By:

Mary Antonette L. Rodriguez

Importance of High- Quality Clinical Specimens

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High-quality clinical specimens are required to achieve accurate, clinically relevant laboratory results (i.e., results that provide information about the patients infectious disease).

Introduction
The 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 and 4. Implementing the proper selection, collection, transport, and processing of appropriate clinical specimen

Clinical Specimen
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Refers to the various types of specimen (e.g., blood, urine, feces, cerebrospinal fluid) that are collected from patients and used to diagnose or follow the progress of infectious diseases

Types of Clinical Specimen Submitted to the Clinical Microbiology Laboratory

TYPE OF SPECIMEN TYPE(S) OF INFECTIOUS DISEASE THAT THE SPECIMEN IS USED TO DIAGNOSE B, F, P, V B V B, F, P, V B B, V B, P, V Blood Bone Marrow Bronchial and bronchoalveolar washes Cerebrospinal fluid (CSF) Cervical and vaginal swabs Conjunctival swab or scraping Feces and rectal swabs

Hair clippings Nail (fingernail and toenail) clippings Nasal swabs Pus from a wound or abscess Scotch tape prep Skin scrapings

F F B B P F

Skin snip
Sputum Synovial (joint) fluid Throat swabs Tissue (biopsy and autopsy) specimens Urethral discharge material Urine Urogenital secretions (e.g., vaginal discharge material, prostatic secretions) Vesicle fluid or scraping * B, BACTERIAL INFECTIONS ; F, FUNGAL INFECTIONS

P
B, F, P B B, V B, F, P, V B B, P, V B, P V * P, PARASITIC INFECTIONS; V, VIRAL INFECTIONS

Roles of Healthcare Professionals in the Submission of Clinical Specimens

A close working relationship among the members of the healthcare team is essential for the proper diagnosis of infectious diseases. When an attending physician suspects that a patient has a particular infectious disease, appropriate clinical specimens must be obtained and certain diagnostic tests may be requested. The doctor, nurse, medical technologist, or other qualified healthcare professional must select the appropriate specimen, collect it properly, and then properly transport it to the laboratory where it is processed.

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. Healthcare 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. Healthcare personnel who collect clinical specimens must strictly adhere to the safety policies known as standard precautions.

According to the Clinical and Laboratory Standards Institute (CLSI), All specimens should be collected or transferred into a leakproof primary container with a secure closure. Care should be taken by the person collecting the specimen not to contaminate the outside of the primary container . Within the institution, the primary container should be placed into a second container, which will contain the specimen if the primary container breaks or leaks in transit to the laboratory.

Importance of High- Quality Clinical Specimens

> High-quality clinical specimens are required to achieve accurate, clinically relevant laboratory results (i.e., results that provide information about the patients infectious disease). The three components of specimen quality are: 1. Proper specimen collection (i.e., the correct type of specimen must be submitted) 2. Proper specimen collection and 3. Proper transport of the specimen to the laboratory. > The laboratory must provide written guidelines regarding specimen selection, collection, and transport in the form of a book.

 However, the person who collects the specimen is

ultimately responsible for its quality. When clinical specimens are improperly collected and handled, 1. the etiologic (causative) agent may not be found or may be destroyed 2. overgrowth by indigenous microflora may mask the pathogen , and 3. contaminants may interfere with the identification of pathogens and the diagnosis of the infectious disease

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