Specimen Requirements

Acceptable Specimens:

Note: Only 1 ESwab is required when this test KOH Preparation are requested together. If Mycobacteriology (AFB) culture (LAB877, LAB7000, LAB7001)) is also requested, collect an additional specimen using a second ESwab Minitip Collection Kit.

Abscess, aspirate, or wound: ≥1 mL in a leakproof screw-capped, sterile container or 1 ESwab per test request in sterile collection tube. 

Biopsy or tissue: ≥1 g in a leakproof screw-capped, sterile container

Bronchial, tracheal: ≥5 mL in a leakproof screw-capped, sterile container

Eye: conjunctiva and cornea-1 ESwab Minitip Collection Kit; ocular fluid (anterior chamber, aqueous humor, vitreous)-≥0.5 mL in a leakproof screw-capped, sterile container or Anerobic Transport media

Sterile Fluids (CSF, pericardial, pleural, synovial, etc.): ≥1 mL in a leakproof screw-capped, sterile container

Hair, Skin scrapings, Nails: ≥10 affected hairs with bases of shaft intact; enough skin or nail scrapings to cover the head of a thumb tack

Sputum: ≥5 mL in a leakproof screw-capped, sterile container

Urine: ≥5 mL in a BD VACUTAINER grey-top C & S Preservation Tube or a leakproof screw-capped, sterile container

Unacceptable Specimens:

Stool

Specimen collected with ESwab Collection Kit is unacceptable if received without fluid or swab in the transport tube.

Collection Procedure:

Note: Specimen source is required.

Abscess, Aspirate, or Wound
1. Disinfect surface of abscess or wound.
2. Aseptically collect purulent material by aspiration (≥1 mL) or by using an ESwab. Frequently, viable organisms are only associated with abscess wall, so adequately sample this area. If material is aspirated, aseptically inject specimen into a leakproof screw-capped, sterile container or a plain, red-top tube.
3. If ESwab is used, return ESwab into transport tube following instructions on kit.
4. Maintain sterility and forward promptly.

5. If transport is delayed, keep specimen at room temperature.

Biopsy or Tissue
1. Aseptically collect ≥1 g of tissue from border of lesion. Because there may be only a few viable organisms in a lesion, specimen must be large enough to permit their recovery.
2. Place specimen in a leakproof screw-capped, sterile container.
3. Maintain sterility and forward promptly.

4. If transport is delayed, keep specimen at room temperature.
 

Bronchial or Tracheal
1. Aseptically collect ≥5 mL.
2. Place specimen in a leakproof screw-capped, sterile container.
3. Maintain sterility and forward promptly.

4. If transport is delayed, refrigerate specimen.
 

Eye

1. Conjunctiva or cornea
Call Barnes-Jewish Hospital Laboratory Customer Service at 314-362-1470 to obtain ESwab Minitip Collection Kit.
A. Collect specimen before application of topical anesthetics because topical anesthetics possess antimicrobial activity.
B. Cleanse skin around eye with mild antiseptic.
C. Gently remove makeup and ointment with sterile cotton and saline.
D. Collect specimen by passing ESwab 2 times over lower conjunctiva or over cornea. Avoid eyelid border and lashes (culture these separately in a similar fashion, if indicated).
E. Place ESwab in transport tube following instructions on kit. 
F. Maintain sterility and forward promptly.

G. If transport is delayed, keep specimen at room temperature. 

2. Ocular fluid (anterior chamber, aqueous humor, vitreous)
A. Aseptically collect ≥0.5 mL of fluid.
B. Place specimen in a leakproof screw-capped, sterile container or Anaerobic Transport media.
C. Maintain sterility and forward promptly.

D. If transport is delayed, keep specimen at room temperature.

Additional information on ocular specimen collection requirements can be found here.

Fluid (CSF, Joint, Pericardial, Synovial, etc.)
1. Aseptically collect ≥1 mL of fluid.
2. Place specimen in a leakproof screw-capped, sterile container.
3. Maintain sterility and forward promptly.

4. If transport is delayed, keep specimen at room temperature.
 

Hair

1. Aseptically collect ≥10 affected hairs with bases of shaft intact.
2. Place specimen in a leakproof screw-capped, sterile container.
3. Maintain sterility and forward promptly.

4. If transport is delayed, keep specimen at room temperature.
 

Nails
1. Wipe nail with 70% alcohol. Use gauze (not cotton).
2. Clip away generous portion of affected area, and collect material or debris from under nail. 
3. Obtain enough scrapings to cover the head of a thumbtack.
4. Place specimen in a leakproof screw-capped, sterile container.
5. Maintain sterility and forward promptly.

6. If transport is delayed, keep specimen at room temperature.
 

Skin
1. Cleanse affected area with 70% alcohol.
2. Gently scrape surface of skin at active margin of lesion. Do not draw blood.
3. Obtain enough scrapings to cover the head of a thumbtack.
4. Place specimen in a leakproof screw-capped, sterile container.
5. Maintain sterility and forward promptly.

6. If transport is delayed, keep specimen at room temperature.
 

Sputum
1. Aseptically collect early-morning specimen in a leakproof screw-capped, sterile container. It is optimal to collect a specimen each day for 3 consecutive days. (Saliva is not acceptable.)
2. Instruct patient to brush his/her teeth and rinse mouth well with water.
3. Have patient remove dentures.
4. Instruct patient to take a deep breath, hold it momentarily, and then cough deeply and vigorously into container. Collect ≥5 mL of discharged material.
5. Maintain sterility and forward promptly.

6. If transport is delayed, refrigerate specimen.
 

Urine
1. Aseptically collect ≥5 mL of urine in a BD VACUTAINER grey-top C & S Preservation Tube or a leakproof screw-capped, sterile container.

2. Maintain sterility and forward promptly.

3. If transport is delayed, refrigerate specimen.