Types & Quality of

Specimen
Group 2
Proper specimen collection and
handling is an integral part of
obtaining a valid and timely
laboratory test result. Specimens
must be obtained in the proper
tubes or containers, correctly
labeled, and then promptly
transported to the laboratory.
 TABLE OF CONTENTS
01 02
Genital Tract Hair, Nails, & Skin

03 04 05
Respiratory Tract Tissue Urine
01.a
Genital Tract
Female Specimen
 Bartholin Cyst
● This is a small fluid-filled sac just
inside the opening of the vagina. This
cyst produces discharge that can be
tested for STI’s or other bacterial
infection.

- Specimen: Aspirate fluid

- Location: Near the vagina and the vulva
- Specimen Appearance: Thick, light
yellow to brown or red discharge
- Container: Anaerobic transport
- Storage: 24 hrs/ RT Figure 1: Anaerobic Transport Media
 Cervix
● Cervical mucus is a fluid produced by
and released from the cervix (the
opening to uterus). Hormones cause
your cervical mucus to change in
texture, volume and color throughout
your menstrual cycle. It can be used
to identify when you are most fertile.
 Cervix
- Specimen: Swab
- Appearance:Sticky, creamy, pasty, watery,
stretchy or slippery.
NOTE:
At the most fertile time, mucus is slippery
and watery. If not fertile, the mucus will be
thick or pasty.
- Odor: Odorless
- Volume: 0.51 mL.
- Container: Stuart’s or Amie’s medium
- Storage: 24hrs/RT Aspirate fluid Figure 2: Cervical Swab for Pap’s smear
 Cul-de-sac
● Also known as pouch of Douglas Specimen:
- Aspirate fluid
exists between behind the vagina, the
Container:
uterus and the rectum, and it is the
- Anaerobic transporter
most dependent area of the pelvis, Storage:
where fluids pool. - 24hrs/RT
● A sample of fluid may be taken and Primary Plating Media:
tested for infection. - BA, CA, Mac, Ana and TM
 Endometrium
● The container must be a anaerobic transporter
● Surgical biopsy or transcervical aspirate via sheathed catheter
● Storage: 24hrs/RT
● Primary Plating Media: BA, CA, Mac, Ana and TM
● Endometrium will show up as a dark line on the screen
● The normal range of thickness varies according to what stage the life in
● Usually 1 to 3 mL of fluid is sufficient to achieve enough separation of
both anterior and posterior endometrial
 Urethra
- A discharge of white or clear mucus may be
evident when first urinating in the morning,
making the urine appear cloudy.
- The same discharge may be noticed on
underclothes. The more severe the infection,
the darker and heavier the discharge.
- The normal range for 24-hour urine volume is
800 to 2,000 milliliters per day (with a normal
fluid intake of about 2 liters per day).
 Urethra
- Swab must be moistened with Stuart’s or
Amie’s medium
- Remove exudate from urethral opening
- Collect discharge by massaging urethra
against pubic symphysis or insert flexible swab
for 2 seconds
- Collect at least 1 hr after patient has urinated
- Storage before Processing: 24hrs/RT
- Primary Plating Media: BA, CA and TM
Figure 3: Urethral Swab for Gram stain
 Vagina
Color & Appearance Importance:
● Normal: White with a flocculent discharge ○ To diagnose infections and complications
● Abnormal: of pregnancy, and for forensic testing in
○ Increased thin, homogeneous sexual assault patients.
white-to-gray discharge often seen ○ Examine for Bacterial vaginosis, especially
in bacterial vaginosis
white blood cells, clue cells, gram (+) rods
○ White “Cottage cheese”- like
indicative of Lactobacillus, and curved,
discharge (Candida infections)
○ Yellow-green, frothy,adherent
gram (-) rods indicative of Mobiluncus
discharge spp.
(T. vaginalis) Container: Swab moistened with Stuart’s or
○ Yellow, opaque cervical discharge Amie’s medium or JEMBEC transport system
(C. trachomatis) Specimen: Swab
● pH: 3.8-4.2 Storage: 24hrs
01.b
Genital Tract
Male Specimen
 Prostate
● This prostatic fluid is slightly alkaline, milky or
white in appearance.
● Those in prostatic fluid have better motility, STORAGE BEFORE PROCESSING:
longer survival, and better protection of - Swab: 24 hrs/RT
genetic material. - Tube: Plate secretions
● Ideally a volume of 25 mL immediately

● Swab must be moistened with Stuart’s or

PRIMARY PLATING MEDIA:
Amie’s medium - BA, CA, Mac,TM, CNA tube
● On a screw-cap tube
● Specimen sample must be on swab or in tube
 Urethra
● Urethral discharge culture is a laboratory test
done on men and boys.
● This test is used to identify germs in the
urethra that may be causing urethritis.
● Urethra is the tube that drains urine from the
bladder.
● A discharge of white or clear mucus may be
evident when first urinating in the morning,
making the urine appear cloudy. The same
discharge may be noticed on underclothes.
The more severe the infection, the darker and
heavier the discharge.
● Swab must be moistened with
Stuart’s or Amie’s medium
Or JEMBEC transport system
● Flexible swab must be insert 2-4 cm
into urethra, rotate for 2 seconds.
● STORAGE BEFORE
PROCESSING:
Swab: 24 hrs/RT
Put JEMBEC at 37 C immediately
on laboratory
● PRIMARY PLATING MEDIA: BA,
CA, TM
 Semen
a. Normal Semen Appearance: Gray-white color,
appears translucent and has a characteristic of musty
odor
b. Volume: Normal semen volume ranges between 2-5
mL
c. Viscosity:
- Pours in droplets
- Refers to the consistency of the fluid and may be
related to specimen liquefaction.
- It should be easily drawn into a pipette and form
small discrete droplets that do not appear Figure 4: Semen Sample
clumped or stringy when falling by gravity from
the pipette
 Semen
NOTE:
-Droplets that form threads longer than 2cm – Considered as
Highly viscous and recorded as ABNORMAL.
-Increased Viscosity & Incomplete liquefaction will IMPEDE
the testing for sperm motility, sperm concentration,
antisperm antibody detection and measurement of
biochemical markers.
Semen Viscosity can be reported as:
- By Ratings 0 to 4 (gel-like)
- Low, Normal or High

D. pH: 7.2 to 8.0 (Normal) Figure 5: Semen’s Viscosity

E. Causes of Rejection: Prolong standing of specimen,
improperly labeled and collected specimen
03.
Hair, Nails or
Skin scrapings
Hair, Nails or
Skin scrapings
● Hair: Collect hair with intact shaft; 4-6 hairs
● Nail:
○ Clipped through the entire thickness of the nail.
○ Crumby material are concentrated on the
- underside of the nail
○ Nails are cut into small thin strips with sterile
scissors
● Skin: Scrape skin at leading edge of lesion
● Primary Media Plating; Sab, IMAcg, Sabcg
04.
Respiratory
Tract
Lower Respiratory Tract
BAL, BB, BW
● Must be placed on a sterile,
screw-top tube
● Anaerobic culture
- appropriate only if sheathed
(protected) catheter used.
STORAGE BEFORE PROCESSING: 24
hrs/4’C
PRIMARY PLATING MEDIA: BA, CA,
MAC
SPUTUM, tracheal aspirate
(suction)
● Sterile, screw-top container
● Have patient brush teeth and then
rinse or gargle with water before
collection
● Have patient collect from deep
cough
● Specimens are thick and contain
mucoid or mucopurulent material.
● Ideally, 3–5 ml in volume, although
smaller quantities are acceptable
if the quality is satisfactory.
Lower Respiratory Tract
Specimens that are used to diagnose lower respiratory tract
infections include expectorated sputum, endotracheal
specimens, translaryngeal aspirates, and bronchoalveolar
lavage.

It is important to obtain deep cough secretions that will yield

productive results. A saline gargle or use of nebulized saline
without disinfectants may enhance the collection.

Collection of the first morning specimen is recommended, as

it will contain more pooled bacteria.
 Upper Respiratory Tract
Nasopharynx Pharynx (throat)

● Swab must be moistened with Stuart’s ● Swab must be moistened with Stuart’s
or Amie’s medium or Amie’s medium
● Insert flexible swab through nose into ● Swab posterior pharynx and tonsils;
interior nasopharynx and rotate for 5 ● Routine culture for group A
seconds Streptococcus (S. pyogenes only)
● Specimen of choice for Bordetella
pertussis TRANSPORTATION TO LABORATORY: Within 24
hrs/RT
TRANSPORTATION TO LABORATORY: Within 24 STORAGE BEFORE PROCESSING: 24 hrs/RT
hrs/RT PRIMARY PLATING MEDIA: BA
STORAGE BEFORE PROCESSING: 24 hrs/RT
PRIMARY PLATING MEDIA: BA, CA
05.
Tissue
 Tissue Specimen
Must be placed on an anaerobic transporter or sterile, screw-cap tube

Skin must be disinfected

Do not allow specimen to dry out; Moisten with sterile, distilled water if not bloody

Volume Requirement: As much as possible; add 2-3 ml sterile saline

TRANSPORTATION TO LABORATORY: Within 24 hrs/RT

STORAGE BEFORE PROCESSING: 24 hrs/RT
PRIMARY PLATING MEDIA: BA, CA, Mac, Ana (thio if indicated)
06.
Urine
 Clean-voided midstream (CVS)

● On a sterile and screw-cap container

- A first morning urine is preferred because it Female
provides a more concentrated specimen - clean area with soap and
water
- The first portion of the urine flow washes
- hold labia apart and
contaminants from the urethra and the begin voiding
midstream portion is more representative of that
in the bladder Male
- The presence of more than 2 species at greater - clean glands with soap
than 10^5 CFU/mL is isolated from urine and water; retract
foreskin
suggests contamination
- A pure culture of E.coli at greater than 10^5
CFU/mL would likely represent true infection
 Storage before Processing: 24hrs/4
degree C
Primary Plating Media: BA and Mac
Optional: Chromogenic agar

● It used to avoid contaminating the

urine sample with bacteria that are
normally present in the urethra and
appear in a voided urine sample.
● It is used for a routine urinalysis, urine
culture, or other urine tests that
require uncontaminated urine for
accurate results.
● It can collect about 2 ounces of urine.
 Straight catheter (in and out)

● On a sterile and screw-cap container

● Clean urethral area with soap and water
● Insert catheter into bladder and allow first 15mL to pass Storage before Processing
then collect the remainder - 24hrs/4 degree C
● Straight catheters are prescribed for men and women
who can use catheters themselves, and who are less Primary Plating Media
prone to infections. Some situations requiring a straight - BA and Mac
catheter could be Overflow Incontinence, paraplegia, or
nerve issues that affect the function of the bladder.
● These catheters generally have 5- and 30-mL balloons
 Indwelling catheter (Foley)

● Must be placed on a sterile, screw-cap container Transportation to

● Disinfect catheter collection port Laboratory
● Aspirate 5-10 ml of urine with needle and syringe - Within 2 hrs/4’C
● Wash the visible part of the catheter and the area
where it enters your body with warm soapy water once Storage before Processing
daily during your shower. Men – you may notice a slight - 24 hrs/4’C
discharge around your catheter where it enters your
penis. In most cases this is a normal bodily discharge Primary Plating Media
from the urethra - BA and Mac
● It is typically inflated with 10 mL of sterile water
 Suprapubic aspirate

● A suprapubic catheter is a tube that goes into your

child’s bladder through the belly. Storage before Processing
● Connect the syringe to the catheter tubing. Slowly push - Plate as soon as
the 10 ml of flush into the bladder. Do not force the flush. received
Pull back slowly on the plunger of the syringe until you
see urine. Primary Plating Media
● Because this is an invasive technique, it is performed - BA, Mac, Ana, Thio
only when absolutely necessary.
 First Morning 24-hour (timed
Random Specimen
Specimen specimen)

● Most ideal for

● Four routine and
routine and
qualitative urinalysis ● For quantitative
pregnancy testing
● Not reliable due to its analysis
● Most concentrated
diurnal variation, ● For electrolytes
and most acidic
physical activity, and
● Best for cast and
dietary intake.
crystal retrieval
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