Microbiologic specimens may be collected from many sources, such as blood, tissue, pus or wound exudates or drainage, urine, sputum, feces, genital discharges or secretions, cerebrospinal fluid (CSF), and eye or ear drainage. During specimen collection, these general procedures should be followed:

1. Label specimens properly with the following information (institutional requirements may vary):

   1. Patient’s name, age, gender, address, hospital identification number, and healthcare provider’s full name

   2. Specimen source (e.g., throat, conjunctiva)

   3. Date and time of collection

   4. Specific studies ordered

2. Include specific information in the patient’s medical record:

   1. Clinical diagnosis; suspected microorganisms

   2. Patient’s history

   3. Patient’s immune status

   4. Previous and current infections

   5. Previous or current antibiotic therapy

   6. Isolation status (e.g., contact, respiratory, wound)

   7. Other information pertinent to testing

3. Avoid contaminating the specimen; maintain aseptic or sterile technique as required:

   1. Special supplies may be required:

      1. For anaerobes, sterile syringe aspiration of pus or other bodily fluid

      2. Anaerobic transport containers for tissue specimens

   2. Sterile specimen containers

   3. Precautions to take during specimen collection include:

      1. Observe standard precautions.

      2. Take care to maintain cleanliness outside container surfaces.

      3. Use appropriately fitting covers or plugs for specimen tubes and bottles.

      4. Replace sterile plugs and caps that have been contaminated.

4. Ensure the preservation of specimens by delivering them promptly to the laboratory. Many specimens may be refrigerated (not frozen) for a few hours without any adverse effects. Note the following exceptions:

   1. Urine culture samples must be refrigerated unless a preservative that allows for short-term storage at room temperature is used.

   2. CSF specimens should be transported to the laboratory as soon as possible. If this is problematic, the culture should be incubated (meningococci do not withstand refrigeration). Both culture bottles must be maintained at room temperature prior to being placed in the analyzer.

   3. Blood culture bottles must be maintained at room temperature.

5. Transport specimens quickly to the laboratory to prevent desiccation of the specimen and death of the microorganisms.

   1. For anaerobic cultures, no more than 10 minutes should elapse between time of collection and culture. Anaerobic specimens should always be placed into an anaerobic transport container.

   2. Feces suspected of harboring Salmonella or Shigella organisms should be placed in a special transport medium, such as Cary-Blair, if culturing of the specimen will be delayed longer than 30 minutes.

6. Ensure that specimen quantity is adequate. With few exceptions, the quantity of the specimen should be as large as possible. When only a small quantity is available, swabs should be moistened with sterile saline just before collection, especially for nasopharyngeal cultures.

7. Handle specimen collection the following way:

   1. Submit entire fluid specimen collected. Do not submit fluids on swabs.

   2. Whenever possible, specimens should be collected before antibiotic regimens are instituted; for example, complete all blood culture sampling before starting antibiotic therapy.