Wound Culture

Superficial Wound

1. Limit swab sampling to wounds that are clinically infected or those that are chronic and not healing.

2. Remove superficial debris by thorough irrigation and cleansing with non-bacteriostatic sterile saline.

3. Collect specimen by rotating swab over a 1 cm area with enough pressure to express fluid (Levine Technique) or gently roll swab over surface of wound approximately five times focusing on area where there is evidence of inflamed tissue.

4. Place culture in blue (modified Amies) transport swab.

5. Label tube with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

6. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Bite Wound

1. Aspirate pus from wound or obtain it at time of incision and drainage, or debridement of infected wound. Fresh bite wound is not acceptable for culture as infectious agents are not likely to be recovered.

2. Place culture in sterile container or swab in blue (modified Amies) transport swab.

3. Label tube with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Bone

1. Obtain bone during surgery.

2. Place in a sterile cup without formalin. Specimen may be kept moist with a small amount of sterile saline.

3. Label cup with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Burn Specimen

Culturing surface area alone on a burn wound can be misleading due to colonization that occurs in these wounds. Biopsy of deeper tissue is often indicated as well as sampling several different areas of burn for culture.

1. Clean burn with alcohol and disinfect with an iodine solution (1-2% tincture of iodine or a 10% solution of povidine-iodine 1% free iodine) to prevent introduction of infection. If tincture of iodine is used, remove with alcohol following procedure to avoid burn.

2. Place culture swab in blue (modified Amies) transport swab.

3. Label tube with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Decubiti and Surface Ulcer

1. Aspirate material by needle and syringe after disinfecting surface area or collect small curetting specimen from deep tissue at wound margin and place in a sterile cup.

2. Label syringe/cup with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

3. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Deep Wound or Abscess

1. Clean site with alcohol and disinfect with an iodine solution (1-2% tincture of iodine or a 10% solution of povidine-iodine 1% free iodine) to prevent introduction of infection. If tincture of iodine is used, remove with alcohol following procedure to avoid burn.

2. Aspirate deepest portion of lesion, avoiding contamination by wound surface. If collection is done at surgery, a portion of abscess wall should also be sent for culture.

3. Place culture in sterile cup or use blue (modified Amies) transport swab.

4. Label cup/container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

5. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Punch Skin Biopsy

1. Clean site with alcohol and disinfect with an iodine solution (1-2% tincture of iodine or a 10% solution of povidine-iodine 1% free iodine) to prevent introduction of infection. If tincture of iodine is used, remove with alcohol following procedure to avoid burn.

2. Collect a 3 mm to 4 mm specimen with a dermal punch.

3. Place specimen in a sterile cup without formalin. Specimen may be kept moist with a small amount of sterile saline.

4. Label cup with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

5. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Soft Tissue Aspirate

1. Clean site with alcohol and disinfect with an iodine solution (1-2% tincture of iodine or a 10% solution of povidine-iodine 1% free iodine) to prevent introduction of infection. If tincture of iodine is used, remove with alcohol following procedure to avoid burn.

2. Aspirate deepest portion of lesion or sinus tract. Be careful to avoid contamination by wound surface during collection.

3. Place culture in sterile cup or use blue (modified Amies) transport swab.

4. Label cup/container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

5. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Specimen Obtained Surgically by Laparoscopy, Culdocentesis, IUD Device, and Gastric Duodenal Aspirate

1. All are appropriate for anaerobic culture.

2. Place culture in sterile cup or use blue (modified Amies) transport swab.

3. Label cup/container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Sterile Fluid

1. Clean needle puncture site with alcohol and disinfect with an iodine solution (1-2% tincture of iodine or a 10% solution of povidine-iodine 1% free iodine) to prevent introduction of infection. If tincture of iodine is used, remove with alcohol following procedure to avoid burn.

2. Physician will aseptically perform percutaneous aspiration to obtain pleural, pericardial, peritoneal, or synovial fluid.

3. Expel any air bubbles from syringe, and immediately inject specimen into either a transport system or remove needle from syringe.

4. Label container/syringe with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

5. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Ulcer and Nodule

1. Clean site with alcohol and disinfect with an iodine solution (1-2% tincture of iodine or a 10% solution of povidine-iodine 1% free iodine) to prevent introduction of infection. If tincture of iodine is used, remove with alcohol following procedure to avoid burn.

2. Remove overlying debris.

3. Culture base of ulcer or nodule.

4. If exudate is present from ulcer or nodule, collect with a blue (modified Amies) transport swab.

5. Label syringe/container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

6. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.