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South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
SOUTH SHORE HEALTH LABORATORY SERVICES
Microbiology Collection Manual
South Shore Regional Laboratory Service
90 Glen Allan Dr.
Bridgewater, NS
Phone 902-527-5263 • Fax 902-527-5283
1
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Table of Contents
1.0
GENERAL GUIDELINES ............................................................................................................................................................................ 3
1.1 Collection ...............................................................................................................................................................................................................................................3
1.2 Specimen Identification and Information .........................................................................................................................................................................................4
1.3 Specimen Transport..............................................................................................................................................................................................................................5
1.4 Common Transport Container ..............................................................................................................................................................................................................6
2.0
COLLECTION INSTRUCTIONS FOR SPECIFIC SITES ......................................................................................................................... 7
2.1Genital Specimen ......................................................................................................................................................................................................................................7
2.2 Gastrointestinal Tract Specimen ......................................................................................................................................................................................................... 11
2.3 Respiratory Tract Specimen................................................................................................................................................................................................................. 14
2.4 Wound, Tissue, Skin Specimens ......................................................................................................................................................................................................... 20
2.5 Surveillance Testing .............................................................................................................................................................................................................................. 24
2.6 Sterile Body Fluid Specimen ................................................................................................................................................................................................................ 26
2.6.1 Blood Culture Specimen ................................................................................................................................................................................................................ 26
2.6.2 CSF Specimen.................................................................................................................................................................................................................................. 28
2.6.3 Urine Specimen ............................................................................................................................................................................................................................... 29
2.6.4 Sterile Body Fluids: (Excluding CSF, Blood and Urine) ........................................................................................................................................................... 31
3.0 Specimen handling for specific condition or organisms ................................................................................................................................... 32
4.0
Inappropriate Specimen for Bacterial Culture .............................................................................................................................................. 33
5.0
Specimen Rejection ....................................................................................................................................................................................... 37
6.0
Appendix........................................................................................................................................................................................................ 38
6.1 Laboratory Services Fax Request for Patient Information Form------------------------------------------------------ ..................................................................... 38
6.2 Laboratory Service Documentation of Verbal Request from Health Care Providers--------------------------- .......................................................................... 38
6.3 Critical/ None-recollectable Unlabelled/ Mislabelled Specimen Form----------------------------------------------- ..................................................................... 38
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South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
1.0 GENERAL GUIDELINES

Specimens should be collected before starting antimicrobial agents.

Specimens should be collected in an approved container. Specimens in unapproved containers (i.e. mason jars) will not be processed.

When Specimens are collected, it is important that the external surface of the specimen container and the requisition are not contaminated.
External contamination will usually result in rejection of the specimen by our laboratory.

As soon as the specimen is collected and appropriately labeled, the specimen container should be placed in the plastic specimen bag. Fill out
the requisition completely and place it in the separate pouch from the specimen container.

The requisition must include the following information:
 Patient’s full name
 Health Care Number ( or alternate unique identifier)
 Date of Birth
 Physician requesting the test
1.1
Collection

Use appropriate specimen collection material. Sterile collection material and aseptic technique must be used for collection of
specimens using invasive procedures.

The specimen should be collected in the standard containers available from Materials Management or from the Lab.

For specimens from non-sterile sites, attempt to collect the specimen with as little contamination from the surrounding normal flora as
possible

If a specimen is to be collected through intact skin, the skin should be disinfected thoroughly, allowing several minutes for the
disinfectant to have effect. Examples of skin disinfectants include 70% alcohol, iodine solution, chlorhexidine, etc. If tincture of
iodine is used, remove with 70% ethanol after procedure to prevent burning.
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South Shore Health
Laboratory Services
Microbiology Collection Manual-2015

1.2






An adequate amount of specimen should be collected. As a general rule, more is better than less. For example, a tube or sterile
container with 10 ml of pus is a better specimen than a swab. Small amounts of specimen are subject to drying, becoming aerobic and
other forms of deterioration, whereas larger volumes minimize the risk of false negative results.
Specimen Identification and Information
The specimen container should be labeled with the patient’s full name and Health Care Number (or other unique identifier),
Admission label or the Meditech large bar code label.
Date and Time of Collection and collector initial should be clearly indicated on the specimen.
The specimen source should be clearly indicated on the requisition to ensure that the appropriate processing takes place. For example,
a “swab of hip” taken in the OR from a joint would be processed quite differently from a superficial swab of a hip ulcer.
When specific diagnoses are being considered, they may have a bearing on the processing of the specimen. This diagnosis should be
indicated on the requisition to ensure that the specific questions can be answered. This is particularly important if the suspect
organism is unusual or requires special processing.
Pertinent historical data (i.e. travel, association with a known outbreak, immunosuppression, or underlying disease) should also be
indicated on the requisition.
Antibiotic information: Ideally, specimens should be collected before starting antimicrobial agents. If patient is already on
antimicrobial treatment, please indicate on the requisition.
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South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
1.3
Minimum Turn Around time
Culture
Urine Culture
Stool Culture
Throat Culture
Miscellaneous Swabs
Group B Screen
Fluids
MRSA Screen
Minimum Turn Around Time
1 day
3 days
1 days
2 days
3 days
4 days
1 day
1.4 Specimen Transport

Specimens should be transported to the laboratory as quickly as possible.

Stool for parasitology should be mixed well with the SAF fixative and can be held at room temperature.


Stool for culture should be mixed well with the enteric transport medium.
If a syringe is used to collect the sample, remove the needle before transporting to the Lab. If the volume of the specimen is very low,
non bacteriostatic sterile saline may be drawn up and used to flush the syringe into a sterile container.

The following Chart is a quick guide for common specimens.
Specimen type
Urine
Stool
Sputum
Swabs in Transport System
Body fluids
Blood Culture
Dermatophytes Culture
Store /Transport condition
4 oC
4 oC
4 oC
4 oC
Room Temp
Room Temp
Room Temp
5
Deliver to Lab
Within 24 hours
Within 24 hours
Within 24 hours
Within 24 hours
Within 1 hour
A.S.A.P
Within 72 hours
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
1.5 Common Transport Container

Amies Transport Swab: Microorganism collection and transport system for aerobes and anaerobes

Dry Sterile Container: Commonly used for Urine, Body Fluids, Aspirate, Sputum , Stool

Viral Transport Swab: For Viral Culture: Always check swab expiry date before collection. Collect with expired swab will be rejected
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South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
2.0 COLLECTION INSTRUCTIONS FOR SPECIFIC SITES
2.1Genital Specimen
Meditech
Vaginal
Culture
VAGC
Specimen
Source
Vaginal
Transport
Stability
Amies swab
*if Actinomyces is
suspected, please collect
anaerobic transport swab,
which is available from lab
Vaginosis
Screen
VAGS
Vaginal
secretion
Proper labeled Air Dried
Slide
Procedure
2-8oC/48
1. Use a speculum without
hrs
lubricant.
2. Collect secretions from the
mucosa high in the vaginal
canal with a sterile swab
7 days
1. Use a speculum without
lubricant.
2. Collect secretions from the
mucosa high in the vaginal
canal with a sterile pipette
or swab.
Vag Group B
screen
(Prenatal)
VAGB
Vaginal/rectal
Note
Only For
 Patient < 13
 Patient with recurrent
yeast infection
 Diagnosis of toxic shock
syndrome/ puerperal
fever
 Post-OP
 No fixative or cyto-spray
 Yeast is included in the
screen
 Nugent score is only
valid for women under
55
 Method of choice for
yeast infection
3. Prepare a smear in the
clinic, allowing it to air dry
before sending to the
laboratory.
2-8oC/48 1. Collect specimen at 35-37 Please indicate if patient has
hrs
weeks gestation.
penicillin allergy
2. Swab the distal vagina
(vaginal introitus),
followed by the rectum
(insert swab through the
anal sphincter)
Amies swab
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South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Specimen
Source
Genital lesion
Transport
Stability
Procedure
Viral Transport swab
2-8oC/48 Clean lesion surface with
hrs
0.85%NaCl
Collect fluid from vesicle
Amies Transport
2-8oC/48 Use a swab for each site and
hrs
label accordingly
Amies swab
Sterile container
2-8oC/48 Disinfect scrotal skin
hrs
Fluid or pus aspirates from
abscess
Note


Genital
Ulcer/Lesion
VIRC
True Swab
MISC
Testicular
abscess
MISC
Penile Swab
MISC
Amniotic
fluid
Vulva
BFC
Head of penis Amies swab
or foreskin
Amniotic fluid Sterile Container
MISC
Vulva
Cervical
Culture
Urethral
Culture
Please refer to Chlamydia/ Neisseria gonorrhoeae Screening.
Common causes of Cervitis are Chlamydia, Neisseria or Herpes, culture do not provide clinical useful information
Indicate sites
Eye, ear,
placenta,
vagina..etc
Testicular
abscess fluid
/pus
2-8oC/48 Collect pus from under
hrs
foreskin
A.S.A.P Aspirate fluid by catheter at Csection or at amniocentesis
o
2-8 C/48 1. Clean surface with saline
hrs
2. Collect exuadate/ pus
Amies Transport
8
Viral request: HSV
Request for T. palladium
should order RPR
serology
 Always check swab
expiry date before
collection. Collect with
expired swab will be
rejected
Routine screen:
Group B strep and Listeria
moncytogenes
Routine aerobic bacterial
culture. If Mycobacterium is
suspected. Contact
Microbiology
Only for wound
Collect only if pain,
erythema or edema is present
H. ducreyi will only be
screened upon request
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Chlamydia/
Neisseria
gonorrhoeae
Specimen
Source
CHLGCDNA Cervical
Transport
Stability
BD ProbeTec Swab
2-8oC/72 1. Remove excess mucus with
cleaning swab and discard.
hrs
2. Insert the Female
Endocervical Swab into the
cervical canal and rotate for
15 to 30 seconds.
3. Place swab in tube
4. Break shaft at score line.
5. Screw cap firmly onto tube.
6. Label tube with patient info
and date/time collected.
1. Insert the Male Urethral
Swab 2 to 4 cm into the
urethra.
2. Rotate for 3 – 5 seconds.
3. Place swab in tube
4. Break shaft at score line.
5. Screw cap firmly onto tube.
6. Label tube with patient info
and date/time collected
15-60 mls of first void or 1 hour
since last void urine
specimen.The patient should
collect the first 15-60 ml of
voided urine (The first part of
the stream-not midstream) If
>60 mls urine collected test not
processed and specimen
recollection indicated ( do not
discard portion of sample to
obtain 60 ml requirement)
Urethral
Urine
First void urine in sterile
container
9
Procedure
Note

If a swab and urine
sample received on same
patient urine specimen is
not processed. Maximum
acceptable transport time
(from collection to
receipt in YRH
Microbiology) - 6 days
refrigerated Please do
not share Urine
Chlamydia specimens
with urinalysis and/or
urine culture test
requests. 2 separate
samples are required.

Throat swab for
Chlamydia screen require
different transport swab,
please contact Micro for
direction
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Abscess
MISC
Specimen
Source
Endometrium
Transport
Stability
Amies swab
Sterile container
2-8oC/24 1. Insert endometrial suction
hr
curette or catheter
protected Dacron swab
through the cervical and
transfer beyond the
cervical opening into the
uterine cavity.
2. Collect sample within the
cavity
1. Decontaminate skin
2. Aspirate material from the
duct
A.S.A.P Obtain aspirates during
laparoscopy
21.Collect mid stream urine
8oC/24hr (Pre-massage specimen )
2.Perform a digital massage
through rectum
3. Have patient pass prostatic
secretion in the urethra by
urination (Post-massage
specimen)
Batholin cyst
Skene’s gland
Prostate
URNC
Fallopian
tubes
Pre/Post
Sterile Container
massage urine
specimen
10
Procedure
Note
Routine Screen: enteric
bacteria, Group A and Group
B strep
Anaerobic and Chlamydia
Require special transport
device, please contact Lab
before procedure
Clear indicate on requisition
for Prostatitis investigation
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
2.2 Gastrointestinal Tract Specimen
Meditech
Stool
Culture
Stool O+P
STOC
Specimen Transport
Source
Stool
Enteric
Transport
OPSR- routine
Stool
screen for
Cryptosporidium
And Giardia
Stool O+P OPCTMicroscopy Only available
when criteria is
met ( see note)
Stool
Stability
Procedure
Note
2-8oC/24 hr
1. Do not allow water or
urine to touch the stool.
2. Collect the stool sample
on a clean dry surface
such as a disposable
container or onto plastic
wrap placed under the
toilet seat.
3. Using the scoop attached
to the inside of the lid,
add a tablespoon size
amount of stool to the vial
until the fill line is
reached. Use the scoop to
thoroughly mix the stool
with the material in the
vial.
4. Screw the lid on firmly.
Do not get any stool on
the outside of the
container

SAF
Container
2-8oC /14 DAYS
SAF
Container
2-8oC /14 DAYS



Order by lab
only ( send
specimen with
microbiology
Req)

11
Do not obtain sample from the
toilet bowl. Pass stool into a
clean, dry, wide mouth
container or bedpan and
transfer into the appropriate
lab container
Samples from
patients in
Hosp.>3 days and not admitted
with diarrhea are not suitable
for testing.
Avoid mineral oil, bismuth,
barium and kaolin
(Kaopectate), or laxatives for 5
days before collecting the
sample.
This test is only available if
any of the following criteria
are met:
1. Pediatric ( children <16
years old)
2. Recent Travel/Immigration
History (outside North
America)
3. Immunocomprimized
4. Special Request
Samples from
patients in
Hosp.>3 days and not admitted
with diarrhea are not suitable
for testing.
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Stool CDiff CDIF
Specimen Transport
Source
Stool
Sterile
container
Stability
Procedure
Note
2-8oC /72 hr
1. Do not allow water or
urine to touch the stool.
2. Collect the stool sample
on a clean dry surface
such as a disposable
container or onto plastic
wrap placed under the
toilet seat.
3. Put a sample of stool into
the container you were
given (at least 1/3 full).
4. Screw the lid on firmly.
Do not get any stool on
the outside of the
container.


1. Pass the tip of a sterile
swab approximately 1
inch beyond the anal
sphincter.
2. Carefully rotate the swab
to sample the anal crypts,
and withdraw the swab.
3. Fecal staining must be
visible on the swab
Routine testing for VRE only. If
abscess/wound related, please
obtain aspirate specimen for
wound culture
Stool, Viral
VIRC
Stool
Sterile
Container
2-8oC /48hr
Anal
VREC
Anal
swab
Amies
transport
2-8oC /48 hr
12



Must be a diarrhea sample
Repeat sample must be 48 hrs
apart
Children <12 months old will
not be processed
Indicate suspected virus
If its outbreak related,
outbreak number must be
clearly indicated on requisition
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Specimen Transport
Source
Anal
Vaseline
swab
Swab
Pinworm
PINW
Aspirate/
biopsy
specimen
Contact Microbiology before collection
Stability
Procedure
Refrigerated/24hr 1. Used for the detection of
enterobius vermicularis
ova (pinworms). Use the
Vaseline swab provided
by the lab.
2. With the patient lying on
his/her side, the perianal
skin should be exposed
and the swab should be
rolled over the skin
within 1 cm of the anus.
3. The swab should alson be
inserted, not more than 5
mm into the anal canal.
4. Replace the Vaseline
swab back into the tube
and seal tight.
13
Note
The ideal time for specimen
collection is after the patient has
settled for the night or first thing
in the morning, before the patient
has either washed or passed stool.
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
2.3 Respiratory Tract Specimen
General Consideration: If Corynebacterium diphtheriae, Arcanobacterium haemolyticum, Bordetella pertusis, N.gonorrhoeae,
Chlamydia or mycoplasmas are suspected, the physician should contact the microbiology lab prior to specimen collection because
special techniques and/or media are required for the isolation of these agents.
Meditech
Transport
Stability
Procedure
Amies
Transport
2-8oC /48
hr

Throat
Dacron
swab
2-8oC
/24hr

EYEC
Conjunctiva/
lid margin
Amies
Transport
2-8oC /48
hr


MISC
Dacryocystitis Amies
, cellulitis
Transport
canaliculitis
Nose
Amies
Transport
2-8oC /48
hr
Collect superficial wound culture
2-8oC /48
hr
1. Insert a sterile swab into the nose until
resistance is met t the level of the turbinates
2. Rotate the swab against the nasal mucosa
Throat
THRCRoutine
culture
Throat
THSCRapid
antigen test
Eye
Nasal
Specimen
Source
Throat
MRSACUL
14
Note
Extend sterile swab between the tonsillar pillars
and behind the uvula. (Use a tongue depressor
to avoid touching the cheeks, tongue, uvula or
lips.)
Sweep the swab back and forth across the
posterior pharynx , tonsillar areas and any
inflamed areas to obtain sample.
Submitted primarily
for the detection of
Group A, C and G
streptococci.
 Only for patients
<16 years old
 A throat culture
specimen must
also be submitted
Obtain specimen with a sterile amies swab
Roll the swab over the conjunctiva before
topical medication is applied.
Eye culture for
keratatis. viral or
endophtalmitiscontact microbiology
before collection
Nose swab is for
MRSA screening
only. If it’s for
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Specimen
Source
Transport
Stability
Procedure
3. Repeat the process on the other side
Ear
EARC
MISC
Otitis enterna
Otitis media
fluid
Otitis media
fluid collected
by
tympanocente
sis
Amies
Transport
2-8oC /48
hr
Sterile
container
A.S.A.P
1. Insert sterile swab into ear canal until resistance
is met
2. Rotate swab and allow fluid to collect on swab
Clean external canal with mild detergent
Use a syringe aspiration technique to obtain fluid
from the ear drum
Send specimen in sterile container
Sinus
Aspirates
MISC
Sinus
Sterile
Container/
Anaerobic
transport
A.S.A.P
1. Using a syringe aspiration technique, a
specially trained physician or an
otolaryngologist will obtain material from
maxillary, frontal or other sinuses.
2. Place the contents of the syringe into an
anaerobic transport system.
Mouth
MOUC
Oral cavity/
tongue
Amies
Transport
2-8oC /48
hr
1. Rinse mouth with sterile saline.
2. Wipe the lesion with dry sterile gauze.
3. Swab or scrape areas of exudation or ulceration
Expectorated
Sputum
SPUC
Sputum
Sterile
Container
2-8oC /24
hr
1. If possible, have the patient rinse mouth and
gargle with water prior to sputum collection.
Clean teeth without toothpaste.
2. Instruct the patient not to expectorate saliva.
3. Collect specimen resulting from a deep cough
in a sterile screw-cap container.
15
Note
wound/ abscess or
sinus , collect aspirate
specimen for wound
culture
Invasive procedure.
These specimen are
usually submitted to
diagnose middle ear
infection only if
previous therapy has
failed
Contact
Microbiology before
collection
Please contact Micro
lab for TB culture
instruction
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Induced
Sputum
SPUC
Specimen
Source
Sputum
Transport
Stability
Procedure
Sterile
Container
2-8oC /24
hr
1. Using a wet toothbrush, brush the buccal
mucosa, tongue and gums prior to the
procedure.
2. Rinse the patient’s mouth thoroughly with
water.
3. Using an ultrasonic nebulizer, have the patient
inhale approximately 20-30 ml of 3-10% NaCl.
4. Collect the induced sputum in a sterile screwcap container.
Tracheostomy
and
Endotracheal
Aspirations
SPUC
Trachea
Sterile
container
A.S.AP
1. Tracheostomy is followed by colonization
within 24 hours of insertion of the tube. Results
must be correlated with clinical findings such as
fever or infiltrate on chest X-ray.
2. Aspirate the specimen into a sterile sputum trap.
Bronchial
wash
/Bronchoalve
olar lavage
SPUC
FUNS
PCPE
AFBC
Bronchial
Sterile
Container
A.S.A.P
1. Inject sterile 0.85% NaCl (generally 5-20ml
aliquots) from a syringe through a biopsy
channel of the bronchoscope.
2. Gently suction the saline into a sterile container
before administering the next aliquot. (In
general, 50-75% of the saline instilled is
recovered in the lavage effluent.)
3. Obtain one specimen for each test request
16
Note
Bronchial wash and
bronchoalveolar
lavage specimens are
generally obtained
before brushing or
biopsy specimens to
avoid excess blood in
the recovered fluid,
because blood may
alter the
concentration of
cellular and
noncellular
components:
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Bronchial
Brush
Specimens
SPUC
FUNS
PCPE
AFBC
Specimen
Source
Bronchial
Transport
Sterile
Container
Lower
Respiratory
tract Biopsies
and Aspirate
Contact Microbiology before collection
Nasopharyngeal aspirates
RSV
Posterior
pharynx
Syringe
with
suction
tubing in
sterile
container
Stability
Procedure
Note
A.S.A.P
1. Insert a telescoping double catheter plugged
with poly-ethylene glycol at the distal end (to
prevent contamination of the bronchial brush)
through the biopsy channel of the
bronchoscope.
2. Obtain one specimen for each test request
For PCP exam,
Specimen must be at
QE2 within 16 hours
and before 1700 .
Contact
Microbiology before
collection
A.S.A.P
1. Attach disposable 5cc Luer fitting syringe to the
control device of a No.5 French whistle tip
suction catheter.
2. Pass the catheter through the nares into the
posterior pharynx. DO NOT ALLOW THE
TIP TO ENTER THE ORAL CAVITY. The
distance to which the catheter is passed must be
estimated according to the size of the patient’s
head. A cough will be provoked if the catheter
tip touches the larynx, at which point the
catheter should NOT be advanced further and
should be withdrawn somewhat.
3. When the catheter is in position, close the side
arm of the control device with the thumb.
GENTLY apply suction using the syringe and
at the same time slowly withdraw the catheter.
4. When sufficient sample has been collected (0.1
ml for RSV and just visible sample for
Pertussis) the catheter may be completely
withdrawn. Leave the syringe attached and
place the END portion of the catheter into a
If both RSV and
Pertussis are
requested, separate
samples must be
collected
17
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Specimen
Source
Transport
Stability
Procedure
sterile specimen container.
5. Label and place the complete apparatus in a
clean zip-lock plastic specimen bag and forward
immediately to the Microbiology Lab.
Pertussis PCR
NPAC
Nasopharyngeal aspirates
Nasopharyngeal swab
Suction
tubes in
Sterile
Container
Viral
Transport
Container
A.S.A.P
See RSV collection Procedure
A.S.A.P
See Viral Culture Collection Procedure
18
Note
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Nasopharyngeal swabs`
VIRC
Specimen
Source
Posterior
pharynx
Transport
Viral
Transport
Medium
Stability
2-8oC /48
hr
Procedure
1. When you collect the specimens, wear gloves

and a mask. The mask is to protect you if the
patient coughs or sneezes while you are
collecting the specimen. Change gloves and
wash your hands between each patient.
2. Viruses live in cells. If the patient has a lot of
mucus in the nose, this can interfere with the
collection of cells. Either ask the patient to use
a tissue to gently clean out visible nasal mucus
or clean the nostril yourself with a swab.
3. How to estimate the distance to the
nasopharynx: Prior to insertion, measure the
distance from the corner of the nose to the front
of the ear and insert the shaft approximately
2/3 of this length.
4. Seat the patient comfortably. Tilt the patient’s
head back slightly to straighten the passage
from the front of the nose to the nasopharynx to
make insertion of the swab easier.
5. Gently insert the swab along the medial part of
the septum, along the floor of the nose, until it
reaches the posterior nares – gentle rotation of

the swab may be helpful. (If resistance is
encountered on one side, try the other nostril, as
the patient may have a deviated septum.)
6. Allow the swab to sit in place for 5-10 seconds.
7. Rotate the swab several times to dislodge the
columnar epithelial cells. Insertion of the swab
usually induces a cough.
8. Withdraw the swab and place it in the collection 
tube.
9. Refrigerate immediately.
10. Remove gloves. Wash hands.
19
Note
Collect specimens
as soon after
onset of
symptoms as
possible because
the likelihood of
obtaining positive
results is
generally greatest
within the first 3
days after onset
of symptoms and
diminishes
rapidly as the
course of
infection
proceeds in
otherwise healthy
and
immunocompeten
t individuals.
Viruses may be
recovered from
clinical samples
for prolonged
periods with
disseminated or
persistent
infections.
Collect autopsy
specimens as
soon after death
as possible.
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
2.4 Wound, Tissue, Skin Specimens
Meditech
Superficial MISC
Wound
Deep
wounds/
Abscess
MISC
Specimen
Source
Wound/specify
Wound/Abscess
Transport
Stability
Amies
Transport
2-8oC /48 hr
Sterile
Container
A.S.A.P
20
Procedure
Note
1. A syringe aspiration is preferable to a swab
collection.
2. Disinfect the surface of the wound with 70%
alcohol and then with an iodine solution (12% tincture of iodine or a 10% povidoneiodine). Allow the disinfectant to dry prior
to collecting the specimen. If tincture of
iodine is used, it must be removed with 70%
alcohol after the procedure to prevent burns.
3. Using a 3-5ml syringe with a 22-23 gauge
needle, a physician will aspirate the deepest
portion of the lesion. If a vesicle is present,
collect both fluid and cells from the base of
the lesion.
4. If the initial aspiration fails to obtain
material, inject sterile nonbacteriostatic
0.85% NaCl subcutaneously and repeat the
aspiration attempt.
1. Disinfect the surface. with 70% alcohol and
then with an iodine solution (1-2% tincture
of iodine or a 10% povidone-iodine). Allow
the disinfectant to dry prior to collecting the
specimen. If tincture of iodine is used, it
must be removed with 70% alcohol after the
procedure to prevent burns.
2. Aspirate the deepest portion of the lesion,
avoiding contamination by the wound
surface.
Wound swabs are
assessed
microscopically
for quality which
determines the
workup
For open wound:
debride and rinse
with sterile saline
if appropriate
prior to collection.
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Ulcers and
Nodules
MISC
Catheter
tips
MISC
Skin/Nail/
Hair
Scraping
FUCD
Specimen
Source
Wound/ Specify
Indwelling
Catheter tips
Skin/ Nail/ Hair
Transport
Stability
Procedure
Note
Amies
Transport
2-8oC /48 hr
1. Clean the area with 70% alcohol and then
with an iodine solution (1-2% tincture of
iodine or a 10% povidone-iodine). Allow
the disinfectant to dry prior to collecting the
specimen. If tincture of iodine is used, it
must be removed with 70% alcohol after the
procedure to prevent burns.
2. Remove overlying debris.
3. Curette the base of the ulcer or nodule.
4. If exudate is present, collect it with a syringe
or sterile swab
Decubitus ulcers
specimen is not
suitable for culture
Sterile
Container
A.S.A.P
1. Clean the skin with 70% alcohol prior to
catheter removal.
2. Observing aseptic technique, hold the
exposed end of the catheter and carefully
remove the catheter from the patient with a
sterile instrument, taking care to avoid
contact with exposed skin.
3. Holding the distal end over a sterile
container, cut the tip with sterile scissors,
dropping the last 4-5 cm into the container.
4. Transport to the lab as soon as possible to
avoid drying.
Order if catheter
related sepsis
suspected.
Wrap
scraping in
black
construction
paper and
place in an
envelope
RoomTemp/72 1. Clean the surface 70% alcohol and allow to
hours
air dry
2. Using a scalpel blade, scrape the periphery
of the lesion border.
3. Samples from scalp lesions should include
hair that is selectively collected for
examination.
21
Blood culture
must accompany
specimen.
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Specimen
Source
Transport
Stability
Bite
Wound
MISC
Pus from wound
Sterile
Container,
Amies
Transport
A.S.A.P
Bone
BONC
Surgically
Removed Bone
Sterile
container
A.S.A.P
Punch
Skin
biopsy
TISC
Skin Biopsy
Sterile
container
A.S.A.P
Soft tissue
Aspirate
MISC
Sinus tract,
lesion
Sterile
Container
A.S.A.P
Procedure
4. If there is nail involvement, obtain scrapings
of debris or material beneath the nail plate.
5. Refold the paper so that the specimen is
contained and cannot fall out
6. Place the black paper in the envelope and
label accordingly
1. Aspirate pus from the wound, or obtain it at
the time of incision, drainage or debridement
of the infected wound.
2. Clearly indicate source of the bite
1. Obtain specimen at surgery
2. Submit in sterile container without formalin.
3. The specimen may be kept moist with sterile
0.85% NaCl.
1. Disinfect the surface. with 70% alcohol and
then with an iodine solution (1-2% tincture
of iodine or a 10% povidone-iodine). Allow
the disinfectant to dry prior to collecting the
specimen. If tincture of iodine is used, it
must be removed with 70% alcohol after the
procedure to prevent burns.
2. Collect 3-4mm sample with a dermal punch.
3. Submit in a sterile container without
formalin
4. .The specimen may be kept moist with
sterile
0.85% NaCl.
1. Disinfect the surface with 70% alcohol and
then with an iodine solution (1-2% tincture
of iodine or a 10% povidone-iodine). Allow
the disinfectant to dry prior to collecting the
specimen. If tincture of iodine is used, it
22
Note
Do not culture
fresh bite wounds,
as infectious
agents will likely
not be recovered
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Specimen
Source
Transport
Stability
Procedure
must be removed with 70% alcohol after the
procedure to prevent burns.
2. Aspirate the deepest portion of the lesion or
sinus tract. Be careful to avoid
contamination by the wound surface.
23
Note
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
2.5
Surveillance Testing
Meditech
Specimen
Source
Nares
Groins
MRSA
VRE
MRSACUL
Transport
Stability
Procedure
Amies
Transport
2-8oC /48
hr
Amies
Transport
2-8oC /48
hr
1. moisten tip of swab with sterile saline/water or
by inserting the tip of the swab into the culture
medium located in the bottom of the culture
tube
2. gently insert the swab and rotate 5 times in the
anterior nare
3. Using the same swab, repeat the process in the
other nare.
1. Moisten tip of swab a with sterile saline/water
or by inserting the tip of the swab into the
culture medium located in the bottom of the
culture tube
2. gently rotate swab 5 times over groin areas
3. using same swab repeat the process in the other
groin
Moisten tip of swab a with sterile saline/water or
by inserting the tip of the swab into the culture
medium located in the bottom of the culture tube
Rotate swab on the surface
Incisions,
lesions, exit sites
of indwelling
catheters
Amies
Transport
2-8oC /48
hr
Stool
Sterile
Container
2-8oC /48
hr
1. Do not allow water or urine to touch the stool.
2. Collect the stool sample on a clean dry surface
such as a disposable container or onto plastic
wrap placed under the toilet seat.
3. Put a sample of stool into the container
4. Screw the lid on firmly.
5. Do not get any stool on the outside of the
container.
Rectal Swab
Amies
Transport
2-8oC /48
hr
1. Moisten the swab with the medium in the
collection tube or sterile saline or water.
2. Gently insert the swab into the rectum or stoma
VREC
24
Note
Please refer to
infection control
policy for ordering
surveillance
testing
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Meditech
Specimen
Source
Transport
Stability
Procedure
in order to obtain stool on cotton tip
of the swab (visible stool will provide the best
specimen)
25
Note
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
2.6 Sterile Body Fluid Specimen
General Considerations:
1. Inform Laboratory before collection
2. Deliver to Laboratory immediately. DO NOT REFRIGERATE.
3. Clearly indicate specimen source and test requested on the requisition or in Meditech
2.6.1 Blood Culture Specimen
 Adult Population (14 YEARS OLD AND ABOVE)
Meditech : BLDC
 During a single patient encounter, two sets of blood cultures, drawn from two separate sites or same site at least 20 minutes apart should be
drawn. Although blood occasionally may need to be obtained from intravenous lines and similar access devices, a culture of blood from such
a device should be paired with another culture of blood obtained by venipuncture to assist in interpretation in the event of a positive result.
 If a 3rd set is required obtain from another patient encounter 20 minutes later or a more appropriate time convenient for patient/lab personnel.
 The recommended volume is 15-20 ml per venipuncture site
 The maximum amount of blood cultures per patient per day is 3 sets. Requests for additional blood cultures require consultation
with a Laboratory pathologist.
 Pediatric Population (13 YEARS OLD AND UNDER)
Meditech: BLPE


During a single patient encounter, blood will be drawn from one site only.
The recommended volume for infants and younger children should be no more than 1% of the patient’s total volume.
26
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Patient’s Weight
Volume of
blood to be
drawn
Less than 1 Kg
0.5 to 1.0 mL
1 to 2 Kg
1.0 to 1.5 mL
2 to less than10 Kg 1.5 to 3.0 mL
25 to less than 35
3.1 to 10 mL
Kg
35 to less than 40
10 to 15 mL
Kg
BacT/ALERT PF Ref#259794 Pediatric (Yellow top)
BacT/ALERT PF Ref#259794 Pediatric (Yellow top)
BacT/ALERT PF Ref#259794 Pediatric (Yellow top)
BacT/ALERT PF Ref#259794 Pediatric (Yellow top)
Greater than 40
Kg
BacT/ALERT SA Ref#259789 Aerobic
(Royal Blue top) x 2 bottles
20 mL
Bottles to use
BacT/ALERT SA Ref#259789 Aerobic
(Royal Blue top) x 1 bottle
 Procedure:
1. Remove caps from blood culture bottles
2. Cleanse top of blood culture bottles with 70% v/v isopropyl alcohol swab and allow to air dry
Note: For patients less than 34 weeks gestation- use 2% Chlorhexidine Aqueous Solution (alcohol free). Allow to air dry completely
before breaking the skin (approx. 3 minutes).
3. Cleanse venipuncture site first with 70% V/V Isopropyl alcohol swab and allow to air dry
4. Cleanse venipuncture site second with 2% w/v Chlorhexidine Gluconate/70% V/V Isopropyl alcohol swab and allow to air dry
5. Do not palpate the venipuncture site after cleansing unless sterile gloves are worn.
6. Collect 5-10 mls(adult) or 0.5-4mls(pediatric)
7. Record the following information on the requisition and specimen labels:
a. Time of collection
b. Site of collection
c. Order of collection eg., 1A, 1B, 2A,2B
d. Initials of phlebotomist
27
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
2.6.2 CSF Specimen
 General Considerations:
 Inform lab service one hour before collection
 Clearly indicate request for bleed or infection investigation since the specimen will be processed differently
 An initial CSF sample should be collected prior to antimicrobial therapy for highest diagnostic sensitivity.
 Meditech : CSFC- Bacterial Culture (Tube2)
VIRC-Viral Culture/PCR (Tube 4)
 Procedure: (Reference only)
1. Lumber puncture: (This procedure is a medical procedure that is performed by a physician guided by appropriate precautions)
a.
b.
c.
d.
e.
f.
g.
Sequentially collect CSF into 4 calibrated sterile tubes labeled no.1-4
CSF culture will be performed on Tube 2
Minimum specimen for CSF culture is 1 ml.
Label specimen accordingly Form# F20.3.064
Record time of collection and signature of collector on LIS requisition and specimen label.
Place specimens in plastic specimen transport bag and labels in outside pouch.
Deliver immediately to laboratory.
2. Ommaya reservoir fluid or ventricular shunt fluid
a. Clean reservoir site with antiseptic solution and alcohol perior to removal of fluid to prevent introduction of infection.
b. Remove fluid by aspiration of CSF FROM ommaya reservoir, ventricular drain or shunt.
c. Sequentially collect CSF into 4 calibrated sterile tubes labeled no.1-4
d. CSF culture will be performed on Tube 2
e. Minimum specimen for CSF culture is 1 ml.
f. Label specimen accordingly Form# F20.3.064
g. Record time of collection and signature of collector on LIS requisition and specimen label.
h. Place specimens in plastic specimen transport bag and labels in outside pouch.
i. Deliver immediately to laboratory.
28
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
2.6.3 Urine Specimen
 General Considerations
 Never collect urine from a bedpan or urinal.
 Thoroughly clean the urethral opening (and vaginal vestibule in females) prior to collection procedures to ensure that the specimen is
not contaminated with colonizing microorganisms in this area.
 Soap, rather than disinfectants is recommended for cleaning the urethral area. If disinfectants are introduced into the urine during
collection, they may be inhibitory to the growth of micro-organisms.
 Transport specimen to the laboratory immediately or refrigerate. (Bacterial counts will remain stable for up to 24 hours at 4°C).
 Transport urine for viral cultures on wet ice in a sterile container.
 For mycobacterial cultures, send the first morning voided urine. Three consecutive first morning urine specimens are recommended.
 Meditech : URNC
 Procedure
Clean Catch Urine Specimen
1. Wash hands with soap.
2. Remove and open the towelettes.
3. Clean genital area with using all of the towelettes.
a. Females: separate the folds of urinary opening with thumb and forefinger and clean inside with towelettes, using front to back
strokes only. Keep separated during urination (peeing) into container.
b. Males: Retract the foreskin, wash penis, ending near the tip.
4. Remove container from package/holder. Do not touch the inside of the container.
5. Begin urinating (peeing) into the toilet. Stop the flow and then begin urinating directly into the container until half full. Stop the flow.
Finish urinating in the toilet.
6. Remove cap from package with thumb and forefinger. Do not touch inside of cap.
7. Screw the cap tightly onto the container.
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South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Ileal Conduit urine
1. Remove the external urinary appliance, and discard the urine within the appliance.
2. Gently swab and clean the stomal opening with a 70% alcohol pad and then with 2% tincture of iodine or a 10% povidone-iodine. Allow
the disinfectant to dry prior to collecting the specimen. If tincture of iodine is used, it must be removed with 70% alcohol after the
procedure to prevent burns.
3. Using sterile technique, insert a double catheter into the stoma. A double catheter helps to minimize contamination of the specimen with
skin flora.
4. Catheterize the ileal conduit to a depth beyond the fascial level.
5. Collect the urine drained into a sterile container.
Straight (In/Out) Catheter Urine
1. In/out catheter urine specimens are useful when clean-catch urines cannot be obtained or when results from clean-catch urine specimens
are equivocal and a diagnosis is critical.
2. Prior to catheterization, the patient should force fluids until the bladder is full. (Forcing fluids may reduce organism number.)
3. Clean the patient’s urethral opening (and in females, the vaginal vestibule) with soap, and carefully rinse the area with water.
4. Using sterile technique, pass a catheter into the bladder.
5. Discard the initial 15-30 ml of urine.
6. Collect a sample in a sterile container.
Indwelling Catheter urine
1.
2.
3.
4.
Do not collect urine from collection bag.
Clean the catheter collection port with a 70% alcohol wipe.
Using sterile technique, puncture the collection port with a needle attached to a syringe.
Aspirate the urine, and place it in a sterile container.
30
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
2.6.4 Sterile Body Fluids: (Excluding CSF, Blood and Urine)
 Meditech: BFC
 Procedure
Percutaneous Aspirate:
1. Clean the needle puncture sites with alcohol and disinfect it with an iodine solution. If tincture of iodine is used,
remove with 70% ethanol after the procedure to avoid burn.
2. Aseptically perform percutaneous aspiration with syringe and needle to obtain fluid
3. Use safety device to protect from needle exposure
4. Immediately place the specimen in a sterile container or a Red-top tube
5. Label specimen accordingly
Drainage:
6.
7.
8.
9.
Collect a fresh specimen of the fluid draining out from the device in a sterile container
Label according
Indicate on requisition that this is a drainage specimen
The device, tubes or tips are not suitable for culture and will not be processed.
31
South Shore Health
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Microbiology Collection Manual-2015
3.0 Specimen handling for specific condition or organisms
 Please refer to Provincial Public Health Laboratory Network of Nova Scotia Provincial Microbiology Users
Manual
http://www.cdha.nshealth.ca/pathology-laboratory-medicine
Click on above link and Select Provincial Microbiology Users Manual
 Contact Microbiology Lab at 527-5263 for inquiries
32
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
4.0 Inappropriate Specimen for Bacterial Culture
 Stool
Inappropriate Specimen
Reason and Explanation
Note
Alternative
Rectal swab for enteric pathogens
Insufficient quantity
Pathogens may die or
insufficient quantity of stool
reducing sensitivity
Stool specimens taken from
inpatients for routine
culture/parasites are rarely useful
May produce false negative results.
The specimen of choice would
be Stool
Specimen not processed. Studies have shown
that after 72 hours of admission, stool
specimens taken from inpatients for routine
culture/parasites are rarely useful. Specimen
will be held for 3 days. Please contact the
microbiology department to arrange
processing if circumstances warrant.
"Please note: Specimen not processed.
Clostridium difficile toxin testing is not
performed on stool specimens of children <=
12 months of age as up to 65% of healthy
infants have asymptomatic carriage of this
organism.
A specimen for C.difficile toxin was received
in preservative. Please resubmit sample in a
plain container without any preservative.
Formed sample received, only watery stools
are acceptable for this procedure. Specimen
not processed, please re-submit.
Patients with positive tests should not have
repeat testing including test of cure, unless
they have relapse of their symptoms after
completion of therapy. Toxins may be
detectable for weeks to months after therapy.
Specimens for C.difficle toxin must be at least
48 hours apart.
Possible causes of diarrhea for
inpatient : Cdiff or viral origin
Stool Culture or Ova Parasite
testing for patient that have been
admitted >72 hours
(unless outbreak)
Stool, C.difficile
Patient <= 12 months old
Received in preservative
Formed sample received
Positive test within 7 days of
collection of this spec.
C.diff test Request must be 48
hours apart
33
Other causes of diarrhea should
be considered."
Recollect
Recollect watery specimen
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
 Genital
Inappropriate Specimen
Reason and Explanation
Note
Alternative
Semen/seminal fluid
Results may be insensitive or
misleading
Antibacterial substance may give
false negative result. Interpretation
difficult as contaminated by normal
urethral flora
Inaccurate result
Contaminated with normal flora
Semen samples are not processed
because results are not diagnostic and
are difficult to interpret.
Pre- and post massage urine
specimen for prostatitis
IUD
Cervical / Urethal Swab for C+S
Culture Method not available
Routine Vaginal Culture
Will only be performed on
1. patient <13 years old
2. history of recurrent yeast
infection
3. Toxic Shock syndrome/ puerperal
fever
4. Post-op
Change of Normal Flora in this age
group
Vaginosis Screen for patient >55
Penis swab
(unless lesion, wound or laceration)
Lochia
Contaminated with normal flora
This specimen was collected from a
source from which testing may be
insensitive, misleading or that seldom
yields clinically useful information.
Misleading
Contaminate with normal flora
34
Intra uterine devices are no longer
processed for culture and sensitivity
as results are not diagnostic and do
not contribute to patient care.
Please order Chalmydia GC
DNA testing.(CHLGCDNA)
If patient is between 13-55
years old without any of the
indication, only Bacterial
Vaginosis Screen ( Nugent
score) will be done.
Nugent score will not be performed
for patient >55 years old because
Nugent score has not been validated
for patients over the age of 55.
Only WBC and yeast will be
reported
Treatment, if required is best
done on an empirical basis.
Cultures of Lochia specimens are not
routinely cultured due to
contamination from normal vaginal
flora.
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
 Respiratory
Inappropriate Specimen
Reason and Explanation
SPUTUM with quality score (Q score) zero
Result may be insensitive or
misleading
Pathogen cannot be distinguished
from normal flora
Results may be insensitive or
misleading
Pathogen cannot be distinguish from
normal flora
Reject if patient is >16 years old
NOSE
Throat, Rapid screen
Note
Alternative
Send Repeat specimen if clinically
indicated
Routine cultures of nasal swabs are
not performed because results are
not predictive of disease.
For wound / abscess- Collect
aspirate specimen
This test is reserved for
Children<16
Order Throat Culture
 Miscellaneous
Inappropriate Specimen
Reason and Explanation
Note
Alternative
Treatment, if required is best
done on an empirical basis.
If it’s for wound/ abscess
;collect wound/ abscess aspirate
specimen
Treatment, if required is best
done on an empirical basis.
Anal/rectal/perianal/perirectal
swab
Results may be insensitive or
misleading
These specimens grow heavy normal
flora
This specimen was collected from a source
from which testing may be insensitive,
misleading or that seldom yields clinically
useful information.
Pilonidal from Coccyx, Cyst
OR Sinus
Heavy growth of normal flora
Results may be insensitive or
misleading
Fistula( vaginal or enteric)
Inaccurate result
Heavy growth of normal flora
Axilla swabs for MRSA
Results may be insensitive or
misleading
Not suitable for MRSA screening
This specimen was collected from a source
from which testing may be insensitive,
misleading or that seldom yields clinically
useful information.
This specimen was collected from a source
from which testing may be insensitive,
misleading or that seldom yields clinically
useful information.
Axilla swabs are not suitable for routine
MRSA screening. Two sets of nare and
groin swabs should be collected
35
Treatment, if required is best
done on an empirical basis.
Nares/ groins for MRSA
screening
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
Inappropriate Specimen
Reason and Explanation
Foley Catheter tips
Inaccurate results
Colostomy/ileostomy/stoma
drainage
Results may be insensitive or
misleading
Heavy growth of normal flora
Gastric washings
Only set up if from newborn
Ulcers
Note
Alternative
Foley Catheter tips are unacceptable for
culture.
This specimen was collected from a source
from which testing may be insensitive,
misleading or that seldom yields clinically
useful information.
This specimen was collected from a source
from which testing may be insensitive,
misleading or that seldom yields clinically
useful information.
Urine Culture
Reject if from decubitus, bedsore or
buttocks.
Set up if from extremities
This specimen was collected from a source
from which testing may be insensitive,
misleading or that seldom yields clinically
useful information.
Treatment, if required is best
done on an empirical basis.
Tips
Culture tip is not of value if not
accompany by blood culture request for
clinically suspected septicemia.
Order Blood Culture
Bag Urine culture specimen
Urine from bag is not suitable for
culture
Most pathogen lose viability on dry
swabs
Duplicate test within defined time does
not improve sensitivity
Catheter tips for culture should be
submitted with an accompanying
peripheral blood culture for correlation
purposes.
Specimen does not meet storage
requirement
Dry Swabs
Duplicate Tests
Only most recent specimen will be
processed
36
Treatment, if required is best
done on an empirical basis.
Treatment, if required is best
done on an empirical basis.
Collect Catheter or Cystopic
specimen if clinically indicated
Collect swabs in Amies
Transport
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
5.0 Specimen Rejection
Non-critical specimen: Urine, Stool, Sputum, Wound, Vaginal and Miscellaneous swabs collected by non-invasive procedure
Critical specimen: Blood Culture, Fluid Culture, OR specimen, Specimen collected by invasive procedures
Specimen ID issue
Requisition issues
Inappropriate Collection and
Transport
Inappropriate specimen and
request
Duplicate specimen within 24
hours
Specimen with Major Leak
Critical Specimen
1.Collection site must signed and
submit Form# F20.6.035
2. Specimen will be processed with
comment
 Health care provider should faxed a
replacement requisition for the
specimen
 Specimen will be processed
 Result will be released when
amendment requisition received
HCP will be informed
Specimen will be proceed Comment on
final report
HCP will be informed.
Specimen will be processed with
approval from Medical Director
Process as usual
Specimen will be processed with
interpretive caution
37
Non-critical Specimen
Reject specimen



Health care provider should faxed a replacement
requisition for the specimen
Specimen will be processed
Result will be released when amendment
requisition received
Reject specimen
Reject specimen
Process most recent specimen
Reject other specimen with “DUP” code
Reject specimen
South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
6.0 Appendix
6.1 Laboratory Services Fax Request for Patient Information Form------------------------------------------------------P35
6.2 Laboratory Service Documentation of Verbal Request from Health Care Providers---------------------------P36
6.3 Critical/ None-recollectable Unlabelled/ Mislabelled Specimen Form-----------------------------------------------P37
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Laboratory Services
Microbiology Collection Manual-2015
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Laboratory Services
Microbiology Collection Manual-2015
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South Shore Health
Laboratory Services
Microbiology Collection Manual-2015
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