Delaware Department of Health and Social Services Division of Public Health Laboratory and Epidemiology Laboratory Specimen Collection Procedures September 2007 SECTUIB I. CULTURE AND/OR IDENTIFICATION OF ORGANISMS: TEST ORGANISM TYPE OF SPECIMEN METHOD TRANSPORT INSTRUCTIONS PROCESSING OTHER MEDIUM AND FOR TRANSPORT TIME TYPE OF CONTAINER Acid Fast Bacilli Mycobacteria Respiratory, wounds Smear: 50 ml plastic tubes Refrigerate (2-8? C) 4-6 weeks (AFB) smear and and stool Fluorescent Stain supplied by culture Culture: DPHLab Conventional and liquid culture medias ________________________________________________________________________________________________________________________________________________________________________________ Bio-Terrorism agents: Call DPH Lab Director at 223-1520. ________________________________________________________________________________________________________________________________________________________________________________ Chlamydia Chlamydia Swab of Culture for Viral Transport Refrigerate (2-8? C) 10 working days Sent to VA Culture trachomatis endocervix, organism Media (VTM) immediately: deliver on urethra, wet ice conjunctiva or nasopharynx _________________________________________________________________________________________________________________________________________________________________________________ Nucleic Neisseria Swab from Nucleic Acid Gen-Probe Refrigerate (2-8? C) 2-3 working days Amplification for gonorrhoeae endocervix or Amplification collection kit for or Room temp Neisseria and Chlamydia urethra swab or urine Specimen stable for 30 gonorrhea and trachomatis days in collection kit Chlamydia First void Urine Transfer urine within 24 trachomatis hrs to collection kit. __________________________________________________________________________________________________________________________________________________________________________________ Eastern Equine Arbovirus CSF ELISA (IgG, IgM) Sterile container Refrigerate (2-8? C) 4-5 working days Encephalitis (EEE) Real time PCR immediately: deliver on wet ice __________________________________________________________________________________________________________________________________________________________________________________ Food E. coli 0157:H7 Food Culture for 25-100 grams in Refrigerate (2-8? C) 5-7 working days Contact Epidemiology at Listeria organism sterile container or 744-4541 for prior Salmonella in original container approval. Shigella Must specify target Staph aureus organism on lab slip. BT agents ___________________________________________________________________________________________________________________________________________________________________________________ Gonorrhea Neisseria Swab of Culture for Modified Thayer Place in CO2 2-3 working days Specimens must be Culture gonorrhoeae endocervix, organism Martin (MTM) container, store in an received within 4 days urethra, incubator at 35?C and of collection or they oropharynx transport within 4 days. will be rejected. or rectum ___________________________________________________________________________________________________________________________________________________________________________________ Herpes Herpesviridae Swab of vesicle, Culture for virus Viral Transport Refrigerate (2-8? C) 3-7 working days genital lesion, Media (VTM) immediately: deliver on conjunctiva, wet ice throat CMV Urine Viral Transport Refrigerate (2-8? C) 2 weeks to 1 month 1/3 VTM and 2/3 Media (VTM) immediately: deliver on or more urine wet ice within 12 hours of collection ___________________________________________________________________________________________________________________________________________________________________________________ Human Immunodeficiency Retrovirus Oral swab from Western Blot Orasure HIV-1 Refrigerate (2-8? C) 5 working days Virus (HIV), oral buccal mucosa (confirmatory) specimen collection kit ___________________________________________________________________________________________________________________________________________________________________________________ Miscellaneous Pathogenic Swab of site to be Culture for Culturette with Refrigerate (2-8? C) 2-3 working days Blood cultures culture organisms cultured (i.e. eye, organism transport media in and anaerobic throat, wound, tube cultures are not endocervix, accepted sputum) OCME (Office of Pathogenic Swab of site to be Culture for Culturette with Refrigerate (2-8? C) 2-3 working days Autopsy specimens Chief Medical organisms cultured, tissues, organism transport media in Examiner) body fluids tube or sterile container ____________________________________________________________________________________________________________________________________________________________________________________ Norovirus Norwalk like Stool PCR Sterile container Refrigerate (2-8? C) 2-3 working days Contact viruses (NLV) immediately; deliver on Possibly longer Epidemiology at wet ice. because specimens 744-4541 for prior will be run in approval. batches. _____________________________________________________________________________________________________________________________________________________________________________________ Ova and Parasites Pathogenic ova Stool Direct and Formalin (5%) and Room temperature 2-3 working days Do not refrigerate and parasites concentrated smears Polyvinyl Alcohol specimen. Trichrome (PVA) Cryptosporidiosis Cryptosporidium Stool Modified Acid Formalin (5%) and Room temperature 2-3 working days Do not refrigerate Cyclospora parvum Fast stain Polyvinyl Alcohol specimen. Isospora Cyclospora (PVA) cayetanenis Isospora belli _______________________________________________________________________________________________________________________________________________________________________________________ Malaria smear Plasmodium and Blood Giemsa stain EDTA tube Refrigerate (2-8? C) 1-2 working days Contact other blood (purple top) Microbiology at parasites 223-1520 for prior approval. Pinworm Enterobius Transparent tape Microscopic Scotch tape prep Room temperature 2-3 working days Use only vermicularis applied to the examination or Pinworm prep transparent, not perianal skin then kit translucent tape applied to a glass slide or a Pinworm prep kit. ________________________________________________________________________________________________________________________________________________________________________________________ Pertussis Bordetella Swab of PCR Nasopharyngeal Room temperature 3 working days Swab kits pertussis nasopharynx only rayon swab available from the collection kit (no DPH Lab. transport media) Call 223-1520. ________________________________________________________________________________________________________________________________________________________________________________________ PFGE (Pulsed-field Salmonella Grown culture Gel Nutrient agar slant Refrigerate (2-8? C) 3-5 working days Gel Shigella Electrophoresis Electrophoresis) E. coli 0157:H7 Listeria _________________________________________________________________________________________________________________________________________________________________________________________ Rabies Rabies Virus Mammal brain Fluorescent Double bagged or Refrigerate (2-8? C) 1 working day Do not freeze! antibody (FA) sealed container _________________________________________________________________________________________________________________________________________________________________________________________ Serotyping Salmonella, Grown culture Slide and tube Nutrient agar slant, Room temperature 3 days to 2 weeks Mueller Hinton Shigella, agglutination Brain Heart Infusion agar slants are Haemophilus slant or Chocolate unacceptable influenzae, agar slant Neisseria meningitidis, and E. coli 0157:H7 _________________________________________________________________________________________________________________________________________________________________________________________ Stool Culture Campylobacter, Stool or rectal Culture for Cary and Blair Refrigerate (2-8? C) 3-4 working days Other organisms E. coli 0157:H7, swab organism transport media: must be Salmonella, One marble sized requested on the Shigella, piece or one lab slip. tablespoon is and other enteric sufficient for all pathogens tests. Shigatoxin EIA producing E. coli _________________________________________________________________________________________________________________________________________________________________________________________ Strep throat Streptococcus Swab of throat Culture for Culturette with Refrigerate (2-8? C) 1-2 working days culture pyogenes organism transport media in tube _________________________________________________________________________________________________________________________________________________________________________________________ Urine culture UTI causing Clean caught Culture for Sterile container Refrigerate (2-8? C) 1-2 working days bacterium urine organism __________________________________________________________________________________________________________________________________________________________________________________________ Viral Culture VZV (Chicken Pox) Throat or Urine Culture for virus Viral Transport Refrigerate (2-8? C) 4-10 working days Media (VTM immediately: deliver on wet ice West Nile Virus CSF Culture, MIA Sterile container Refrigerate (2-8? C) 4-5 working days Send to Virology MIA first for splitting 10 working days culture _____________________________________________________________________________________________________________________________________________________________________________________________ Virus Stool Adenovirus Stool: One marble Culture for virus Viral Transport Refrigerate (2-8? C) 4-10 working days Coxsackie sized piece or one Media (VTM) immediately: deliver on Echovirus tablespoon is wet ice within a few Enterovirus sufficient for all hours of collection Poliovirus tests. Norovirus Stool PCR Sterile container Refrigerate (2-8? C) 2-3 working days Contact (Norwalk virus) immediately: deliver on Epidemiology at wet ice 744-4541 for prior arrangement. _____________________________________________________________________________________________________________________________________________________________________________________________ Viral Throat Coxsackie Swab of throat or Culture for virus Echovirus nasopharynx, Enterovirus nasal washing, Poliovirus bronchial washing Influenza A and B PCR Viral Transport Refrigerate (2-8? C) 4-10 working days Media (VTM) or dry immediately: deliver on Confirmatory swab for PCR wet ice within a few testing may take 20 testing. hours of collection working days or longer Parainfluenza Shell Vials 1,2,and 3 Adenovirus Respiratory Syncytial Virus (RSV) _______________________________________________________________________________________________________________________________________________________________________________________________ SECTION II. SEROLOGIC TESTS: _______________________________________________________________________________________________________________________________________________________________________________________________ Human Retrovirus Serum ELISA-HIV 1 Sterile red top or Refrigerate (2-8? C) 10 working days Immunodeficiency Virus sterile container (HIV) Western Blot (confirmatory) ________________________________________________________________________________________________________________________________________________________________________________________________ Syphilis Serology: RPR (Rapid Plasma Treponema Serum Nontreponemal Sterile red top or Refrigerate (2-8? C) 3-5 working days Reagin) pallidum antigen sterile container TPPA (Treponemal Treponema Serum Treponemal Sterile red top or Refrigerate (2-8? C) 3-5 working days Pallidum Particle pallidum antigen sterile container Agglutination) FTA (Fluorescent Treponema Serum Fluorescent Sterile red top or Refrigerate (2-8? C) 5-10 working days Not done at DPHL/ Treponemal Antibody) pallidum Antibody Stain sterile container Sent to MD for special requests VDRL (Venereal Disease Treponema CSF Nontreponemal Sterile red top or Refrigerate (2-8? C) 5 working days Test performed on Research Laboratory) pallidum antigen sterile container CSF only _______________________________________________________________________________________________________________________________________________________________________________________________ Viral Hepatitis Hepatitis A Serum Antigen/Antibody Sterile red top or Refrigerate (2-8? C) 3-7 working days Hepatitis C testing is Hepatitis B titers: sterile container not performed at DPHLab HAV IgM HAV IgG (for epi purposes) Hep B surface Ab Hep B Surface Ab tests are batched Viral Serological Tests: Arbovirus: (Eastern Various viruses Serum ELISA (IgG, IgM) Sterile red top or Refrigerate (2-8? C) 2-5 working days Equine Encephalitis HAI sterile container (EEE) and West Nile WNV-MIA Virus (WNV) Herpes simplex 1 & 2 serum ELISA (IgG) Sterile red top or Refrigerate (2-8? C) Batched weekly sterile container Varicella (Chickenpox) Serum IFA (IgG, IgM) Sterile red top or Refrigerate (2-8? C) 1-2 working days sterile container __________________________________________________________________________________________________________________________________________________________________________________________________