Specimen collection

A patients guide to taking samples

Your GP or other healthcare professional may ask for a urine sample to aid diagnosis or to rule out certain health problems.  Your GP should provide specific instructions on how to collect the sample and where to deliver it to.

Urine may be used to diagnose

—Urinary tract infection

—Sexually transmitted disease

—Pregnancy

—Various metabolic conditions such as diabetes

Collecting your urine sample

You should:

Collect your urine sample in the container provided by your GP

If you cannot hand it in strait away store in fridge in a sealed plastic bag.

What is a mid-stream urine sample ( MSU)?

A mid-stream urine sample means that you don’t collect the first part of the urine that comes out. This reduces the risk of the sample being contaminated from your hands or from the skin around the urethra 9 the tube that caries the urine out of the body).

—If not already done, label the container with your name and date of birth.

—Wash your hands

—Start to urinate but don’t collect the first part of the urine that comes out.

—Collect a sample of urine (mid-stream) that comes out in the sterile container provided.

—Some types of containers need to be filled to have a minimum volume line.

—Screw the lid of the container shut.

—Wash your hands again thoroughly.

If you can’t hand your sample in within an hour you should keep it in the fridge at around 4 C in a sealed plastic bag for no longer than 24 hours. If the sample is not refridgerated, and kept at room temperature, bacteria in it may multiply and produce an incorrect result.

Different types of container for collecting urine samples. The red topped version contains a substance that stabilises bacterial growth if there is a delay in transport to the laboratory. The brown container is only used for detection of renal TB.

Stool (faeces) specimen.

Your GP or other healthcare professional may ask you for a faeces sample to aid diagnosis in various conditions affecting the bowel. The faeces may contain harmful bacteria or other substances that may affect the digestive system that can be detected in the laboratory. Your GP should provide you with a plastic sealable container and explain how to collect the sample.

A stool sample can be tested to help diagnose.

— Gastroenteritis

— Inflammatory bowel disease such as Crohn’s disease

— Food poisoning.

—Bowel parasites

Collecting a stool sample

— Label the faeces container with your name and date of birth.

— Place something in the toilet to catch the stool such as a clean potty or empty plastic food container. (Note you need to bin this after use).

— Make sure the sample does not touch the inside of the toilet.

— Use a disposable spoon or spatula  to place the faeces inside the container to about one third full, replace the lid a screw securely shut.

— Put anything used to collect the sample inside a plastic bag, tie it up and place in the bin.

— Wash your hands thoroughly with soap and warm running water.

Try not to collect urine or toilet water during this process. Stool samples should be delivered to the GP practice or laboratory as soon as possible and should not be stored for any significant amount of time.

Sputum collection.

Sputum is the phlegm coughed up from your lungs. It is not spit or mucous from the mouth or back of the throat. You’re GP or other health care professional may ask you to produce a sputum specimen to aid diagnosis of the bacteria that may be affecting your lungs in various respiratory diseases:

—Pneumonia

—COPD exacerbations

—Bronchiectasis.

Collecting a sputum sample.

An early morning sputum (i.e. as soon as you wake up) is best, but if not possible sputum can be collected at other times of the day. You’re GP should provide a special container for this specimen collection.

— Rinse mouth out with water (not mouth wash) and remove dentures if present.

— Cough hard to bring up sputum from deep in your lungs (this may take a lot of coughing).

— From the mouth the sputum should go directly into the container provided then screw the top on securely.

— Label the container with your name and date of birth.

— Place container in sealed plastic bag.

— Deliver to GP or laboratory as soon as possible. If there is a delay, the sample can be kept in the fridge for up to 24 hours.

Note your GP may need to take several other specimens to diagnose your respiratory condition. E.g. throat swab, urine or blood.

Vaginal swab and urine for detection of sexually transmitted disease.

Self-collected vaginal swabs, and urine collection, for chlamydia screening is not routine and would only be requested by the Sexual Health department doctors in particular circumstances.

Instructions for self-collection of these tests are provided on the chlamydia testing request form supplied by sexual health department.

Further information on any aspect of sample collection can be obtained from you GP or Walsall Manor Hospital laboratories at 01922 721172  (ext, 6481 or 7127).

Sample Requirement

Where possible use order comm. to request samples using the printed sticker to label specimen.  In addition, please handwrite DATE and TIME of collection on the specimen and the form. Where handwritten forms are used, please provide at least two patient identifying data on the sample label and three patient identifying markers on the form.

When un-dated samples are received, the date of the form will be used as the sample date. Please note that this may result in rejection of samples if the date on the form pre-dates the sample 

Condition or specimen type	Clinical information required	Sample requirement	Sample container
Ear infection	Clinical presentation Recent antimicrobial therapy	Ear swab, middle ear effusion	Swab in charcoal transport media. Fluid in white top universal.
Conjunctivitis	Clinical presentation Recent antimicrobial therapy	Eye swab	Swab in charcoal transport media. Swab in viral transport media if virus suspected. If Chlamydia examination required take two samples- 1.take conjunctival scraping, smear directly on to microscope slide and fix with acetone prior to transport. 2. Inoculate into a unisex swab collection kit Chlamydia testing kits available from the laboratory
Investigation of oral samples	Clinical presentation Recent antimicrobial therapy	Mouth swab	Swab in charcoal transport media
Investigations of nasal samples	Clinical presentation Recent antimicrobial therapy	Nose swab, antral washout, sinus aspirate and sinus washout	Swab in charcoal transport media. Fluid in white top universal.
Whooping cough	Vaccination history Date of onset Severity Recent antimicrobial therapy	Pernasal swab, nasopharyngeal aspirate	Blue top Trans-swab placed in viral transport media or a plain universal Fluid in white top universal Do NOT use the charcoal media supplied. For more information on collection, please click here. NB Culture for Bordetella is being discontinued and replaced by PCR test.
Throat infections, Epiglottitis	Clinical presentation Travel history Date of onset N. meningitidis case or contact Diabetic Recent antimicrobial therapy	Throat swab, posterior pharyngeal swab, nasopharyngeal swab, pharyngeal washings, pus aspirate, oropharyngeal swab	Swab in charcoal transport media.
Skin, Superficial and non-surgical wound infections	Clinical presentation Diabetic Animal bite Give specific description of anatomic site. Recent antimicrobial therapy. Travel history	Skin swab, swab from superficial wound, swab from non-surgical wound	Swab in charcoal transport media.
Fish tank granuloma	Clinical presentation Specific anatomic site Recent antimicrobial therapy	Biopsy, aspirate	Sample in a sterile leak-proof container
Abscess or deep seated infections	Clinical presentation Immunosuppressed Specific anatomic site Recent antimicrobial therapy . Recent travel history	Abscess pus, abscess swab, deep-seated pus swab, post-operative wound swab, wound exudates, tissue, biopsy	sample in sterile leak-proof container Swab in charcoal transport
Biliary infection	Clinical presentation Recent antimicrobial therapy	Bile	Sample in sterile, leak-proof container
Cannula-related infections	Clinical presentation Specific site and type of tip Recent antimicrobial therapy	Line tips eg CVP or Hickman lines, swabs of cannula insertion sites	Sample in sterile, leak-proof container Swab in charcoal transport media
Continuous ambulatory peritoneal dialysis (CAPD) peritonitis	Clinical presentation immunocompromised Recent antimicrobial therapy	CAPD fluid	Sample in sterile leak-proof container
Amnionitis	Clinical presentation immunocompromised Recent antimicrobial therapy	Amniotic fluid	Sample in sterile leak-proof container
Pericarditis	Clinical presentation immunocompromised Recent antimicrobial therapy	Pericardial fluid	Sample in sterile leak-proof container
Peritonitis	Clinical presentation immunocompromised Recent antimicrobial therapy	Ascitic fluid, Peritoneal fluid	Sample in sterile leak-proof container
Pleurisy	Clinical presentation Recent antimicrobial therapy	Pleural fluid	Sample in sterile leak proof container
Septic arthritis	Clinical presentation immunocompromised Recent antimicrobial therapy	synovial (joint) fluid	Sample in sterile leak proof container
Bursitis	Clinical presentation immunocompromised Recent antimicrobial therapy	Bursa fluid	Sample in sterile leak-proof container
Meningitis/encephalitis	Clinical presentation, Immunocompromised Details of recent travel,	CSF, Blood culture, EDTA blood for PCR	Sample in sterile leak-proof container
Sub-arachnoid haemorrhage	Clinical presentation Recent antimicrobial therapy	CSF	Sample in 3 sterile leak-proof containers, labelled 1-3 in order of collection
Vaginal infection (other than STI’s)	Clinical presentation Recent antimicrobial therapy	High vaginal swab (HVS), vaginal discharge, vulval swab, labial swab, cervical swab, endocervical swab, ,genital ulcer swab, aspirates from bartholin’s gland, fallopian tube, tuboovarian abscess, pouch of Douglas fluid, products of conception	Swab in charcoal transport media.
Intrauterine contraceptive devices associated infection	Clinical indications of PID or other inflammatory conditions	IUCD	Sample in a sterile leak-proof container
Infections (other than STIs) of the Male Genital Tract	Clinical presentation Recent antimicrobial therapy	penile swab, urethral swab, semen	Swab in charcoal transport media Samples in a sterile leak-proof container
Herpes simplex	Clinical presentation Date of onset Sample site	Swab from lesion	Swabs in viral transport media
Chlamydia/gonorrhoea detection	Clinical presentation Date of onset Sample site	Urine (male and female accepted) Endocervical, urethral swab. Self-taken vaginal swabs (Chlamydia Screening Programme only)	Urine in Aptima Urine transport tube Endocervical and urethral swabs in Aptima collection swab (white and purple label Self taken swabs in Aptima collection swab (orange label)
MRSA screening		Nose. Groin, axilla swab	Swab in charcoal transport media
Gastroenteritis	Clinical presentation Date of onset Travel history Contacts Recent antimicrobial therapy	Stool sample. NB C.difficile and norovirus will not be tested on formed stools	Sterile leak-proof container
Faecal parasite infections	Date of onset Travel history Contacts	Stool sample on 3 consecutive days	Sterile leak-proof container
Enterobius / threadworm	Symptoms contacts	Moistened plain peri-anal swab broken off into a plain universal or sellotape slide taken on waking, before bathing.	Sterile leak-proof container. Place slide in slide carrier which is available from pathology
Schistosomiasis	Symptoms Travel history	A terminal sample of urine taken between noon and 3pm (preferably after light exercise) to provide the optimum number of ova. Also send 3x stool samples and 7ml clotted blood for EIA	Sterile leak-proof container
Fungal infection – skin, nail and hair	Type of rash Specific anatomic site	Skin scrapings, nail clippings Hair – up to 2 cm hair strand with root attached	Skin scrapings in folded black paper, inside sterile leak-proof container Nail and hair in sterile leak-proof container Hair
Mycobacterium investigation	Clinical presentation Contacts Travel history	Sputum, gastric washing, sterile site body fluids (CSF, pleural fluids etc.), urine, skin or tissue biopsies, bone marrow, broncho-alveolar washings, blood, bone. NB if sending a urine sample, 3 whole early morning urines should be sent	Sterile leak proof container Containers for early morning urine samples are available from pathology Blood should be received in light blue top tube
Urinary tract infection	Relevant clinical details Specimen type Recent antimicrobial therapy	Bag urine, pad urine, catheter urine, prostate massage/secretions, clean catch urine, suprapubic aspirate, cystoscopy urine, ureteric urine, ileal conduit urine, urostomy urine, mid-stream urine, nephrostomy urine	Sterile leak-proof container with/without boric acid
Osteomyletis		Intra-operative samples of bone, bone biopsies, soft tissue, aspirates	Sterile leak-proof container
Prosthetic joint revision	Relevant clinical details Specimen type Recent antimicrobial therapy	Tissue Fluid Swab	Tissue – Sterile leak-proof container containing glass beads Fluid – Sterile leak-proof container Swab – Black topped trans-swab