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[MT 6320] Clinical Bacteriology Laboratory > [1S] UNIT 1.3 Specimen Collection & Handling > Flashcards

[1S] UNIT 1.3 Specimen Collection & Handling Flashcards

1
Q

T/F: Collect specimen in the acute phase of the infection. Collect prior to administration of antibiotics

A

T

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2
Q

Swabs are primarily for?

A

Aerobic Bacteria

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3
Q

Aspirates are primarily for?

A

anaerobic bacteria

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4
Q

● Provide exact anatomic site
● Cleanse the area prior to collection
● Collect at the margin (swabs)
● Place material into an appropriate tube/vial

A

Lesions, Wounds, and Abscesses

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5
Q

LESSIONS, WOUNDS AND ABSCESSES

● Swab: _________ ______
● Aspirate: deep wound

A

superficial wounds

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6
Q

TYPES OF SWABS

for Bacterial Culture

A

Dacron, Calcium Alginate, Rayon

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7
Q

TYPES OF SWABS

for Viral Culture

A

use Cotton and Dacron

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8
Q

UPPER RESPIRATORY TRACT SWAB

isolation of Group A Streptococcus

A

Throat Cultures

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9
Q

UPPER RESPIRATORY TRACT SWAB

for diagnosis of pertussis, middle ear infections, carrier state of S. aureus

A

Nasopharyngeal Cultures

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10
Q

SWABS

Gonococcal urethritis, vaginosis, vaginitis

A

Urogenital Swabs

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11
Q

T/F: Swabs should be collected in duplicates

A

T

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12
Q

Preferred for urine collection

A

Clean catch midstream

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13
Q

for diagnosis of lower respiratory tract infections (bacterial pneumonia, PTB)

A

Sputum

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14
Q

SPUTUM

○ Proper collection: _____ ml
○ Expectorated
○ Induced
○ Gastric contents (children)

A

5-10

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15
Q

SPUTUM

○ Collect 2 specimens of sputum
○ Other specimens: transtracheal aspirate, BAL, bronchial washings

A

For Pulmonary Tuberculosis

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16
Q

SPUTUM

Early morning specimen

A

For other infections

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17
Q

T/F: Prior to culture and sputum examination, pre-examine the submitted sputum.

A

T

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18
Q

SPUTUM

Microscopic Examination: Gram Stain Bartlett’s Classification
● ___ leukocytes/LPF
● ___ epithelial cells/LPF

A

> 25
<10

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19
Q

is the specimen of choice for the diagnosis of gastrointestinal pathogens.

A

Stool

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20
Q

T/F: Rectal swabs may be used if stool is present on the swab during sample collection

A

T

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21
Q

○ diagnosis of fever of unknown origin (FUO)
○ Septicemia, Bacteremia, Typhoid Fever, SBE
○ Collection: Venipuncture
○ Aerobic and Anaerobic

A

Blood

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22
Q

T/F: Septicemia, Bacteremia, Typhoid Fever, SBE Collect before and right after fever spike; 2-3 cultures placed an hour apart

A

T

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23
Q

Blood:Media Ratio

A

1:10

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24
Q

BLOOD

● Media of Choice:
● Anticoagulant:

A

Broth (BHI, TSB, Biphasic Media, Thioglycollate Broth)
SPS (0.025-0.030%); other anticoagulants – heparin

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25
● Includes the abdominal fluid, amniotic fluid, ascitic fluid, bile, synovial fluid, pleural fluid, pericardial fluid ● Collected by needle aspiration ● Disinfect the site prior to aspiration
Body Fluids
26
T/F: Body fluids should be placed immediately in culture media
T
27
Use of Gastric Tubes such as Levine and Rehfuss Tubes
Gastric Specimens
28
Diagnosis of Meningitis or Meningoencephalitis
CSF
29
Diagnosis of Meningitis or Meningoencephalitis
CSF
30
Collection for CSF
>/=1ml Lumbar Tap (3rd-4th Lumbar Vertebra)
31
3 sterile tubes for CSF collection
Tube 1 = chemistry and immunology testing. Tube 2 = microbiology testing. Tube 3 = hematology testing.
32
T/F: Aspirates should be placed in a container with tight lid or in an aerobic transport system
F; anaerobic
33
PRESERVATION, STORAGE AND TRANSPORT Ideally and preferably up to how many hours should a specimen be transported?
○ Ideally: 30 minutes ○ Preferably up to 2hours
34
PRESERVATION, STORAGE AND TRANSPORT T/F: If not transported immediately, specimens must be added with preservatives, anticoagulants or placed in transport/culture media
T
35
PRESERVATION, STORAGE AND TRANSPORT Preservatives
○ Boric Acid ○ Refrigeration
36
PRESERVATION, STORAGE AND TRANSPORT maintains viability ○ Cary Blair ○ Stuart’s or Amie’s ○ JEMBEC Media
Transport Media/Holding Media
37
PRESERVATION, STORAGE AND TRANSPORT 0.025% - 0.03% Sodium polyanethol sulfonate (LIQUOID)
Anticoagulants
38
PRESERVATION, STORAGE AND TRANSPORT ● Antiphagocytic, anticomplementary ● May inhibit some antimicrobials (aminoglycosides) ● May inhibit certain bacteria such as Neisseria, Gardnerella vaginalis, Streptobacillus moniliformis and Peptostreptococcus anaerobius
0.025% - 0.03% Sodium polyanethol sulfonate (LIQUOID)
39
STORAGE APPLICATION catheter tips, CSF for viruses, outer ear swab, unpreserved feces and urine, feces (for isolation of Clostridioides difficile toxin), sputum, swabs
Refrigerator temperature (4 degree Celsius)
40
STORAGE APPLICATION CSF for bacteria, abscess, lesion, wound, body fluids, inner ear, preserved urine and stool, nasal specimens, tissues
Ambient/Room temperature (22 degree Celsius)
41
STORAGE APPLICATION CSF
Body temperature (37 degree Celsius)
42
STORAGE APPLICATION Serum for Serology (-20C); long term storage (-70C)
Freezer temperature (-20 or – 70 degree Celsius)
43
SPECIMEN COLLECTION / REJECTION GUIDELINES T/F: Requisition and specimen label must match
T
44
CRITERIA FOR SPECIMEN REJECTION prone to contamination and may dilute out the pathogen because of the normal flora
Twenty-four-hour sputum collections
45
SPECIMEN COLLECTION / REJECTION GUIDELINES T/F: Re-collect specimens that do not meet criteria when possible and whose procedures for collection are not difficult or invasive for the patient
T
46
SPECIMEN COLLECTION / REJECTION GUIDELINES T/F: Document why the specimen was rejected and communicate to the individual who collected the specimen why it was rejected
T
47
SPECIMEN COLLECTION / REJECTION GUIDELINES T/F: Try not to reject specimens that are difficult to collect, such as CSF or surgical biopsies
T
48
SPECIMEN COLLECTION / REJECTION GUIDELINES T/F: Set up cultures when the situation cannot be resolved, do not comment concerns on the report and how the results may be affected
F; comment concerns
49
SPECIMEN COLLECTION / REJECTION GUIDELINES T/F: Communicate to and educate hospital personnel who collect speciments through laboratory directives, manuals, and other forms of communication.
T
50
CRITERIA FOR SPECIMEN REJECTION T/F: One swab for many requests, such as aerobes, anaerobes, and fungi
T
51
CRITERIA FOR SPECIMEN REJECTION may present a biohazard and be contaminated
Leaking containers
52
CRITERIA FOR SPECIMEN REJECTION T/F: ● Nonsterile or contaminated containers ● Culture or agar plates that are overgrown and dry except for specific mycology requests ● Specimens contaminated with dyes, oils, or chemicals ● Formalin in any specimen
R
53
CRITERIA FOR SPECIMEN REJECTION: ANAEROBIC T/F: ● Gastric washes ● Feces, except for Clostridiu difficile and Clostridium perfringes
T
54
CRITERIA FOR SPECIMEN REJECTION: ANAEROBIC T/F: ● Throat, nares, or oropharyngeal specimens ● Most swabs, including superficial skin swabs
T
55
CRITERIA FOR SPECIMEN REJECTION: ANAEROBIC T/F: Midstream urine
T
56
SPECIMEN PRIORITY Amniotic fluid, blood, brain, CSF, heart valve, pericardial fluid
LEVEL 1: Critical/Invasive
57
SPECIMEN PRIORITY Bloody fluids, bone, wound drainage
LEVEL 2: Unpreserved
58
SPECIMEN PRIORITY feces, sputum, tissue
LEVEL 2: Unpreserved
59
SPECIMEN PRIORITY feces, sputum, tissue
LEVEL 2: Unpreserved
60
SPECIMEN PRIORITY heart valve, pericardial fluid
LEVEL 1: Critical/Invasive
61
SPECIMEN PRIORITY Catheter tip, urine, tissue for quantification
LEVEL 3: Quantitation Required
62
SPECIMEN PRIORITY Feces in preservative, urine in preservative, swabs in holding medium
LEVEL 4: Preserved
63
SPECIMEN COLLECTION AND PROCESSING ○ Gross appearance and physical appearance ○ Determine specimen adequacy and quality
Macroscopic Observation
64
SPECIMEN COLLECTION AND PROCESSING ○ Useful and rapid information ○ Specimen Quality ○ Infectious Process Indication ○ Guide
Microscopic Observation
65
Done prior to inoculation ○ Homogenization ○ Concentration ○ Filtration ○ Decontamination ○ Vortex
Specimen Preparation
66
PRIMARY ISOLATION MEDIA Isolation of gram(+) and gram(-) abaerobes
Anaerobic phenylethyl alcohol agar
67
PRIMARY ISOLATION MEDIA Isolation of gram(-) anaerobes
Anaerobic kanamycin-vancomycin agar
68
PRIMARY ISOLATION MEDIA Isolation of Bordetella pertussis
Bordet-Gengou media
69
PRIMARY ISOLATION MEDIA Enrichment used to isolate Legionella
Buffered charcoal yeast extract (BCYE)
70
PRIMARY ISOLATION MEDIA Isolation of Campylobacter; Brucella agar and sheep blood with antibiotics
Campy blood agar
71
PRIMARY ISOLATION MEDIA Enriched, nonselective medium to isolate fastidious organisms, such as Neisseria and Haemophilus
Chocolate agar
72
PRIMARY ISOLATION MEDIA Isolation of Yersinia species
Cefsulodin-Irgasan-novobiocin agar
73
PRIMARY ISOLATION MEDIA Isolation of gram(+) bacteria
Colistin-nalidixic acid agar
74
PRIMARY ISOLATION MEDIA Differential: isolation of gram(-) bacilli and differentiation of lactose fermenters from non-lactose fermenters
Eosin-methylene blue agar
75
PRIMARY ISOLATION MEDIA Differential: isolation of gram(-) bacilli and differentiation of lactose fermenters from non-lactose fermenters
Eosin-methylene blue agar
76
PRIMARY ISOLATION MEDIA Enrichment broth to enhance recovery of stool pathogens and inhibit normal flora coliforms
Gram(-) broth
77
PRIMARY ISOLATION MEDIA Selective: isolation of stool pathogens through inhibition of normal flora coliforms
Hektoen enteric agar
78
PRIMARY ISOLATION MEDIA Primary isolation medium for Mycobacterium
Lowenstein-Jensen
79
INCUBATION CONDITIONS Usual incubation time for most bacteria; AFB
18-24 hours at 37C
80
INCUBATION CONDITIONS Pseudomonas aeruginosa, Campylobacter jejuni
42 C
81
INCUBATION CONDITIONS Listeria monocytogenes and Yersinia enterocolitica
4C (Cold enrichment medium)
82
INCUBATION CONDITIONS Aerobic bacteria eg. P. aeruginosa
Ambient air (21% oxygen)
83
INCUBATION CONDITIONS Anaerobic eg. Fusobacterium, Bacteroides, Clostridium
Use of anaerobic jars such as Gas-Pak, Brewer Jar, Glove Box method, Biobag System
84
INCUBATION CONDITIONS Enterics
Facultative anaerobes
85
INCUBATION CONDITIONS Capnophiles
Capnophiles (growth in 5-10% carbon dioxide; Use of Candle Jar
86
INCUBATION CONDITIONS Microaerophiles eg. Campylobacter jejuni, Helicobacter pylori
Reduced oxygen (5-6%)
87
INCUBATION TIME Aerobic Bacteria
21% Oxygen, 0.03% CO2
88
INCUBATION TIME Anaerobe
0% Oxygen
89
INCUBATION TIME Capnophiles
5-10% CO2; 15% Oxygen
90
INCUBATION TIME Microaerophiles
5-6% Oxygen
91
Critical Results that should be reported immediately
Panic Values

[MT 6320] Clinical Bacteriology Laboratory (15 decks)

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