A Guide to Specimen Management in Clinical Microbiology

The face of infectious diseases has changed since the second edition of A Guide to Specimen Management in Clinical Microbiology was published in 1999. Despite improved surveillance and vaccinations, tens of millions of people visit physicians annually for a possible microbial or parasitic infection. Identifying the infectious agent in a patient remains a top priority, and proper identification begins with careful collection, appropriate packaging and transport, and responsible reporting of patient specimens.

For these reasons, A Guide to Specimen Management in Clinical Microbiology is as essential as ever. The book is divided into four sections and features tips and words of wisdom that come directly from experts in the field.

Communicating laboratory needs explains to all members of the healthcare team what role the clinical microbiology laboratory plays in patient care. It also emphasizes that microbiology specimens contain living organisms that require proper handling to remain viable.

Specimen management policies and rationale provides a framework for creating a specimen management policy and a specimen collection and handling manual that, together, support good medicine and good laboratory practice.

Specimen collection and processing contains detailed protocols for selecting, collecting, storing, and transporting adult and pediatric specimens to the clinical microbiology laboratory. This section can serve as a model for preparation of the specimen management manual.

Specimen management summary tables are handy reference guides that provide answers to most questions regarding the laboratory needs for a wide variety of bacterial, viral, fungal, and parasitic organisms found in patient specimens.

Because patient care is a team effort, all members of the health care team—physicians, nurses, nurse practitioners, physician assistants, specimen collectors, and laboratorians—will benefit greatly from reading this book.

CONTENTS

Preface

How To Use This Book

SECTION I

COMMUNICATING LABORATORY NEEDS

Basic Issues

Selecting a Representative Specimen

Requisitions

Specimen Packaging and Transport

Color-Coded Vacuum Tubes

Catheters Often Used in Medical Procedures

Specimen Priority

Specimen Rejection Criteria

Rejection Statements of Addenda to Laboratory Reports

Specialty Testing

Environmental Samples

Hand Wash Specimens

Laboratory Reports

SECTION II

SPECIMEN MANAGEMENT POLICIES AND RATIONALE

Collection Times

Collection Procedures

Specimen Transport

Specimen Processing: General

Specimen Processing: Molecular

Lower Respiratory Tract Specimens

Urine Specimens

Wound Specimens

Spinal Fluid Specimens

Throat and Nasopharyngeal Specimens

Vaginal and Endometrial Specimens

Miscellaneous Specimens

SECTION III

SPECIMEN COLLECTION AND PROCESSING

Body Fluid Specimens

Abdominal-Peritoneal Fluid (Paracentesis, Ascites)

Blood Specimens

Cerebrospinal Fluid

Pleural-Thoracentesis Fluid

Gastrointestinal Specimens

Duodenal Contents

Gastric Contents

Pinworm Eggs Collected by Adhesive Tape Preparation

Rectal and Anal Swab Specimens

Sigmoidoscopy Specimens for Amebiasis

Stool or Feces for Culture or Parasitology Studies

Stool Specimen Collection Directions

Genital Specimens

General Information

Cervical or Endocervical Specimens

Genital Smears for Herpes

Urethral and Penile Specimens

Respiratory Specimens

General Information

Bronchoscopy-Bronchial Washing

Nasal Specimens

Nasopharyngeal Specimens

Sputum

Tracheal Aspirate

Transtracheal Aspirate

Throat Specimens

Urine Specimens

General Information

Urine from Catheters

Clean-Catch Urine

Cytoscopic Specimens: Bilateral Urethral Catheterization

Suprapubic Aspirate for Urine Cultures

Urine Specimens: Bladder Washout

Urine Specimens: Ileal Conduit

Viruses, Chlamydiae, Rickettsiae, and Fungi

Chlamydia Culture

Specimens for Mycoplasma and Ureaplasma spp.

Fungal Specimens

Rickettsial Specimens

Viral Specimens

Wound Specimens

General Information

Ear (Otitis Media) Specimens

Eye Specimens

Skin and Contiguous Tissue Specimens

SECTION IV

SPECIMEN MANAGEMENT SUMMARY TABLES

Bacteriology and Mycology Specimen Collection Guidelines

Specimen Management for Infrequently Encountered Organisms

Specimen Guide for Virus Isolation

Virology Specimen Collection Guidelines

Parasitology: Anatomic Sites Containing Diagnostic Stages

Parasitology Specimen Collection Guidelines

References

Index