Aptima Combo 2, Urine:
Collect the first 20-30 mL of the stream. The lab does not want a clean catch. It is recommended that urine be collected at least 1 hour after last urination. Transport specimen in polypropylene containers, which are provided on request.
Bone Marrow
Collect specimen in a heparinized syringe or transfer immediately into a heparinized blood tube. Store and transport to the laboratory at room temperature.
Buffy Coat Cultures
Draw blood into 10 mL EDTA or heparinized tube. Buffy coat cultures should be stored and transported at room temperature.
Cervix Specimen
Clean off vaginal secretions and debris from the cervix. For Viral cultures, swab the exocervix and endocervix. For Chlamydia cultures, swab the endocervix only. Cut or snap off the swab into the transport media vial. Cytobrushes are recommended for collection of endocervicalChlamydia cultures from non-pregnant females. For Aptima Combo 2 specimens, use the small blue swab for collecting all specimens; the large swab is provided only for cleaning the specimen site.
Eyes, Conjunctival Swab (Chlamydia)
Pus accumulated at the inner canthus or the palpebral margin is NOT an adequate specimen. Both eyes should be sampled. For clinical purposes, both specimens may be pooled. Apply traction to the lower eyelid to pull the mucosa away from the globe. If the infant is crying, a piece of tissue paper on the lid will provide better traction. Hold a flexible wire shafted swab about 2 cm. from the end used to sample the conjunctiva. Hold the swab vertically. Press the swab to the lower conjunctival sac. Vigorously rub the mucosal surface of the lower palpebral conjunctiva with the swab. If Chlamydia is present, slight bleeding may occur. Cut swabs off into the transport media.
Fluid Specimen
For viral cultures, fluid specimens should be collected into sterile containers, without dilution in Viral Transport Media. For CSF’s, submit a minimum volume of 1 mL for viral culture. For body fluids, submit a minimum of 5 mL for viral culture. For Chlamydia culture, however, fluid specimens should be pelleted in a high-speed centrifuge within 2 hours of collection and the pellet transferred into Chlamydia Transport Media, M4 or M5. If no centrifuge is available, transfer up to 0.5 mL of the specimen to transport medium.
Lesion Swab
Open vesicular-pustular lesions and vigorously rub the base to dislodge infected cells. Break off the swab into the transport media vial.
Nasal Wash (Optimal Specimen for RSV)
Suction the patient if there is mucous in his/her nose. Place a mucous trap “in line” in the suction tubing and rapidly instill sterile saline into the nare. Immediately suction tubing and rapidly instill sterile saline into the nare aspirate with a suction catheter. As an alternative, squirt sterile saline into one nostril and suction back out immediately. Squirt the solution and mucous back into a sterile leak-proof container. Do not use Viral Transport Media (which contains penicillin) to collect nasal washes. Nasal wash specimens are not acceptable for Chlamydia culture.
Nasopharyngeal (NP) Swab
Insert the swab through the nostril into the posterior nasopharynx, rotate the swab when removing it. Cut swab off into the transport media. Nasopharyngeal swabs can be pooled in the same transport media vial with a throat swab. Sample both sides of the nasopharynx for Chlamydia culture.
Rectal Swab
For viral specimens, gently insert swab into rectum to dirty the swab; break off the swab into Viral Transport Medium. For Chlamydia specimens, clean the rectum of stool, then insert a second swab and gently rotate it within the rectum; break it off into Chlamydia Transport Medium M4 or M5.
Throat Swab
Rub dry sterile swab over posterior pharynx or both tonsillar fossae. Break swab off into the transport media.
Urethral Specimen (Chlamydia)
Remove any external urethral discharge with a large swab or sterile gauze. For females, insert a wire shafted swab 1 to 2 cm. into the urethra and gently rotate several times; for males, insert a wire shafted swab 3 to 4 cm. into the urethra. Withdraw and cut or snap off the swab into the transport media vial. For Aptima Combo 2 specimens, use the small blue swab for collecting all specimens; the large swab is provided only for cleaning the specimen site.