Collection:

Abscess and Wounds: Collect specimen from margin of leading edge of wound.  Specify location of abscess or wound on request

Unacceptable/Rejected Specimens: Specimens on swab.

Blood: Obtain a special Blood Culture bottle for Mycobacterial Isolation (Myco F Lytic) from Microbiology Lab (843-792-5161). These bottles are glass and cannot be transported in the tube system. Collect 3-5 mL blood in tube or bottle.  Only one (1) specimen at a time should be collected.  Collect one (1) specimen per day for three (3) days. 

Unacceptable/Rejected Specimens: Bacterial blood culture bottles, blood collected in any anticoagulant, coagulated blood.

Bone Marrow:  Obtain Bone Marrow Collection Kit from Microbiology (843-792-5161).

Collect 0.5 ml in Mycobacterial (Myco F Lytic) Blood Bottle.

CSF; other CNS fluids (specify):  Specify if CSF shunt fluid on requisition.

Cornea, Corneal scrapings, Corneal lesions, Donor rim, collected by physician:  Inoculate directly to media.  Specify on request whether OS or OD and, if fluid, vitreous or aqueous humor.

Vitreous or Aqueous Humor: Send capped syringe (without needle) or inoculate directly to media. Unacceptable/Rejected Specimens: Syringe with needle.

Gastric Lavage Fluid or Gastric Aspirates : Collect fasting early morning specimens, one on each of three (3) consecutive days, for optimum detection of AFB.  Use sterile saline. Specimen must be neutralized in the Micro Lab within 45 minutes of collection. 

Unacceptable/Rejected Specimens: Specimens more than 1 hour old.

Sputum, Endotracheal or Tracheal Aspirate: Sputum is primarily the specimen of choice for the diagnosis of pulmonary TB. Patients with a productive cough may have 3 specimens collected, one every 8 hours, as long as one of them is an early morning specimen.

If this criteria cannot be met, early morning specimens should be collected on 3 successive days.

Specimens collected within 8 hours may be pooled. AFB techs will notify the patients nurse that specimens have been pooled, the duplicate cancelled and a new specimen outside the 8 hour time frame is needed. 

Sterile Body Fluids : Collect in sterile container. 

Unacceptable/Rejected Specimens : Clotted specimens.  Specimens > 2 hrs old.  Specimens in Bacterial or Mycobacterial blood culture bottles

Stool: Stool unacceptable for AFB culture.

For disseminated Mycobacterium avium-intracellulare (MAC), order AFB Blood Culture.

For Cryptosporidium, order LAB2143 Gastrointestinal (GI) Panel by PCR or order LAB2307 OTHER LAB-MUSC SEND OUT and comment Cryptosporidium Antigen.

For Isospora or Cyclospora, order LAB2143 Gastrointestinal (GI) Panel by PCR or order LAB2307 OTHER LAB-MUSC SEND OUT and comment Parasitiology Stain by Modified Acid Fast.

Tissue or Organ Biopsy (specify source):  Submit tissue in sterile container with small amount of saline or eSwab tube without swab.  ***Remove swab from the eSwab vial*** before adding specimen to the vial.  Select caseous material, if present.   Use Nonbacteriostatic saline. 

Unacceptable/Rejected Specimens: Specimens in bacteriostatic saline, saline with preservatives or formalin; dried-out specimen; specimen more than 2 hrs old.       

Urine (Clean Catch, Catheterized, suprapubic, nephrostomy): Collect three (3) early morning specimens, one each on consecutive days, for optimum detection of AFB.  Collect after proper cleansing of patient. 

Unacceptable/Rejected Specimens: 24 hr pooled specimens; Urine from catheter bag; More than one urine specimen per day, Volume less than 20 ml.