Diagnosing Infectious Diseases: “Specimen collection”

Proper diagnosis of an infectious disease requires:

1. Taking a complete patient history

2. Conducting a thorough physical examination of the patient

3. Carefully evaluating the patients signs and symptoms

Implementing the proper selection, collection, transport, and processing of appropriate

clinical specimens

 Those that are collected from patients and used to diagnose or follow the progress
of infectious diseases
 It is important that these specimens are of highest possible quality and that they
are collected in a manner that does not jeopardize either the patient or the person
collecting the specimen

Role of health care professionals in the submission of clinical specimen:

1. Health care professionals must select the appropriate specimen, collect it properly,
and properly transport it to the laboratory where it is processed.
2. Laboratory findings must then be conveyed to the attending physician as quickly as
possible to facilitate the prompt diagnosis and treatment of the infectious disease.
3. Health care professionals who collect and transport clinical specimens should
exercise extreme caution during the collection and transport of clinical specimens
to avoid sticking themselves with needles, cutting themselves with other types of
sharps, or coming in contact with any type of specimen.
4. HCP who collect clinical specimens must strictly adhere to safety policies known as
“Standard Precautions”
5. “All specimens should be placed into a leak proof primary container having a secure
closure. Care must be taken not to contaminate the outside of the primary
container. The primary container should be placed into a second container, which
will contain the specimen.

Importance of high quality clinical specimen:

1. to achieve accurate, clinically relevant laboratory results (i.e., results that
provide the information about the patient’s infectious disease)
The quality of the laboratory work performed in the CML, can be only as good as
the quality of specimens that are received
Three components of specimen quality are:
1. Proper specimen selection (i.e., the correct type of specimen must be submitted)
2. Proper specimen collection,
3. Proper transport of the specimen to the laboratory

Improper collection and handling of clinical specimens may results to:

1. The etiologic (causative) agent may not be found or may be destroyed
2. Overgrowth of indigenous microflora may mask the pathogen, and
3. Contaminants may interfere with the identification of pathogens and the
diagnosis of the infectious disease

Proper selection, collection, and transport of clinical specimens

1. The specimen must be properly selected.
2. The specimen must be properly and carefully collected
3. The material should be collected from a site where the suspected pathogen is
most likely to be found and where the least contamination is likely to occur
4. Whenever possible, specimens should be obtained before antimicrobial therapy
has begun. If not the CML should be informed
5. The acute stage of the disease (when the patient is experiencing the symptoms
of the disease) is the most appropriate time to collect most specimens
6. Specimen collection should be performed with care and tact to avoid harming the
patient, cause discomfort, or causing undue embarrassment. Give a detailed
collection instructions.
7. A sufficient quantity of the specimen must be obtained to provide enough
material for all required diagnostic tests.
8. All specimen should be placed or collected into a sterile container to prevent
contamination of the specimen by indigenous microflora and airborne microbes.
9. specimen should be protected from heat and cold and promptly delivered to the
laboratory so that the results of the analysis will validly represent the number and
types of organisms present at the time of collection.
10. hazardous specimens must be handled with even greater care to avoid
contamination of the courier, patients, and health care professionals.
11. Whenever possible, sterile, disposable containers should be used.
12. The specimen container must be properly labeled and accompanied by an
appropriate request slip containing adequate instructions.
13. Specimens should be collected and delivered to the laboratory as early in the
day as possible to give the technologists sufficient time to process the materials,
especially when the hospital or clinic does not have 24-hour laboratory service
Types of specimens usually required to diagnose infectious diseases

1. Blood
-Usually sterile
-Bacteria in the blood stream may indicate bacteremia
-Temporary or transient of this may occur following oral surgery, tooth extraction,
etc.
Special techniques: Procedure
1. Locate a suitable vein
2. Apply a tourniquet, disinfect the site with 70% isopropyl alcohol and iodophor
(allow it to dry)
3. Withdraw 10 to 20 mL of blood with gauge 21 needle into a sterile blood culture
bottle, containing anticoagulant
4. After venipuncture remove the iodophor from the skin with alcohol
5. Transport the blood to the laboratory for incubation of 37OC.