Instructions for Doctors
1. Blood Culture Collection :
(Special bottles are available from UNILAB at request).
1. Wash and dry hands thoroughly.
2. Inspect the venepuncture site (antecubital fossa usually).
3. Clean patients’ skin thoroughly for 1-2 minutes with spirit and allow skin to dry before taking blood.
4. Remove the Viscap covers of blood culture bottle with scissors avoiding contamination of the bottle tops.
5. Wipe the penetrable part of the rubber on the bottle tops with separate swabs containing spirit and allow the rubber to dry before puncturing with a needle.
6. Withdraw 10ml of blood into the syringe (if 10ml not possible then at least 2ml).
7. Remove the needle and replace it with a sterile one, taking care not to touch the end of the syringe.
8. Inoculate the blood into each bottle through the penetrable rubber. Mix gently by swirling.
9. Please write brief details of patients’ relevant history on request form, including any recent antibiotic therapy, the data and time of collection.
10. Transfer to the laboratory as soon as possible.
2. Sampling of specimens requiring Chlamydial Testing by Immunofluonescence (Reference method) :
Urethral Samples (Males)
• Patient preferably should not have urinated one hour prior to sampling.
1. Insert small Dacron swab 2-4 cm into urethra.
2. Rotate swab and withdraw.
Cervical Samples (Cytobrush)
• Performance studies using the cytrobrush on pregnant patients have not been conducted.
1. Wipe exocervix with cotton or Dacron swab to remove excess mucus. Dispose of swab.
2. Gently insert cytobrush into endocervical canal past squamocolumnar junction.
3. Leave in place 2-3 seconds.
4. Rotate cytobrush one full turn (360o).
5. Rotate cytobrush without touching any vaginal surfaces.
Cervical Samples (Swab)
• The large or small swab should be used to sample pregnant patients or patients with small cervical os.
1. Wipe exocervix with cotton or Dacron swab to remove excess mucus. Dispose of swab.
2. Insert large or small Dacron swab into endocervical canal until most of Dacron tip is not visible.
3. Rotate swab for 5-10 seconds inside endocervical canal.
4. Withdraw swab without touching any vaginal surfaces.
Rectal Samples
• Samples should be collected only from symptomatic patients.
• Only tecnicians proficient in the interpretation of urogenital specimens should examine rectal specimens; check with the laboratory for availability of qualified technicians before submitting rectal specimens.
1. Insert large Dacron swab approximately 3 cm into anal canal.
2. Move swab from side to side to sample crypts.
3. Withdraw swab. If fecal contamination occurs, discard swab and obtain another specimen.
Conjunctival Samples
• Samples should be collected only from symptomatic patients.
1. Apply a topical proparacaine-based anaesthetic to the eye or eyes (optional).
2. Using the small swab, thoroughly swab the inner surface of the lower, then the upper eye. If samples are taken from both eyes, use the swab on the less affected eye first to avoid further contamination of that eye.
In conjunctival specimens, at least 10 intact columnar epithelial cells should appear on the slide to ensure specimen adequacy.
