collected in three special sterile tubes
numbered in order of collection.
● Laboratory protocol dictates which tests are to be
performed on each particular tube unless the physician
indicates otherwise.
● Normally:
o the first tube à is used for chemistry and immunology
tests,
o the second à for microbiology studies,
o the third à for cell counts.
● CSF should be kept at room temperature, delivered to the lab
stat, and analyzed immediately.
GASTRIC FLUID / GASTRIC ANALYSIS
● Gastric fluid is stomach fluid.
● A gastric analysis examines stomach contents for abnormal
substances and measures gastric acid concentration to
evaluate stomach acid production.
● A basal gastric analysis involves aspirating a sample of gastric
fluid by means of a tube passed through the mouth and
throat (oropharynx) or nose and throat (nasopharynx) into
the stomach after a period of fasting.
● This sample is tested to determine acidity prior to
stimulation.
● After the basal sample has been collected, a gastric
stimulant, most commonly histamine or pentagastrin, is
administered intravenously and several more gastric
samples are collected at timed intervals.
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● All specimens are collected in sterile containers.
● The role of the phlebotomist in this procedure is to help label
specimens and draw blood for serum gastrin (a hormone
that stimulates gastric acid secretion) determinations.
NASOPHARYNGEAL SECRETIONS
● The nasopharynx consists of the nasal cavity and pharynx.
● Nasopharyngeal (NP) secretions are cultured to detect the
presence of microorganisms causing diphtheria, meningitis,
pertussis (whooping cough), and pneumonia.
● NP specimens are collected using a sterile Dacron or
cotton-tipped flexible wire swab.
● The swab is inserted gently into the nose and passed into the
nasopharynx.
● There it is gently rotated, then carefully removed, placed in a
sterile tube containing transport medium, labeled, and
delivered to the lab.
SALIVA
● Saliva colorless fluid secreted by glands in the mouth • It is
increasingly being used to monitor hormone levels and detect
alcohol and drug abuse because it can be collected quickly and
easily in a noninvasive manner.
● In addition, detection of drugs in saliva indicates recent drug
use.
● Numerous kits are available for collecting and testing saliva
specimens. Many are point-of-care tests.
● Saliva specimens for hormone tests, however, are typically
frozen to ensure stability and sent to a laboratory for testing.
● For detection of mycobacterium tuberculosis, saliva is not
accepted. Rather, sputum is used for testing.
SEMEN
● Semen (seminal fluid) is the sperm-containing thick
yellowish-white fluid discharge during male ejaculation.
● It is analyzed to assess fertility or determine the
effectiveness of sterilization following vasectomy.
● It is also sometimes examined for forensic (or legal)
reasons (e.g., criminal sexual investigations).
● Semen specimens are collected in sterile or chemically
clean containers and must be kept warm, protected from light,
and delivered to the lab immediately.
● A semen specimen should not be collected in a condom unless
it is one specifically designed for specimen collection.
Regular condoms often contain spermicides (substances that
kill sperm) that invalidate test results.
SEROUS FLUID
● Serous fluid à is the pale-yellow, watery, serum-like fluid
found between the double-layered membranes enclosing the
pleural, pericardial, and peritoneal cavities.
● It lubricates the membranes and allows them to slide past one
another with minimal friction.
● The fluid is normally present in small amounts, but
volumes increase when inflammation or infection is present
or when serum protein levels decrease.
● Effusion à An increase in fluid volume.
● Ascites à Accumulation of excess serous fluid in the
peritoneal cavity, and the fluid is referred to as ascitic fluid.
● Serous fluids can be aspirated for testing purposes or when
increased amounts are interfering with the normal function of
associated organs.
PMLS Handling and Processing of Non-Blood Specimens for Laboratory Testing
● A physician performs the procedure. • Fluid withdrawn for
testing is typically collected in:
o EDTA tubes – if cell counts or smears are ordered
o Heparin or sodium fluoride tubes – for chemistry tests
o Non Anticoagulant tubes – for biochemical tests
o Sterile heparinized tubes – for cultures.
● The type of fluid should be indicated on the specimen
label. Serous fluids are identified according to the body cavity
of origin as follows:
o Pleural fluid: aspirated from the pleural space, or cavity,
surrounding the lungs
o Peritoneal fluid: aspirated from the abdominal cavity
o Pericardial fluid: aspirated from the pericardial cavity
surrounding the heart
SPUTUM
● Is mucus or phlegm that is ejected from the trachea, bronchi,
and lungs through deep coughing.
● Sputum specimens are sometimes collected in the
diagnosis or monitoring of lower respiratory tract infections
such as tuberculosis (TB), caused by Mycobacterium
tuberculosis.
● The microbe that causes TB is called an acid-fast bacillus
(AFB), and the sputum test for TB is often called an AFB
culture.
● First morning specimens are preferred, as secretions tend to
collect in the lungs overnight and a larger volume of specimens
can be produced.
● It is also best to collect the specimen at least 1 hour after a
meal to minimize the risk that the patient will gag or vomit.
● A minimum of 3 to 5 mL is typically required for most tests.
SWEAT
● Sweat is analyzed for chloride content in the diagnosis of cystic
fibrosis, predominantly in children and adolescents under the
age of 20.
● Cystic fibrosis is a disorder of the exocrine glands that
affects many body systems but primarily the lungs, upper
respiratory tract, liver, and pancreas.
● Patients with cystic fibrosis have abnormally high levels (two to
five times normal) of chloride in their sweat, which can be
measured by the sweat chloride test.
● The test involves transporting pilocarpine (a
sweat-stimulating drug) into the skin by means of electrical
stimulation from electrodes placed on the skin, a process called
iontophoresis.
● The forearm is the preferred site, but the leg or thigh may be
used on infants or toddlers.
SYNOVIAL FLUID
● Synovial fluid à is a clear, pale-yellow, viscous fluid that
lubricates and decreases friction in movable joints.
● It normally occurs in small amounts but increases when
inflammation is present.
● It can be tested to identify or differentiate arthritis, gout, and
other inflammatory conditions.
● It is typically collected in three tubes:
o an EDTA or heparin tube à for cell counts, identification of
crystals, and smear preparation;
o a sterile tube à for culture and sensitivity;
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 o and a non additive tube à for macroscopic appearance, o (5) to test for the presence of occult blood. This specimen is
chemistry, and immunology tests and to observe clot collected in a clean and wide-mouth container that is sealed
formation. and sent to the laboratory after collection.

IV. OTHER NON-BLOOD SPECIMENS HAIR

● Buccal swabs ● Hair samples can be used to analyze for trace and heavy
● Bone marrow metals.,
● Breath samples ● They can also be used to detect chronic drug abuse where hair
● Feces (stool) is the preferred specimen not only because it is easy to obtain,
● Hair but also because it is not easy to alter or tamper.
● Throat swabs
● Tissue specimens THROAT SWABS
● Throat swabs are mostly collected to aid in streptococcal (strep)
BUCCAL SWABS infection detection.
● Collection of a buccal (cheek) swab is a less invasive, painless ● A special kit contains a sterile polyester-tipped swab and a
alternative to blood collection for obtaining cells for DNA covered transport tube.
analysis. ● The tube contains the transport medium.
● The phlebotomist collects the sample by gently massaging
the mouth on the inside of the cheek with a special swab. TISSUE SPECIMENS
● DNA is later extracted from cells on the swab. ● The tissue specimen is usually collected using biopsy through
which the tissue sample is removed for examination.
BONE MARROW ● The phlebotomist should check the proper handling procedure
● Because it is the site of blood cell production, bone particularly if the specimen delivered is not immersed in a
marrow is sometimes aspirated and examined to detect and solution.
identify blood diseases. ● In case of genetic analysis, the tissue samples should not be
● A bone marrow biopsy may be performed at the same placed in formalin.
time. To obtain bone marrow, a physician inserts a special ● Improper handling is costly and inconvenient, and the test
large-gauge needle into the bone marrow in the iliac crest (hip cannot be easily repeated.
bone) or sternum (breastbone).
● Once the bone marrow is penetrated, a 10-mL or larger syringe
is attached to the needle to aspirate 1.0 to 1.5 mL of specimen.
● A laboratory hematology technologist is typically present and
makes special slides from part of the first marrow
aspirated.
● Additional syringes may be attached to collect marrow for other
tests such as chromosome studies or bacterial cultures.
● The slides are air-dried and later fixed with methanol and
stained with Wright’s stain in the hematology department.
● The biopsy specimen and several slides are sent to the
histology department for processing and evaluation.
● The remaining slides including biopsy touch slides are sent
to the hematology department for staining and evaluation
under the microscope.

BREATH SAMPLES
● Breath samples are collected and analyzed for hydrogen
content in one type of lactose tolerance test and to detect the
presence of Helicobacter pylori (H. pylori)
● Helicobacter pylori à a type of bacteria that secretes
substances that damage the lining of the stomach and
causes chronic gastritis, which can lead to peptic ulcer disease.

FECES (STOOL)
● The fecal specimen (feces or stool) is collected
o (1) to determine gastrointestinal disorder,
o (2) to analyze for the presence of intestinal ova and
parasites (O&P),
o (3) to be cultured then examined for the presence of
pathogenic bacteria and viruses,
o (4) to check fat and urobilinogen content, or

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