specimen collection for microbiology by javad Abdul gafoor KARUNA MEDICAL COLLEGE

1. GENERAL
CONSIDERATION FOR
SPECIMEN COLLECTION
BY
JAVAD.A

2. BROAD OBJECTIVE
 To be able to correctly collect specimen,
put the specimen in the right container
and transport specimen to the
laboratory correctly and at the right
time .

3. INTRODUCTION
 Quality laboratory results begin with
correct and compete collection.
 Examples include : blood, sputum
urine, deep specimen, feces, cervical,
eye, ear etc.

4. BLOOD SPECIMEN-SKIN
PUCTURES
 Skin punctures are performed when small quantities
of capillary blood are needed for analysis or when the
client has poor veins.
 Capillary puncture is also commonly performed for
blood glucose analysis. The common sites for
capillary puncture are the :
- Finger tip – the inner aspect of palmer fingertip used
most commonly in children and adults.
- Ear lobe – used when the client is in shock or the
extremities are edematous.

5. Expected outcomes
 An adequate blood specimen will be
obtained.
 The client will suffer minimal during the
specimen collection.
 The specimen will be collected and
stores in a manner compatible with the
ordered tests.

6. EQUIPMENT NEEDED
 Antiseptic.
 Collection tubes.
 Sterile cotton wool swabs.
 Sterile lancet.
 Nonsterile gloves.
 Hand towel or absorbent pad.
 Slides.

7. Implementation
 Wash hands, to reduce transmission of
microorganisms.
 Check clients identification band if
appropriate to ensure correct client.
 Explain procedure to client to allay anxiety
and encourages cooperation.
 Prepare supplies:
- Open sterile packages.
- Label specimen collection tubes.

8. - Place in easy reach to ensure efficiency.
 Apply gloves to decrease health care provider`s
exposure to blood borne organisms.
 Select site: lateral aspect of fingertips in adults or
children to avoid damage to nerve endings and
calloused areas of the skin.
 Place the hand or heel in a dependent position; apply
warm compresses if fingers or heels are cool to
touch. This increases the blood supply to the
puncture site.

9.  Place hand towel or absorbent pad under the
extremities to prevents soiling the bed linen .
 Cleanse punctures site with an antiseptic and allow to
dry to reduce skin surface bacteria.
 With nondominant hand, apply gentle milking
pressure above or around the puncture site, do not
touch puncture site . This increases blood to
puncture site and maintain asepsis.
 With the sterile lancet at a 90 degrees angle to the
skin , use a quick stab to puncture the skin . This
provides a blood sample with minimal discomfort to
the client.

10.  Wipe off the first drop of blood with sterile gauge ,
allow the blood to flow freely . First drop may contain
a large amount of serous fluid, which could affect
results. Pressure at the puncture site can cause
hemolysis.
 Collect the blood into tube, if a platelet count is to be
collected, obtain this specimen first. Allows blood
collection, avoids aggregation of platelets at the
puncture site.

11.  Apply pressure to the puncture site with
a sterile gauze to control bleeding.
 Place contaminated articles into a
sharps container to reduce risk for
needle stick injuries.
 Remove gloves, wash hands to reduce
transmission of microorganisms.
 Document in the file the date, time and
type of sample taken.

12. COLLECTING BLOOD SAMPLE
FROM A VEIN
 Apply tourniquet, clean area, prick the vein and if
blood is coming out you are in the vein. Draw the
amount needed for the ordered test and release the
tourniquet .
 Apply pressure with a dry swab after withdrawing the
needle to prevent bleeding from the punctured site.
 Flush the syringe in chlorine 0.5% three times before
discarding.
 Discard the used syringe in a punctured proof
container.

13.  Observe and leave the patient
comfortably.
 Dispose the equipment safely.

14. URINE SPECIMEN
 Urine specimen remains an important
tool for clinical diagnosis. A correct
urine result is influenced by the
collection method, timing and handling.
The laboratory test ordered determines
the type of container to be used for
collecting a specimen.

15. TYPES OF COLLECTION
Laboratory urine specimens are classified by the type of
collection conducted or by the collection procedure used
to obtain the specimen.
 RANDOM SPECIMEN
This is the specimen most commonly sent to the laboratory
for analysis, primarily because it is the easiest to obtain
and is readily available. This specimen is usually submitted
for urinalysis and microscopy analysis. Although there are
no specific guidelines on how to collect the specimen,
avoiding the introduction of contaminants into the
specimen is recommended, by advising the patient not to
touch the inside of the cup or cup lid.

16.  FIRST MORNING SPECIMEN
This is the specimen of choice for urinalysis and
microscopic analysis, since the urine is generally
more concentrated due to the length of time urine
is allowed to remain in the bladder and , therefore,
contains relatively higher levels of cellular elements
and analytes such as protein, if present.
Also called an 8hour specimen, the first morning
specimen is collected when the patient first wakes
up in the morning, having emptied the bladder
before going to sleep.

17. NOTE: any urine that is voided from the bladder during
the eight hour collection period is pooled and
refrigerated, so that a true 8hour specimen is
obtained.
 MIDSTREM CLEAN CATCH SPECIMEN
This is the preferred type of specimen for culture and
sensitivity testing because of the reduced incidence
of cellular and microbial contamination. The patient
should then void the first portion of the urine stream
into the toilet. These first steps significantly reduce

18. the opportunities for contaminants to enter into the
urine stream. The urine midstream is then collected
into a clean container, (any excess urine should be
voided into the toilet). This method of collection can
be conducted at any time of day or night.
 TIMED COLLECTION SPECIMEN
Among the most commonly performed tests requiring
timed specimen are those measuring creatinine, urine
urea nitrogen, glucose, sodium, and potassium. The
bladder is emptied prior to beginning of collection.

19.  CATHETER COLLECTION SPECIMEN.
This assisted procedure is conducted
when a patient is bedridden or cannot
urinate independently. The healthcare
provider inserts a Foley catheter into
the bladder through the urethra to
collect the urine specimen . Specimen
may as well be collected through an
existing Foley catheter.

20. DEEP SPECIMEN
COLLECTION.
 Specimens for wound, lesion, abscess drainage,
effusions, exudates, boils, incisions or ulcerations are best
collected by aspirating with a syringe and needle.
 Using aseptic technique , clean the area in and over the
lesions with sterile saline and sterile gauze prior to
collection.
 Debride skin lesions, removing the crust and any purulent
exudates with the moistened gauze. Explore the base of
the lesion with a sterile moistened swab rolling the swab
through any visible exudates. Replace the swab in the gel
tube, label and transport to the laboratory promptly.

21.  Since delay and exposure to oxygen can
kill these organisms, prompt receipt in
the laboratory is paramount.
 Best results are obtained for cultures
when specimen is collected from the
area closest to the normal tissue after
removal of debris the dried pus.

22. FECES SPECIMEN
 Collect feces specimens in containers provided by the
laboratory. Specimen should be well covered and
labeled.
 For culture only or both culture and parasite
examination the specimen must be returned to the
laboratory within one hour of collection.
 If more than one specimen has been ordered they
should be collected on alternate days for best results.
Consecutive days are acceptable but no more than
one specimen in a single day should be tested.

23. SPUTUM SPECIMEN
 Preferably, the specimen should be a first morning
collection. If more than one specimen is collected,
they should be obtained one per day on consecutive
mornings.
 To properly collect a sputum specimen, ask the
patient to:
i. Remove the container from the package and lift the
top hinged lid(touch only the outside of the
container)
ii. Cough deeply to bring up secretions.

24. - Do not spit into the container as saliva and
postnasal secretions are not the maternal .
- Close the lid, label the specimen.
- Bring the specimen to the clinical laboratory
as soon as possible for best results.
- If there is a delay in transport, refrigerate
specimen. Patients name, ID number,
specimen type and date collection.

25. GENITAL SPECIMEN
 Patients should not use or be exposed to vaginal
medications for 24hours prior to collection.
 In female – insert swabs slowly into vaginal opening.
For endocervical collections remove excess mucus
from the endocervix and discard it. Rotate swab
vigorously for 30seconds, allowing absorption to
occur.
Remove quickly avoiding vaginal wall.
 Males – with a rotating movement, insert small swab
2-4 cm into the urethra. Once inserted rotate swab at
least 1 full rotation using sufficient pressure to
ensure

26. swab comes into contact with all urethral surfaces.
Allow swab to remain inserted for 2-3 seconds.
Replace the swabs in the tube label and deliver to
laboratory promptly .
CERVICAL SMEAR
It’s a screening test that helps a doctor diagnose and
prevent cervical cancer in women. This test is also
know as a cervical pap smear test or simply a pap
test.