Dried blood spot: Specimen

storage &
transport

Dr.t.sundararajan md
Asst professor
Dept of microbiology
Gmkmc,Salem-30.
Dried blood spot: Specimen storage &
transport

Specimen handling, storage, packaging and

transport procedure for Dried Blood Spot (DBS)
specimens for HIV DNA PCR testing
Introduction

•This presentation describes a procedure for

handling, storage, packaging and transport of a dried
blood spot (DBS) specimen obtained from an infant
below 18 months of age for the purpose of
conducting a HIV DNA-PCR test on the collected
specimen.

•This is critical to ensure the safety of the procedure

and to assure the quality of the test results obtained
thereof.
Responsibility

Dried blood spots (DBS) should be handled only by

persons who have been appropriately trained in the
handling of dried blood spots and in standard work
precautions:

• Anyone who has collected the sample

- MO/ Technicians/ Nurse in charge
 Materials required

•Gloves (powderless)

•Glassine paper

•Plastic zip lock packets

•Desiccant sachets

•Humidity indicator cards

•Biohazard labels

•Plain paper envelopes

•Padded paper envelopes

•Stapler

•Pen
Preparation

•Observe Standard work precautions at all times by

wearing gloves and lab coat.

•Lay out all the supplies you will need.

•Ensure that all the DBS specimens are of

acceptable quality and well dried. Drying time will
vary from 4 hours to overnight depending on the
relative humidity at your location
Packaging and storage

• When packaging
DBS into zip lock
bags, separate
each card with a
sheet of weigh
/glassine paper.

• You can store up

to 10 cards in a
single zip-lock
bag.
Packaging and storage – cont’d

• Place DBS cards inside

the ziplock bag gently.

•Add 8-10 silica packets per zip-

lock bag and push the silica
sachets to the bottom of the bag.
Packaging and storage – cont’d

•Add a humidity indicator card such

that the circles are visible through
the ziplock bag.

•Push as much air out of the bag as

possible.

•Seal firmly and double check that

the bag is sealed completely.

•Apply a biohazard sticker to the

outside of this zip lock bag
 Packaging and storage- cont’d
•In case, the specimen is not to be immediately transported, keep DBS
packaged in sealable plastic bags refrigerated until transported to testing lab.
Do not freeze

•Check the color of the humidity indicator card twice a week. Anytime during
storage or before packaging for handing over to the courier/mailing, if you
notice a pinkish tinge in the blue circles on the humidity indicator card,
change the card and replace the moist silica sachets with fresh dry silica
sachets.

•Dry the older sachets and card at 650C in a hot air oven for reuse

•In case the specimen is to be handed over to the courier or mailed, pull out
the stored package from the refrigerator 1 hour before the next steps of final
packaging

•When contents have come to air conditioned room temp (20-250C), place the
zip-lock bag containing the DBS inside an envelope.
 Transportation – cont’d
•Place the ziplock bag with the
packaged specimens inside a plain
paper envelope

•Place the above envelope inside a

padded labeled envelope to avoid
damage to the DBS during postage/
courier transportation.

•Place the test requisition forms and the

compiled delivery checklist in a
separate zip lock bag and place it in this
padded envelope

•Staple the envelope shut.

•Ensure that the outer envelope is

carrying the correct address with pin
code of the testing site
Storage of Dried Blood Spots

•Studies performed indicate that completely dried specimens maybe

stored refrigerated at 2-8 ºC for at least six months under low
humidity conditions.

•DBS can be kept at 20-250C for short term storage- upto 2 weeks

•Storage under elevated temperature conditions (room temperature

37ºC or more) leads to increased degradation of analytes over time.

•Storage of DBS specimens at room temperature or higher is not to

be done

•Do not expose the DBS to sunlight and high temperatures (do not
leave DBS in your vehicle in the hot sun).
 Transport of DBS specimens

•Use a reliable and tested courier/ mailing system for

transportation of the specimen packages

•The DBS specimens can be collected and stored

through the week but the center must dispatch these
collected specimens to the testing laboratory on
Tuesday of the coming week.

•Take care to keep the DBS free from moisture and

humidity.

•Postal and local transport regulations must be

followed if using the postal or courier services.
 Documentation

•Document information of every specimen collected,

packaged, stored, and dispatched in the designated
register.

•Include the test requisition forms and a compiled

delivery checklist that carries a list and requisite
information of all the specimens being dispatched from
the collection site to the testing laboratory with all
couriered/mailed packages.

•Instruct the courier agency to obtain the signatures of

the personnel receiving the samples at the testing site on
a copy of the delivery checklist and return the same to
the dispatching site for records.
Linkages of specimen collection centers (statewide) to
NACO testing labs for HIV DNA PCR testing on infant samples
Linkages of specimen collection centers (statewide) to
NACO testing labs for HIV DNA PCR testing on infant samples
Linkages of sample collection centers (statewide) to
NACO testing labs for HIV DNA PCR testing on infant samples
Linkages of specimen collection centers (statewise) to
NACO testing labs for HIV DNA PCR testing on infant samples
Linkages of specimen collection centers (statewise) to
NACO testing labs for HIV DNA PCR testing on infant samples
Linkages of specimen collection centers (statewise) to
NACO testing labs for HIV DNA PCR testing on infant samples
Linkages of specimen collection centers (statewise) to
NACO testing labs for HIV DNA PCR testing on infant samples
Linkages of specimen collection centers (statewide) to
NACO testing labs for HIV DNA PCR testing on infant samples
 SUMMARY
Standard Operative Procedure (SOP) for Packaging,
Storing and Transport of DBS Specimens

• When packaging DBS into zip lock bags separate

each card with a sheet of weigh /glassine paper
and store maximum 10 cards in a single zip-lock
bag.
• Add 8-10 silica packets per zip-lock bag and push
the silica sachets to the bottom of the bag.
• Add a humidity indicator card such that the
circles are visible through the zip lock bag.
• Push as much air out of the bag
• Seal firmly and double check that the bag is sealed
completely
 (SOP) contd.,
• Apply a biohazard sticker to the outside of
this zip lock bag
• Keep DBS packaged in sealable plastic bags
refrigerated until transported to testing lab.
Do not freeze
• Check the color of the humidity indicator
card twice a week
• If you notice a pinkish tinge in the blue
circles on the humidity indicator card,
change the card and replace the moist silica
sachets with fresh dry silica sachets.
 Standard Operative Procedure (SOP) for
Packaging, Storing and Transport of DBS
Specimens
• When contents have come to air conditioned
room temp (20-25°C), place the zip-lock bag
containing the DBS inside an envelope
• Place the above envelope inside a padded
labeled envelope to avoid damage to the DBS
during postage/ courier transportation.
• Place the test requisition forms and the
compiled delivery checklist in a separate zip
lock bag and place it in this padded envelope
• Staple the envelope shut.