ObtainingSpecimensforMicrobiologicalEvaluation.pptVIP

Obtaining Specimens for Microbiological Evaluation IPM-2 Bacteremia I Most bacteremias are intermittent One blood culture is rarely sufficient Staphylococcus epidermidis Frequent contaminant Commonest cause of PVE Two blood cultures usually sufficient Three or four if suspect likely contaminant Antibiotic therapy Blood Cultures - Volume Blood Cultures - Lab Aspects Additives (SPS, resins) increase yield Aerobic and anaerobic bottle = one blood culture Five days incubation sufficient Exception: Brucella, Histoplasma, Mycobacterium, Bartonella, Legionella Automated Systems detect CO2 Subculture detected bottles Aerobic/Anaerobic Blood Culture Bottles AFB Blood Culture Bottle Obtaining Blood Culture Locate the vein Prep kit Alcohol 5 sec. Dry 30-60 sec Tincture of Iodine-center to periphery. Dry 45-60 sec Remove caps, clean with alcohol Put on gloves Without palpating, draw 20 ml and put 10 in anaerobic and 10 in aerobic bottle Dispose of syringe in sharps container Label bottles and send to lab Blood Culture Prep Kit Sputum Culture Reliability Expectorated unreliable because of contamination Reliability ? if physician observes Laboratory reliability screen 25 PMN’s, 10 oral squamous cells per hpf Sputum Container Sputum Gram stain Useful for immediate therapy May be more reliable than culture Many PMN’s with single bacterial morphology AFB - first morning specimen Pneumocystis carinii - induced specimen Nasal Cultures Virus Use wire swab Place in nose 1-3 cm, rotate, 10-15 sec Obtain viral transport medium from lab Bacterial Culturette with rigid or wire swab Suspect pertussis - special media Wire Swab Throat Cultures For Group A strept, diphtheria, gonorrhea Tongue blade - visualize pharynx and tonsils Rub swab over tonsils and pharynx INCLUDE ANY EXUDATE Insert into holder, crush vial Swabs for Bacterial (red) and Viral (green) Cultures Cerebrospinal Fluid Use sterile technique First or second tube to Microbiology Studies Gram stain - one drop cloudy fluid or