Specimen Collection-Microbiology

Microbiology – Swab Chart

Meadville Medical Center Laboratory has the following types of specimen collection swabs. Please refer to the following chart for preferred specimen collection types.

Preferred Swab	Source	Comments
White /Teal Cap (plain) Stuart’s media	Abscess or sterile body fluid	Fluid is preferred in sterile screw-cap container.
	Eye, ear, nasal	Mini-tip or gel also acceptable
	MRSA for PCR	Plain/teal cap only- moisten tip with sterile saline prior to collection.
	Throat screen for strep	Gel swab unacceptable for rapid strep screen; culture only may be performed.
	Wounds	Aerobic culture of superficial specimen
	Eye, ear, nasal	Mini-tip acceptable
Magenta Cap Gel media suitable for preservation of both anaerobic and aerobic bacteria	Fluid	Some culture sites are unacceptable for anaerobic culture and may be rejected
	Wound	Anaerobic culture of deep specimens
	Infant eye, ear or nasal
Orange Cap (mini-tip) Gel media suitable for preservation of both anaerobic and aerobic bacteria	Urethra	For culture

Microbiology — Special Collection

The list below contains the specialized swabs (or collection kits) needed for the particular test ordered:

Culture	Swab/Kit Needed
Acid Fast Bacillus (AFB), Tuberculosis (TB)	AFB sputum collection container
Bordetella pertussis (whooping cough)	Pertussis (charcoal swab) and slide for DFA
Chlamydia Culture	UTM transport media - Recommendedfor abuse or rape cases.
Chlamydia and/or Gonorrhoeae (RNA detection)	Gen-Probe APTIMA® kits male female urine collection Not recommended for abuse or rape cases.
Neisseria gonorrhoeae culture	G.C. plates (Jembec®) – Store refrigerated until use. Must be delivered to lab within 6 hrs of plating the organism.
Papillomavirus	Digene DNA® specimen collection kit
Pinworm	Swube® kit or CLEAR scotch tape attached to clear slide. (Frosted tape unacceptable)
Stool	Stool collection kit
Vaginitis	BD Affirm VPIII
Viral Culture	UTM transport media

Microbiology – Collection Information

Additional information is available in the Alphabetical Listing section.

This chart contains more detailed information and is an aid in assisting proper entry of specimens into the Meditech system.

Procedure	Acceptable Specimens	Unacceptable Specimens	Notes
AFB Culture/stain	Most specimens	Stool	Same as “TB” or culture for mycobacterium Sent to reference lab
Anaerobic Culture	Abscess Bone Bank Biopsy Bone marrow Bronchial Cervix Dental Deep wound Lung Percutaneous trans. trach. Sterile body fluid Sinus Tissue Urine (needle aspirate from bladder)	Feces Mouth Sputum Superficial skin site Throat Urine (other than needle aspirate) Vagina	Gel-type swab is preferred.
Blood Culture	Adults - 7.0 mL Infants - minimum 0.5 mL		2 sets (set = 2 yellow-top SPS tubes) drawn same time from different sites are acceptable for most cases of suspected sepsis.
Bone Marrow	Contact ACL prior to specimen collection.
Bordetella Pertussis DFA and Culture	Nasal /pharyngeal specimen collected on charcoal swab and slide for DFA
Catheter tip culture	Catheter tips only	Foley cath tip Exit sites - See “Wound Cultures”	Send tips, 1 inch long or less, in sterile container
Cerebral Spinal Fluid Culture	Sterile CSF fluid (5 mL minimum) in tube 2,3 or 4	-Refrigerated specimen -Tube 1	Hand transport for specimen safety
Chlamydia Culture	Cervix Eye (infant or adult) Fluid Nasal/Pharyngeal swab (infant only) Rectum Urethra	Discharges Urine Vagina	Insert swab into site and rotate. Remove swab. Submit swab in UTM™ Transport Medium available from MMC Lab. Recommended for sexual assault or rape.
Chlamydia RNA probe	Cervix Eye Urethra Other sources not approved for Gen-Probe; see “culture”	Fluid Rectum Nasal Urine Vagina (Cotton-tipped wooden shafted collection swabs)	Use Gen-Probe Aptima® collection kits (male, female and urine). Other collection kits not acceptable. Not suitable for sexual assault or rape (order culture).
Clostridium Difficile Antigen and Toxin	Stool – (2 mL. liquid stool minimum)	-Swabs -Stool in preservative
Cryptococcal Antigen	Spinal fluid - 1.0 mL Serum - 1.0 mL		Sent to reference lab
Cryptosporidium Antigen	-10 gm stool in SAF transport medium -fresh unpreserved stool	Unpreserved or unrefrigerated specimen >24 hours old
Culture for Group B Strep Only	Vaginal rectal Plain or gel swab	Cervical not recommended	For detection of Group B strep in pregnant women
Cyclospora cayetanesis	10 gm stool in SAF vial	-Stool not in SAF within 12 hrs -Stool in PVA fixative or culture medium	Sent to ACL
Ear, Eye or Nasal Culture	Ear Eye Nasal -Gel or plain swab -Inner ear tissue in sterile container	Specimens > 24 hours old	For sinus specimens - Refer to Respiratory Culture
Fluid Culture	Any normally sterile body fluid (synovial) or drainage from surgical areas collected in: -Sterile screw-capped cup -Green-top tube -Syringe with needle removed	Fluids poured into culturette tubes	Specify unusual sites in comments. Fluid itself is preferred over swabs. CSF – Refer to CSF Culture Blood – Refer toBlood Culture Urine – Refer toUrine Culture
Fungal Culture	Most sites Skin scrapings Nails Hair	Feces Dried material on slides 24 hour urine	-Preliminary report at 2 wks, or sooner if growth occurs -Final report at 4 wks
Genital Culture	Cervix Eye Groin Penis Scrotum Urethra Uterus Vagina	Non-urogenital sources	For unusual sites; such as endometrium, placenta, etc., specify under comments for source “uterus”.
Giardia Antigen	-10 gm stool in SAF transport medium -fresh unpreserved stool	-Unpreserved specimen >24 hours old -Unrefrigerated bulk stool >24 hrs
Gram Stain	Most specimens collected on plain swabs		Gel swab (impairs stain quality)
Helicobacter Pylori Screen	0.5 mL serum	Plasma	Sent to ACL
Herpes Culture	Collect using viral kit Dermal sites Lesions Urogenital sources		Sent to ACL Plain swab is also acceptable if received within 2 hrs of collection.
Identification, Microscopic	Specimens in leak-proof container	Non-secure container	Ticks – see Pathology
India ink prep	Spinal fluid		Test performed by Micro tech only M-F from 6 AM - 4 PM S-S from 6 AM-2:30 PM
Influenza antigen Types A or B	Nasal wash (preferred) Throat NP aspirate or swab	Frozen specimen
KOH Prep	Cervix Finger or toenails Skin scrapings Vagina Hair		Test performed by Micro tech only M-F from 6 AM - 4 PM S-S from 6 AM-2:30 PM
Legionella Culture	Biopsy specimen Bronchial secretions	Swab specimen not from lower respiratory tract	Sent to ACL
Legionella Smear/Tissue	Biopsy specimen Bronchial secretions Specimen on glass slide	Swab specimen not from lower respiratory tract	Sent to ACL Refrigerate
Lyme disease	Serum CSF Synovial fluid		Sent to ACL
Malaria	Blood
Neisseria Gonorrhoeae Culture	Body fluids Eye Urogenital sources Rectal Throat	Feces Urine (Cotton-tipped wooden shafted swabs)	Do not refrigerate - swabs not plated on Jembec® must be received in lab within 2 hours of collection.
N. Gonorrhoeae RNA Probe	Use Gen-Probe APTIMA® collection kit. Cervix Urethra	Other collection kits are not acceptable. -All other sources not acceptable	Not suitable for sexual assault or rape (order culture).
Ova and Parasites	Stool - minimum amount is pea-size portion in leak-proof container	Rectal swabs	Sent to ACL Must include medical or travel history
Pinworm Exam	Swube® tube Clear tape on glass slide	Frosted tape	Frosted tape cannot be examined under the microscope.
Respiratory Culture	Bronchoscopy Dental (surgical) Gastric Lung Percutanous trans. trach. Sinus Tonsils/ Peritonsillar	Specimens contaminated with oral flora
Respiratory Syncytial Virus Antigen	Nasal wash NP swab	All other specimens	For RSV culture see chart Viral Culture
Rotavirus	Stool (minimum 5 mL)	-Specimen >12 hr old -Stool in preservative
Sputum Culture	Mouth Sputum Tracheal secretions	-Specimen collected in Kleenex -Specimens not in sterile container	Specimen containing excess oral contamination is rejected.
Stool Culture	Colonoscopy material Stool 2 rectal swabs with evident fecal material	Specimens not in screw-capped container such as: Diapers Toilet paper	Test not performed on patients hospitalized >3 days
Stool Culture for VRE only	Stool Rectal swab Urine		For detection of colonization with VRE
Throat (Strep A screen)	Plain swab preferred	Gel swab	Throat culture is performed if strep screen is negative.
Throat (no screen)	Plain or gel swab		Strep screen is not performed.
Tissue Culture	Tissue Biopsy material	Dried specimens
Urine Culture	Urine collected using sterile technique	24 hour urine Catheter bags Unrefrigerated specimens greater than 2 hours old	Notify lab promptly when adding culture to a previously collected specimen.
Viral Culture	Use viral collection kit: Biopsy Rectal Blood Spinal Fluid Eye Sputum Fluid Throat Nasal Urine		Sent to ACL -Plain swab acceptable if received within 2 hours of collection. -Place plain swab in UTM media within 2 hours of collection and is acceptable if received within 24 hours of collection.
Wound Culture	Most body sites including catheter exit sites	Material dried on slides	Plain or gel swab are acceptable.

Microbiology-Source Chart

Download the pdf version of the Source Chart.

Use this chart to determine what type of culture to order and what type of swab to use for a given specimen type.