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 typeClinical information requiredSample requirementSample container
Ear infectionClinical presentation

Recent antimicrobial therapy

Ear swab, middle ear effusionSwab in charcoal transport media. Fluid in white top universal.
ConjunctivitisClinical presentation

Recent antimicrobial therapy

Eye swabSwab 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 samplesClinical presentation

Recent antimicrobial therapy

Mouth swabSwab in charcoal transport media
Investigations of nasal samplesClinical presentation

Recent antimicrobial therapy

Nose swab, antral washout, sinus aspirate and sinus washoutSwab in charcoal transport media. Fluid in white top universal.
Whooping coughVaccination history

Date of onset

Severity

Recent antimicrobial therapy

Pernasal swab, nasopharyngeal aspirateBlue 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, EpiglottitisClinical 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 swabSwab in charcoal transport media.
Skin, Superficial and non-surgical wound infectionsClinical 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 woundSwab in charcoal transport media.
Fish tank granulomaClinical presentation

Specific anatomic site

Recent antimicrobial therapy

Biopsy, aspirateSample in a sterile leak-proof container
Abscess or deep seated infectionsClinical 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, biopsysample in sterile leak-proof container

Swab in charcoal transport

Biliary infectionClinical presentation

Recent antimicrobial therapy

BileSample in sterile, leak-proof container
Cannula-related infectionsClinical presentation

Specific site and type of tip

Recent antimicrobial therapy

Line tips eg CVP or Hickman lines, swabs of cannula insertion sitesSample in sterile, leak-proof container

Swab in charcoal transport media

Continuous ambulatory peritoneal dialysis (CAPD) peritonitisClinical presentation

immunocompromised

Recent antimicrobial therapy

CAPD fluidSample in sterile leak-proof container
AmnionitisClinical presentation

immunocompromised

Recent antimicrobial therapy

Amniotic fluidSample in sterile leak-proof container
PericarditisClinical presentation

immunocompromised

Recent antimicrobial therapy

Pericardial fluidSample in sterile leak-proof container
PeritonitisClinical presentation

immunocompromised

Recent antimicrobial therapy

Ascitic fluid, Peritoneal fluidSample in sterile leak-proof container
PleurisyClinical presentation

Recent antimicrobial therapy

Pleural fluidSample in sterile leak proof container
Septic arthritisClinical presentation

immunocompromised

Recent antimicrobial therapy

synovial (joint) fluidSample in sterile leak proof container
BursitisClinical presentation

immunocompromised

Recent antimicrobial therapy

Bursa fluidSample in sterile leak-proof container
Meningitis/encephalitisClinical presentation,

Immunocompromised

Details of recent travel,

CSF, Blood culture, EDTA blood for PCRSample in sterile leak-proof container
Sub-arachnoid haemorrhageClinical presentation

Recent antimicrobial therapy

CSFSample 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 conceptionSwab in charcoal transport media.
Intrauterine contraceptive devices associated infectionClinical indications of PID or other inflammatory conditionsIUCDSample in a sterile leak-proof container
Infections (other than STIs) of the Male Genital TractClinical presentation

Recent antimicrobial therapy

penile swab, urethral swab, semenSwab in charcoal transport media

Samples in a sterile leak-proof container

Herpes simplexClinical presentation

Date of onset

Sample site

Swab from lesionSwabs in viral transport media
Chlamydia/gonorrhoea detectionClinical 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 screeningNose. Groin, axilla swabSwab in charcoal transport media
GastroenteritisClinical 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 infectionsDate of onset

Travel history

Contacts

Stool sample on 3 consecutive daysSterile leak-proof container
Enterobius / threadwormSymptoms

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

SchistosomiasisSymptoms

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 hairType 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 investigationClinical 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 sentSterile leak proof container

Containers for early morning urine samples are available from pathology

Blood should be received in light blue top tube

Urinary tract infectionRelevant 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 urineSterile leak-proof container with/without boric acid
OsteomyletisIntra-operative samples of bone, bone biopsies, soft tissue, aspiratesSterile leak-proof container
Prosthetic joint revisionRelevant 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