Specimen Collection, Handling, Transport and Processing

[Pages:68]Specimen Collection, Handling, Transport and

Processing

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Part 1: Specimen Collection Handling and Transport

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Specimen Quality is Important

The results of tests, as they affect patient diagnosis and treatment, are directly related to the quality of the specimen collected and delivered to the laboratory.



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Working with Healthcare Providers

? Laboratories must develop a good working relationship with health care providers collecting patient specimens

? Laboratories should have a reference manual for providers that includes: ? Specimen type and volume requirements ? Specimen collection, labeling, storage and transport instructions ? Specimen rejection criteria

? Laboratories should provide specific feedback to individual healthcare providers regarding problems with the quality of specimens received and provide recommendations for improvement

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Specimen Types

I. Respiratory

? Sputum (expectorated, induced)

? Bronchoalveolar lavage (BAL)

? Bronchial wash/brush

? Transtracheal aspirate

II. Non-respiratory ? Tissue ? Body fluids ? Blood ? Stool ? Gastric lavage ? Urine

Refer to the CLSI M48-A document, Laboratory Detection and Identification of Mycobacteria

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Specimen Collection, Handling, Transport and Processing

RESPIRATORY (PULMONARY) SPECIMENS

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Sputum

? Recently discharged material from the bronchial tree, with minimal amounts of oral or nasal material

? Expectorated Sputum: Generated from a DEEP productive cough

? Induced Sputum: produced with hypertonic saline if patient is unable to produce sputum on their own

? Indications for sputum collection

? To establish an initial diagnosis of TB ? To monitor the infectiousness of the patient ? To determine the effectiveness of treatment

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Sputum Quality

? Specimens are thick and contain mucoid or mucopurulent material.

? Ideally, 3?5 ml in volume, although smaller quantities are acceptable if the quality is satisfactory.

? Poor quality specimens are thin and watery. Saliva and nasal secretions are unacceptable.

? Laboratory requisition form should indicate when a specimen is induced to avoid the specimen being labeled as "unacceptable" quality.

Clinical and Laboratory Standards Institute. Laboratory detection and identification of mycobacteria; approved guideline. CLSI Document M48-A. Wayne, PA: CLSI; 2008.



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