Lab Information Manual

Laboratory:

Clinical Microbiology

Test Name:

TISSUE BIOPSY/TISSUE ASPIRATE/ABSCESS/ASPIRATE FLUID/BONE, CULTURE, AEROBIC/ANAEROBIC BACTERIA

Test Code: TISS,TIAN,FLU,FLAN,FLDB,CAPD,MIST[ORTH,ORAN,ORFU(SBH only)]

Clinical Information:

Test Indications: Aerobic and anaerobic bacterial culture of aseptically collected fluid or tissue obtained from a normally sterile site is used to help determine whether there is infection at the site, and the pathogen(s) involved. Susceptibility testing performed on recovered pathogens can help guide therapy.

Recommendations: Generally, all organisms growing from a specimen collected from a normally sterile site are reported. Therefore, great care must be taken during specimen collection to ensure the specimen is not contaminated. Whenever possible, send fluid (aspirate) or tissue rather than a swab. The volume of specimen obtained using a swab as the collection device is suboptimal.
Sterile fluids/aspirates should be submitted to the microbiology lab in a 100mL sterile specimen container. Do not send a swab dipped in fluid. Do not submit a fluid/aspirate sample in an eSwab transport tube unless an appropriate sterile container is unavailable. Never transport a fluid specimen in a syringe with a needle attached.
Tissue should be submitted to the microbiology lab in a 100mL sterile specimen container. For small tissue samples, add a few drops of non-bacteriostatic saline to prevent the specimen from drying out, or cover with sterile gauze moistened with sterile saline. Do not send tissue samples to the microbiology lab in an eSwab transport tube unless an appropriate sterile container is unavailable.
Ideally, obtain specimen prior to initiation of antimicrobial therapy. If not possible, indicate antimicrobic therapy on the requisition.
Clearly indicate on the microbiology requisition the specimen site, the specimen type, and the test(s) requested (e.g. bacterial culture-aerobic, bacterial culture–anaerobic). If other tests (e.g. fungal culture, mycobacterial culture) are also indicated based on the clinical presentation of the patient, these may be requested using the same requisition. Refer to the LIM entries on fungal culture and mycobacterial culture for further details pertaining to these tests.
The lab will automatically perform a Gram stain when appropriate. This does not need to be requested on the microbiology requisition.
If molecular detection of bacteria (16S rRNA PCR and sequencing) directly from the sample is requested, please page the microbiologist on-call for approval. It is best to do this at the time of specimen collection.
If there is clinical suspicion of a level 3 pathogen causing infection (e.g. Brucella, Francisella), please notify the lab at the time of specimen collection

Patient Preparation Instructions: The sample must be obtained using aseptic technique. Follow protocols outlined by your healthcare facility for this sample type. Accurate patient identification must be made prior to sample collection. Patient identification should be done in accordance with site policy. Samples and requisitions must be labeled/completed in accordance with the Shared Health Specimen Acceptance Policy.

Collection Devices:

Preferred Device:	1 - Sterile Specimen Container (100 mL) Sterile Specimen Container (100 mL) Manufacturer: Catalogue #:
Alternate Device:	1 - eSwab eSwab Manufacturer: Catalogue #:

Specimens collected with a swab are not optimal. Every effort should be made to send fluid or tissue to the microbiology laboratory, rather than a small amount of sample on a swab.

Specimen Required:

Fluid or tissue obtained from a normally sterile site. This includes all aseptically collected fluids (e.g., abdominal, amniotic, ascites, bile, joint, paracentesis, pericardial, peritoneal, pleural, synovial, and continuous ambulatory peritoneal dialysis [CAPD] fluid) and aseptically collected tissue/biopsy specimens.
Adult and Pediatric:
Tissue - no minimum volume, optimally 1 g or 1 cm3 for surgically collected tissues, at least 5 to 10 mm3 for surgical biopsy specimens
Fluid: ≥1 mL (Bacterial culture - aerobic)
eSwab: one swab is sufficient for aerobic and anaerobic bacterial culture - if additional tests are requested send one swab for each test.
Larger volumes of specimen (fluid, tissue) will yield better results. When the specimen volume is less than required for multiple test requests, prioritization of testing must be provided to the lab. Do not submit whole digits (e.g., toes).
Where local protocol allows, a CAPD bag may be submitted to the laboratory for peritoneal dialysis fluid culture.

Referral:

Requisition:

_SH Microbiology - Provincial Requisition (R250-10-06)

Reference Values:

A descriptive report will be sent. Cultures will be incubated for up to 5 days before being reported as negative.

Availability:

Daily