Specimen Requirements

Submit only 1 of the following specimens:

Spinal Fluid
1. Submit 2 mL of spinal fluid (from third vial drawn in a series of 3) in a screw-capped, sterile vial.
2. Label vial with patient’s full name (first, last, and middle initial), medical record number (if available), date and time of collection, location of patient, type of specimen, and order in which vials were drawn.

3. Send specimen refrigerated. Maintain sterility and forward promptly.

Note:  1. See “Microbiology” in “Special Instructions” for further information.

2. Specimen source is required on request form for processing.

Sputum
Expectorated
1. Collect an early-morning specimen (minimum volume:  5 mL) on at least 3 consecutive days (1 per day) in a screw-capped, sterile container as follows:
A. Have patient remove dentures.

B. Instruct patient to brush his/her teeth and/or rinse mouth well with water to minimize contaminating specimen with food particles, mouthwash, or oral drugs which may inhibit growth of mycobacteria.

C. Instruct patient to take a deep breath, hold it momentarily, then cough deeply and vigorously into container and collect 2 mL of discharged material. (Nasal secretion, saliva, or 24-hour collection is not acceptable.)
2. Label container with patient’s full name (first, last, and middle initial), medical record number (if available), date and time of collection, location of patient, and type of specimen.
3. Send specimen refrigerated. Maintain sterility and forward promptly.

Note:  1. See “Microbiology” in “Special Instructions” for further information.

2. Specimen source is required on request form for processing.

Induced
1. Collect an early-morning specimen (minimum volume:  5 mL) on at least 3 consecutive days (1 per day) in a screw-capped, sterile container as follows:
A. Induce cough by inhalation of sterile, hypertonic saline, and collect expectorated material.
2. Label container with patient’s full name (first, last, and middle initial), medical record number (if available), date and time of collection, location of patient, and type of specimen.
3. Send specimen refrigerated. Maintain sterility and forward promptly.

Note:  1. Avoid sputum contamination with nebulizer reservoir water.
2. Saprophytic mycobacteria in tap water may produce false-positive culture or smear results.
3. Indicate on request form if specimen is induced sputum, as these watery specimens resemble saliva and risk rejection as inadequate.

4. See “Microbiology” in “Special Instructions” for further information.

5. Specimen source is required on request form for processing.

Tissue
1. Aseptically collect tissue by surgical excision.
2. Submit specimen in a small quantity of saline in a screw-capped, sterile transport vial.
3. Label vial with patient’s full name (first, last, and middle initial), medical record number (if available), date and time of collection, location of patient, and type of specimen.
4. Send specimen refrigerated. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Urine
10 mL to 50 mL of urine from a first-morning specimen passed on 3 consecutive days. Collect specimen as follows:

Catheterized
1. Avoid sending urine that has remained stagnant in catheter tubing for any length of time; do not send catheter bag urine; and avoid sending urine from catheters that have been in place longer than 5 to 9 days.
2. Clean catheter with an alcohol sponge, puncture with sterile needle, and collect in sterile syringe.
3. Transfer urine into a sterile urine container. Mix well.
4. Label container with patient’s full name (first, last, and middle initial), medical record number (if available), date and time of collection, location of patient, and type of specimen.
5. Send specimen refrigerated. Maintain sterility and forward promptly.

Note:  1. See “Microbiology” in “Special Instructions” for further information.

2. Specimen source is required on request form for processing.

Clean-Catch, Midstream
1. Prepare patient for a clean-catch, midstream urine specimen. (24-Hour urine specimen is not acceptable.)

2. After first few teaspoons, place screw-capped, sterile container under stream of urine and collect rest of urine in container. Even 1/4 cup is an adequate specimen for testing.
3. After finishing, tighten cap on container securely and wash any spilled urine from outside of container.
4. Label container with patient’s full name (first, last, and middle initial), medical record number (if available), date and time of collection, location of patient, and type of specimen.
5. Send specimen refrigerated. Maintain sterility and forward promptly.

Note:  1. Follow instructions in “Urine Collection” in “Special Instructions” for clean-catch, midstream specimens.

2. See “Microbiology” in “Special Instructions” for further information.

3. Specimen source is required on request form for processing.