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Bacte LEC > Spx Collection Prt. 2 > Flashcards

Spx Collection Prt. 2 Flashcards

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1
Q

Upper Respiratory Tract

Spx collection

A

Throat swab
Nasopharyngeal swab / aspirate

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2
Q

PATHOGENS OF THE URT:

A

• Haemophilus influenzae
• Corynebacterium diphtheriae
• Streptococcus pyogenes
• Neisseria gonorrheae

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3
Q

URT

Asymptomatic carriers :

A

• Neisseria meningitidis
• Bordetella pertussis
• Staphylococcus aureus
• Streptococcus pneumoniae
• Moraxella catarrhalis

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4
Q

MEDIA for URT specimen:

A

BAP
CAP
Thayer Martin
Bordet Gengou blood agar

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5
Q

MEDIA for URT spx

S. pyogenes:

H. influenzae:

N. meningitidis:

B. pertussis:

A

BAP

CAP or BAP w/ Staphylococcus

CAP/Thayer Martin

Bordet-Gengou blood agar

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6
Q

Nasopharyngeal or Throat Swab use:
2 Sterile swabs

A

Dacron/ Rayon swab - Synthetic fiber swabs

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7
Q

We do not use what type of swabs?

A

calcium alginate
swabs with wooden shafts

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8
Q

Nasopharyngeal aspirate

Aspiration:
• mucus extractor connected an ….

A

Nasogastric tube

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9
Q

Lower Respiratory Tract Collection

A

• Sputum
• Endotracheal aspirate
• Bronchoalveolar lavage
• Bronchoscopy secretions

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10
Q

PATHOGENS OF THE LRT:

MMySSEekeLP

A

• Mycobacterium spp.
• Mycoplasma spp
• S. pneumoniae
• S. aureus
• Enterobacteriaceae
—-Enterobacter
—-Klebsiella
—-Escherichia
• Legionella spp.
• Pseudomonas aeruginosa

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11
Q

Collection & Transport of SPUTUM

container:

time and consistency:

delivery time:

storage time:

A

• Use a dry, wide-mouth bottle (screw cap)

• Collect sample early morning (purulent)

• Transport ASAP

• may be refrigerated but examined w/in 2-3 hrs

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12
Q

Suitability of Sputum for Culture

Bartlett’s Sputum Classification

A

< 10 epithelial cells
> 25 pus cells

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13
Q

Bartlett’s Classification
Number of neutrophils per low-power field

Fewer than 10
10-25
Greater than 25
Mucus

A

Fewer than 10 – 0

10-25 — +1

Greater than 25 — +25

Mucus — +1

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14
Q

Bartlett’s Classification
Number of epithelial cell per low-power field

10-25
Greater than 25

A

10-25 — -1
Greater than 25 — -2

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15
Q

Bartlett’s Classification

Scores of 0 or less indicate…

A

lack of inflammation or presence of saliva.

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16
Q

PROCEDURE for SPUTUM

A

+ Make a direct smear (GS & AFS)
+ Do digestion & concentration
+ Culture

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17
Q

Sputum

What to add? And why?

digestion & concentration technique

A

N-acetyl-L-cysteine-NaOH (NALC-NaOH)

• dissolve fats & mucus to free bacteria

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18
Q

URINE
Purpose:

A

Diagnosis of UTI

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19
Q

URINE

Method of collection:

A

Clean - catch midstream
Suprapubic aspiration
Cystoscopy or catheterization

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20
Q

URINE

Collection Time:

A

Early morning

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21
Q

URINE

• Processing:

A

Within 1 hour after collection

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22
Q

PROCESSING OF URINE

• GS of uncentrifuged urine

A

= rapid UTI screening

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23
Q

GS of uncentrifuged urine

= numerous squamous cells indicates…

A

(vaginal / urethral contamination)

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24
Q

URINE PROCEDURE FOR CULTURE:
1. Inoculate sample on…

  1. Incubate overnight
    (+) growth
    (-) no growth
A

BAP, EMB, Mac with a 1uL loop

(count colonies)
re-incubate for 24 hrs

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25
Computation for CFU/mL
Actual # of colonies x calibration of loop = # of CFU/mL
26
CFU/mL that indicates infection
>100,000 bacterial CFU/mL
27
POUR PLATE METHOD: • prepare______ dilution of urine w/ sterile H2O • transfer_____ of solution to a Petri dish • add_____ & mix well • incubate for_____ • count colonies & multiply by____ • report result in bacteria/mL
1:1000 1 mL Agar agar 1000
28
CEREBROSPINAL FLUID • Samples should be collected… • Avoid delay because of high mortality rate & rapid proliferation of microbes is associated w/…
before treatment meningitis
29
CSF PATHOGENS
•Streptococcus pneumoniae •Haemophilus influenzae type b •Neisseria meningitidis
30
Cerebrospinal Fluid • Collection:
lumbar puncture L3 & L4
31
CSF • Volume: Adults
0.5 - 5.0 ml 3 tubes
32
CSF 1st tube = 2nd tube = 3rd tube =
Chem / Sero Microbiology (GS & culture) Hematology
33
CSF Processing Macroscopic Examination
• Volume (3-5 mL) • Color • Appearance
34
CSF processing Normal CSF Abnormal CSF
• Clear and colorless • Xanthochromic, bloody, cloudy
35
CSF PROCEDURE: • Centrifuge CSF •_____ CSF on recommended media: • Make a smear for______ •______
(2000 pm for 20 mins) Culture GS and India ink Rapid Antigen Testing (RAT)
36
CSF culture media
Trypticase Soy Broth / thioglycollate BAP for Gram (+) cocci CAP for Gram (-) cocci EMB/Mac for Gram (-) bacilli
37
CSF Transport to LABORATORY ***<1*** Centrifuge at 2000 rpm/ 20 mins. Supernatant: Sediment:
Latex agglutination Gram stain/ CAP & BAP
38
CSF Transport to lab ***>1*** Inoculate______ Incubate overnight_____ Subculture to_____
Trans-Isolate Medium 35C in CO2 CAP & BAP
39
For Delays In CSF Processing • CSF for bacterial culture: Incubate @_______ OR; Stand @________
35° C for not > 12 hrs (6) room T° not > 1 hour
40
CSF for ***BACTERIAL CULTURE*** DO NOT REFRIGERATE! - Some orgs. are sensitive to_____ Such as ____ and _____
low T° N. meningitidis H. influenzae
41
• CSF for ***viral culture:*** ______immediately If held for more than 24 hrs,______ specimen at_____
Refrigerate freeze= -70°C
42
STOOL Freshly collected stool (______stage of a disease) •_____may be used
early Rectal swab
43
STOOL •Gastric aspirate -> •Gastric biopsy ->
AFB Helicobacter pylori
44
STOOL Amount: Container: Transport time: Transport medium:
1-2g Clean, wide mouth with lid 2 hours after collection; 24 hrs @ 4°C Cary Blair
45
STOOL PROCEDURE: Put rectal swab in_____ _____is NOT usually done but helps in identifying possible etiologic agents
enrichment broth (Selenite broth) GS
46
Stool Culture: 1St day Inoculate the specimen and incubate it overnight at_____ 2nd day 1. Check enrichment tube:_____ 2. Check differential media for_____ 3. With growth:_____ 4. No growth:_____ (3rd day) 1. Note patterns of biochemical reactions 2. If suggestive of Salmonella, Shigella, Vibrio, DO______ * From no growth in the 2nd day: If growth occurs after doing step 3 (2nd day, DO______ * Incubate overnight and perform step 1 & 2 of day 3
35°C +/- turbidity LFs & NLFs Subculture in another set of tube & plates and do biochemical tests inoculate culture from enrichment media into EMB or Mac serological typing DO biochemical test
47
Stool Culture MEDIA
Differential (EMB, Mac) Selective (SSA, HEA, XLD) Enrichment (Selenite F, APW)
48
EXUDATES
• Wounds • Eye discharge • Boils • Ear discharge • Abscesses • Endocervical • Ulcers • Urethral • Granules • Anorectal discharge • Rash
49
TRANSUDATES Fluids
• Synovial • Pleural • Pericardial •Peritonial • Hydrocele
50
COLLECTION DISCHARGES / FLUIDS: a. Dry wound - b. Skin lesion -
moisten swab w/ NSS before collecting remove crust of pustule/ vesicle cap then gently swab lesion
51
COLLECTION OF DISCHARGES AND FLUIDS Note: 1. Superficial wounds -> 2. Deep wound ->
collected along the edge of the wound after cleaning with sterile saline needle aspiration
52
COLLECTION FOR DISCHARGES AND FLUIDS c. Endocervical : d. Urethra : e. Anorectal:
use swab use swab or scrape mucosa of anterior urethra insert swab about 4-5 cm. into the anal canal
53
Collection of Irrigation, Intravenous or Intra-arterial Catheters
= use of endoscopic procedures
54
EXUDATES / TRANSUDATES: Collection container + Aspirates: + Ulcerative lesions: + Irrigation, Intravenous + Intra-arterial Catheter tips + Swabs: + Fluids: + Corneal scraping:
Sterile vial biopsy in sterile vial w/o preservatives (sterile vial) 2 pc. in a sterile tube syringe with sterile rubber stopper direct inoculation
55
EXUDATES / TRANSUDATES sport time:
TranASAP (30 mins)
56
EXUDATES / TRANSUDATES: Delay in transport:
• Refrigerate • If swabs, place in TSB or Thioglycollate • Amies or Stuart Transport Medium • SBA slant
57
GENITO-URINARY SPECIMEN SPECIMEN
• Cervical (female) • (Urethral (male) • Rectal (may be paired with throat swabs)
58
GENITO-URINARY SPECIMEN PURPOSE For the determination of:
• STDs • Vaginitis • Urethritis • Childbirth infections
59
Possible Pathogens In Anogenital Specimen:
T. pallidum N. gonorrheae C. trachomatis G. vaginalis C. albicans HSV
60
N. gonorrheae: • GS: • CAP: • Modified Thayer Martin:
G (-) diplococci enriched medium + CO2 selective medium to inhibit NMB
61
Transport Medium For N. gonorrhoeae
@TRANSGROW @JEMBEC SYSTEM

Bacte LEC (51 decks)

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