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Nucleic Acid Amplifiation Test (NAAT AFB2) is performed on the first specimen or by request for subsequent specimens. No smear is performed on blood, bone marrow, stool and urine specimens.Ĭulture performed using 1 liquid (MGIT) and 3 solid (LJ and 7H11 bi-plate) media. AFB smear performed using fluorescence microscopy. NotesĪFB smear and culture isolation from sputum or other clinical specimens. Specimen can be shipped at room temperature or cold, using a cool-pack. If specimen cannot be mailed on the day of collection, keep the specimen refrigerated until the day of shipment. Specimen which leaked in transit is not acceptable.
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<40 mL of urine, unless larger volume cannot be obtained, is not acceptable.īlood collected in EDTA, ACD, or in conventional blood culture bottles and coagulated blood are not acceptable. Urine from catheter bag is not acceptable. Gastric aspirates that haves not been neutralized areis not acceptable.įrozen sputum or stool specimen is not acceptable.Ģ4-hour pooled urine or sputum specimen is not acceptable. Tissue specimens submitted in formalin are not acceptable. Waxed containers may produce false-positive smear results. Samples contained in waxed containers are not acceptable. Swabs are not recommended for the isolation of mycobacteria, since they provide limited material. They are acceptable only if a specimen cannot be collected by other means. Negative results obtained from swab specimens are unreliable. Urine: Collect first morning specimen on 3 consecutive days to provide the best yield. Stool: Collect specimen directly into container, or transfer from bedpan or plastic wrap stretched over toilet bowl. Samples of 5 to 10 mL, adjusted to neutral pH, should be collected on 3 consecutive days. Fasting, early-morning specimens are recommended in order to obtain sputum swallowed during sleep. Gastric lavage: Aspiration of swallowed sputum from the stomach by gastric lavage may be necessary for infants, young children, and the obtunded. Induced sputum: Use sterile hypertonic saline. Avoid sputum contamination with nebulizer reservoir water which may contain saprophytic mycobacteria from tap water. Specify Sputum (Induced) on requisition form, since it may resemble saliva which is not an acceptable specimen.īronchoalveolar lavage (BAL): Avoid contaminating bronchoscope with tap water.Ĭerebrospinal Fluid (CSF): Use maximum volume attainable, ideally at least 2 mL. Have patient rinse mouth with water before collecting sputum to minimize contaminating specimen with food particles, mouthwash, or oral drugs, which may inhibit the growth of mycobacteria. Sputum: Three sputum specimens at 8-24 hour intervals and at least one first-morning specimen. Patients who are suspected of having pulmonary TB based on clinical evaluation and who have received no antituberculosis therapy, <7 days of such therapy, or have not received such therapy in the last 12 months may be evaluated with NAAT. Ship the specimen on the day of collection via airmail or by overnight courier. If blood has to be transported before inoculation of the medium, sodium polyanethol sulfate (SPS), heparin, or citrate may be used as anticoagulants. Stool: = 1 g in sterile, wax-free disposable container.īlood: =5 mL adult =1 mL child. Transfer to a sterile container (without formalin or preservatives).
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Tissue: =10 g or as much as possible with a biopsy. Gastric Aspirates: Must be neutralized (pH 7) with sodium carbonate if transport time exceeds four hours from collection. CSF should be maximum volume obtained, ideally at least 2 mL. Collect the first early morning expectoration in a sterile 50 mL polypropylene centrifuge tube capable of withstanding 3,000 x g (i.e, Falcon, Greiner, etc).īody Fluids or Cerebrospinal Fluid (CSF): As much body fluid as possible is aseptically collected by aspiration or during a surgical procedure. Sputum: >5 mL of unprocessed (raw) sputum. Indicate if patient is a Cystic Fibrosis patient (will require different decontamination), or if sample is environmental (contact laboratory before collection), or veterinary (animal type). Indicate specimen source: BAL, CSF, Sputum, Sputum (induced), Stool, Urine, Tissue (specify), Processed Specimen (specify) or Other Other Body Fluid (specify).