Sample collection from the

patient
By Dr Sehr
 Learning objectives
Demonstrate the precautions for collecting blood sample aseptically.
Demonstrate the methods to collect the throat swab from the patient
suffering from upper respiratory tract infections.
Demonstrate the steps for collecting the skin scrapping sample.
Phlebotomists
• Phlebotomists are people trained to draw blood from a patient
(mostly from veins) for clinical or medical testing, transfusions,
donations, or research. 

• Phlebotomists collect blood primarily by performing venipunctures

(or, for collection of minute quantities of blood, finger sticks)
 BLOOD CULTURE
• “…the laboratory detection of bacteremia remains one of the most
important functions of clinical microbiology laboratories.
• A positive blood culture establishes or confirms that there is an
infectious etiology of the patient’s illness.
• Moreover, it provides the etiologic agent and allows antibiotic
susceptibility testing for optimization of therapy.”
 BLOOD C/S
• A blood culture test helps your doctor figure out if you have a kind of infection
that is in your bloodstream and can affect your entire body.
• Doctors call this a systemic infection. The test checks a sample of your blood for
bacteria or yeast that might be causing the infection

• Blood cultures were pioneered in the early 20th century.

• The laboratory detection of bacteremia using blood cultures is one of
the most simple and commonly used investigations to establish the
etiology of bloodstream infections.

• Rapid, accurate identification of the bacteria causing bloodstream

infections provides vital clinical information required to diagnose and
treat sepsis.

• Sepsis is a complex inflammatory process that is largely under-

recognized as a major cause of morbidity and mortality world.
 What Happens During the Test?
• A nurse or a phlebotomist (a medical technician who takes blood) will
clean your skin and insert a thin needle into your vein to draw your
blood. The process will be repeated using another vein to get the most
accurate results.

• Blood is obtained by inserting a needle into a vein in the arm. The

phlebotomist will put the blood into two culture bottles containing
broth for aerobic and anaerobic organisms to grow microbes. These
two bottles constitute one blood culture set.
• A common medium used for anaerobes is thioglycollate broth
What Happens During the Test?
• A second set of blood cultures should be collected from a
different site, immediately after the first venipuncture. A single
blood culture may be collected from children since they often
have high numbers of bacteria present in their blood when
they have an infection.

• For infants and young children, the quantity of each blood

sample will be smaller and appropriate for their body size.
 What Happens During the Test?
• You may be able to get early results within 24 hours of your
blood tests. But you might need to wait 48 to 72 hours to learn
what kind of microorganism is causing your infection. You
might need other tests, too.
• For blood cultures, multiple blood samples are usually
collected for testing and from different veins to increase the
likelihood of detecting the bacteria that may be present in
small numbers and/or may enter the blood intermittently.

• This is also done to help ensure that any bacteria detected are
the ones causing the infection and are not contaminants.
WHAT VOLUME OF BLOOD SHOULD BE
COLLECTED?
• The volume of blood that is obtained for each blood culture set
is the most significant variable in recovering microorganisms
from patients with bloodstream infections
• Blood culture bottles are designed to accommodate the
recommended bloodto-broth ratio (1:5 to 1:10) with optimal
blood volume.
• Commercial continuously monitoring blood culture systems
may use a smaller blood-to-broth ratio (< 1:5) due to the
addition of sodium polyanetholesulfonate (SPS) which
inactivates inhibitory substances which are present in blood.
 INFORM PATIENT THAT:
• Blood cultures are incubated for several days before being reported as
negative. Some types of bacteria and fungi grow more slowly than
others and/or may take longer to detect if initially present in low
numbers.

• The usual risks of venipuncture and the occurrence of false positive

results approximately 3%+ of the time, can lead to inappropriate
treatment
 ANTIBIOTC SENSITIVITY TESTING
• When a blood culture is positive, the specific microbe
causing the infection is identified and 
susceptibility testing is performed to inform the
healthcare practitioner which antibiotics are most
likely to be effective for treatment
 WHAT IF I CAN’T COUGH UP
ENOUGH?
• A technician might be able to induce some sputum if you can’t do it on
your own.
• If you still can’t cough up enough sputum, your doctor might have to
use an instrument called a “bronchoscope” to collect a sample.
• The device has a light and a tiny camera. Your doctor gently inserts it
down your windpipe to locate a sample. You’ll be given drugs to relax
you while this happens, but you may be hoarse and have a sore throat
 afterward.
• There is a small chance of bleeding, getting a fever or pneumonia, or
having a collapsed lung during this process.
 THROAT / EAR SWAB C/S
• A throat swab culture, or throat culture, is a test commonly used to
diagnose bacterial infections in the throat.
• These infections can include strep throat, pneumonia, tonsillitis,
whooping cough, and meningitis.
 How Is a Throat Swab Culture Performed?
Your doctor will ask you to open your mouth and tilt your head back. If
necessary, your doctor may use a tongue depressor.
This can help your doctor have a better view of the back of your throat.
They will then rub a sterile cotton swab across the back of your throat,
your tonsils, and any other sore areas for a few seconds.
The swab will collect a sample of the secretions being produced in the
back of your throat.
There are no risks or complications associated with a throat swab
culture. The test may cause momentary gagging because the back of the
throat is a sensitive area, but it shouldn’t be painful.
 How to Prepare for the Test
• DO NOT use antiseptic mouthwash before this test.
• Stop antibiotic if you are taking any.
 SPECIMEN TRANSPORT
Label the specimen and deliver it to the laboratory as soon as possible
with a completed request form.

The volume of specimen and the nature of the suspected organism

influences the acceptable transport time. The recovery of anaerobes is
compromised if the transport time exceeds 3hr.

If delays in transportation to the laboratory are unavoidable sample

should be placed in the transport medium (Amies transport medium
or Cary-Blair transport medium) to minimize drying and minimize
exposure to oxygen if anaerobes are suspected