A. GENERAL GUIDELINES
Collect at least 5 mL of blood in EDTA and mix gently. EDTA-treated blood is preferred to plain blood as EDTA stabilizes DNA and RNA and prevents haemolysis which can inhibit the PCR process.
Body fluid (CSF, Vitreous Fluid, Amniotic Fluid, Pleural Fluid etc)
Send at least 0.5 mL in a sterile container without any additives. Transport on ice immediately to the laboratory. For eye fluid, send as much sample as possible. Collect sample in a sterile leak-proof container or in a syringe with the needle removed. Cap the syringe with a rubber bung or plastic cap to prevent leaking.
Bronchoalveolar Lavage and Endotracheal Aspirate
Send at least 1 mL in a sterile container without any additives.
Use a speculum during collection. Use a cotton-tipped swab to clean the exocervix of mucus and discard. (Mucus present in the sample may inhibit the PCR assay). Insert a Dacron-tipped swab about 1cm into the cervical canal. Rotate and leave for a few seconds to absorb the secretions. Send swab in swab sheath without any media.
Using a Dacron-tipped swab moistened with tiny amount of sterile saline, pull down the lower lid and swab the conjunctiva firmly, then evert the upper lid and swab similarly. Send swab in swab sheath without any media.
Use a Dacron-tipped swab or flocked swab. Advance the swab tip past the anterior nares to the nasal mucosa (approximately 2–3 cm from the nostrils in adults) and gently rotate to collect nasal secretions from the anterior portions of the turbinate and septal mucosa. Send swab in swab sheath or sterile empty container without any media.
A flexible shafted flocked swab is essential. Insert the swab into the nostril and back to the nasopharynx. The swab should be slid straight into the nostril with the patient’s head held slightly back. The swab is inserted following the base of the nostril towards the auditory pit and will need to be inserted at least 5–6 cm in adults to ensure that it reaches the posterior pharynx. Leave the swab in place for a few seconds. Withdraw slowly with a rotating motion. Send swab in swab sheath or sterile empty container without any media.
Collect only when stools are difficult to collect, as rectal swabs are inferior to stools. Insert a Dacron-tipped swab into the anal orifice, (at least 3cm deep in an adult) and rotate to ensure collection of faeces. Send swab in swab sheath without any media.
Collect semen in an empty sterile container.
Instruct patient to rinse mouth with water prior to sputum collection. Collect sample resulting from deep cough into a sterile screw-capped container. Instruct patient not to expectorate saliva into the container.
At least a pea-sized amount of stool should be collected in an empty sterile container.
Swab the pharynx and both tonsils vigorously with a Dacron-tipped or flocked swab. Send swab in empty container or swab sheath without any media.
Fresh samples are preferred for molecular tests. Fresh tissue samples, at least 5 X 5 X 5 mm in size, should be sent immediately to the laboratory on ice in a sterile empty container with no media. Formalinised or fixed tissues can be used as well, but are less ideal with reduced detection sensitivity.
Use aluminium Dacron-tipped swab. Insert swab 2-4 cm through the urethra and rotate 3-5 seconds to ensure adequate sampling. Send swab in swab sheath.
First morning void urine is best as microorganism is most concentrated. Alternatively, patient must not urinate within two hours prior to urine collection. Collect the first 15-20 mL for Chlamydia trachomatis and 2-10 mL for BK virus into a sterile container without any media.
Use Dacron-tipped swabs. Sample fresh skin vesicles during the first three days following the appearance of the eruption. (Crusted lesions have a lower chance of yielding viable virus.)
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