Geisinger Medical Laboratories
Microbiology Specimen Collection Instructions

MOLECULAR INFECTIOUS DISEASE SPECIMEN COLLECTION

I.    CHLAMYDIATRACHOMATIS/NEISSERIA GONORRHOEAE/TRICHOMONAS VAGINALIS
        (endocervical,vaginal, male urethral, female/male urine)

NOTE: Gen-Probe DNA Amplified Molecular test for C. trachomatis/N. gonorrhoeae and Trichomonas vaginalis is not FDA cleared for testing on prepubescent patients (<14 years) or on known cases of sexual abuse. Cultures for C. trachomatis/N. gonorrhoeae and Trichomonas are indicated in these cases.

A. Collection Kits

  1. APTIMA ® Unisex Swab Collection Kit (endocervical/male urethral)
  2. APTIMA ® Urine Specimen Collection Kit
  3. APTIMA® Vaginal Swab Specimen Collection Kit
  4. Sterile Urine Collection Cup

B.  Collection of Endocervical Specimens

  1. Remove excess mucus from cervical os and surrounding mucosa using the cleaning swab (white-shaft swab in package with red  print) provided in the unisex swab collection kit. Discard the cleaning swab.
  2. Insert the specimen collection swab (blue-shaft swab in package with green print) provided in the  APTIMA® Unisex Swab Collection Kit 1-1.5 cm into endocervical canal.
  3. Gently rotate swab for 30 seconds in endocervical canal to ensure adequate sampling.
  4. Carefully withdraw swab, avoiding any contact with the vaginal mucosa.
  5. IMMEDIATELY place the specimen swab (blue-shaft swab only) into an appropriately labeled APTIMA ® Unisex Swab transport media tube.
  6. Snap off the swab shaft at the score line or cut shaft to fit tube.  Avoid splashing of contents.
  7. Cap tube.
  8. Store and transport at room temperature (2-30°C is acceptable).

Endocervical Specimen Collection

 

C.     Male Urethral Specimen

NOTE: Patient should not have urinated for at least one hour prior to sample collection.
    1. Insert the specimen collection swab (blue-shaft swab in package with green print) provided in the APTIMA® Unisex Swab Collection Kit  2-4 cm into urethra.
    2. Once inserted, rotate swab gently at least one full rotation using sufficient pressure to ensure swab comes into contact with all urethral surfaces. Allow swab to remain inserted for two to three seconds.
    3. Carefully withdraw swab.
    4. IMMEDIATELY place the specimen swab (blue-shaft swab only) into an appropriately labeled APTIMA® Unisex Swab Collection Kit transport media tube.
    5. Snap off the swab shaft at the score line or cut shaft to fit tube.  Avoid splashing of contents.
    6. Cap tube.
    7. Store and transport at room temperature (2-30°C is acceptable).

Collection of Male Urethral Specimens

D. Collection of Urine Specimens

  1. General Guidelines
    1. Do not urinate for one hour prior to providing specimen.
    2. 20-30 ml of first-voided urine is the specimen of choice.
    3. Minimum of 2 ml of urine is required.
    4. Do not collect the specimen by catheterization
    5. Females, do not cleanse the labial area prior to providing specimen.
  2. Collect the specimen in an appropriately labeled sterile urine collection cup, free of preservatives.
  3. Transfer 2 ml of the urine specimen to the APTIMA ® Urine Collection Tube.  The correct volume of urine has been added when the fluid level is between the black lines on the collection tube.  Do not submit overfilled or underfilled.
  4. Recap the urine collection tube. 
  5. Store the specimen and transport it to the laboratory at room temperature (2-30°C is acceptable).
NOTE: When the APTIM ® Urine Collection Kit is not available, collect the urine specimen in an appropriately labeled sterile urine collection cup, free of preservatives.  Store the specimen and transport it to the testing laboratory at room temperature (2-30°C is acceptable).  The specimen must reach the testing laboratory within 24 hours of collection.

E. Collection of Vaginal Specimens

  1. Hold the specimen collection swab (pink-shaft swab in package with pink print), placing your thumb and forefinger in the middle of the swab shaft.
  2. Carefully insert the swab into the vagina about 2 inches past the introitus and gently rotate the swab for 10 to 30 second. Make sure the swab touches the walls of the vagina so that moisture is absorbed by the swab.
  3. Withdraw the swab without touching the skin.
  4. IMMEDIATELY place the swab into the APTIMA® Vaginal Swab Specimen Collection Kit transport tube so that the tip of the swab is visible below the tube label.
  5. Carefully break the swab shaft against the side of the tube. DO NOT spill the contents of the tube.
  6. Cap tube.
  7. Store and transport at room temperature (2-30° is acceptable).
NOTE: The APTIMA® Vaginal Swab Specimen Collection Kit is the only Collection Kit approved for vaginal specimens.

II. COVID-19 SPECIMENS

III.    GROUP A STREPTOCOCCUS (throat)

    NOTE: Throat specimens are the only specimen approved for testing. Collect the specimen using approved swab transport systems 

A. Collection Swabs

    1. Group A Strep Combo Swab
    2. ESwab

B. Procedure

    1. Group A Strep Combo Swab (Rapid strep with confirmatory PCR)
      1. Remove swabs from the combo kit.
      2. Swab posterior pharynx including any visible lesions and/or irritated areas using both swabs. Swab both sides of throat.
      3. Removed flocked swab (white shaft with red score) from the blue cap. IMMEDIATELY place in properly labeled ESwab collection/transport tube, breaking off at scored red line. Tightly screw white cap to prevent leakage during transport.
      4. Return remaining Dacron swab (with tinted shaft) to the properly labeled collection/transport tube. NOTE: Use this swab for rapid strep testing.
      5. Store and transport at room temperature.
    2. ESwab (PCR testing only - no rapid test requested)
      1. Remove swab from package.
      2. Swab posterior pharynx including any visible lesions and/or irritated areas using both swabs. Swab both sides of throat.
      3. IMMEDIATELY place in properly labeled ESwab collection/transport tube, breaking off at scored red line. Tightly screw white cap to prevent leakage during transport.
      4. Store and transport at room temperature. Referigerated specimens are also acceptable.

IV.      GROUP B STREPTOCOCCUS (vaginal/rectal, vaginal and rectal)

A. Collection Swabs

  1. Molecular Testing Swab
  2. BBL Liquid Stuart Culture Swab
  3. Liquid Stuart Copan Transystem
  4. Liquid Stuart Copan Venturi System
  5. Liquid Stuart HealthLink Transporter
NOTE: This assay includes both the culture of the vaginal/rectal swab specimen in LIM Broth followed by real-time PCR

B. Procedure

  1. Insert one molecular testing swab into the distal third of the vagina and sample secretions from the mucosa.
  2. Rotate the molecular testing swab for 30 seconds to ensure adequate sampling.
  3. Carefully withdraw the molecular testing swab and place into appropriately labeled transport container.
  4. Insert second molecular testing swab approximate 2.5 cm beyond the anal/rectal sphincter.
  5. Gently rotate at least one full turn to sample anal crypts.
  6. Carefully withdraw the molecular testing swab and IMMEDIATELY place into above labeled transport container.
  7. Store and transport at room temperature (15-25°C).

V.    HUMAN PAPILLOMA VIRUS - HPV (cervical scraping/biopsy)

A. Collection Using SurePath Preservative Fluid (ThinLayer)

    NOTE: This collection device is for the PrepStain Pap ThinLayer Smear and HPV molecular testing.
    1. Collect the cervical sample according to the Pap smear guidelines using the broom-like collection device provided.
    2. Using the thumb and forefinger of a gloved hand, disconnect the head of the device from the handle and IMMEDIATELY insert the head into the appropriately labeled collection vial. Do not touch head of device. Discard handle.
    3. Tightly cap the vial and shake.
    4. Store and transport at room temperature (15-25°C).

B.   Collection Using Cytyc PreservCyt Collection (ThinPrep)

      NOTE:  This collection device is for the ThinPrep Pap Smear and HPV molecular testing.
    1. Collect the cervical sample according to the Pap smear guidelines using the broom-like collection device provided.
    2. Separate the broom part of the device from the handle by pulling apart, leaving the broom in the appropriately labeled collection device.
    3. Tightly cap the vial and shake.
    4. Store and transport the specimen at room temperature (15-25°C).

VI.    MRSA SCREEN, PCR

A. Collection Swabs

  1. Molecular Testing Swab (preferred).
  2. BBL Culture Swab Liquid Stuart.
  3. Copan Transystem Liquid Stuart.
  4. Copan Venturi Transystem Liquid Stuart.
  5. BBL Culture Swab Liquid Amies
  6. Copan Venturi Liquid Amies

B. Procedure

  1. Using an appropriately labeled swab, insert paired swab approximately 1/2 inch into nostril. Rotate swab against inside of nostril for 3 seconds.
  2. Apply light pressure on the outside of the nose while rotating swab.
  3. Repeat for other nostril with same paired swab.
  4. IMMEDIATELY return both swabs to same transport tube and submit to lab at room temperature (2-28°C) is acceptable.

VII.    STAPH AUREUS, PCR

A. Collection Swabs

  1. Molecular Testing Swab (preferred).
  2. BBL Culture Swab Liquid Stuart.
  3. Copan Venturi Transystem Liquid Stuart.

B. Procedure

  1. Using an appropriately labeled swab transport device, insert paired swabs approximately 1/2 inch into nostril. Rotate swabs against inside of nostril for 3 seconds.
  2. Apply light pressure on the outside of the nose while rotating swabs.
  3. Repeat for other nostril with same paired swabs.
  4. IMMEDIATELY return both swabs to same transportdeviceand submit to lab at room temperature (2-28°C) is acceptable.

VIII.   HERPES SIMPLEX VIRUS - PCR

A. Collection of CSF

  1. Aseptically collect CSF and IMMEIDATELY place into appropriate sterile tubes.
  2. Transport 1 mL of CSF to laboratory on ice at 2-8°C.

Revised: 8/23/2018

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