AFB Culture and Smear

Body Fluid
1. Surgical preparation may be required.

2. Decontaminate skin.

3. Collect by pump, manual expression, aspirate with needle and heparinized syringe, or swab infected area by applying gentle pressure. This may require assistance from a physician.

4. Place in an anaerobic transport tube, culture swab, or a screw-capped, sterile container.
5. Label container/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.

Gastric Washing
1. Patient should be fasting for at least 8 hours prior to collection, if at all possible.
2. Withdraw all water patient may have swallowed.

3. Using 20 mL to 30 mL of sterile water, collect gastric washing into a screw-capped, sterile container. This may require assistance from a physician.
4. Label 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.

Sputum
1. Collect an early-morning specimen on at least 3 consecutive days (1 per day) in a Sputum Collection Kit. Do not disassemble apparatus as this may create dangerous aerosols.

A. Induce cough by inhalation of sterile, hypertonic saline, and collect expectorated material into sputum collection tube. Never fill tube more than 1/4 full.
2. Label tube 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:  1. Specimen source is required on request orm for processing.

2. Avoid sputum contamination with nebulizer reservoir water.

3. Twenty-four hour collection is not recommended. It offers no advantages over early-morning specimens.

Tissue
1. Aseptically collect 1 cm³ or more of tissue, if possible (it may have to be shared with Histology).

2. Place tissue in a screw-capped, sterile container without fixative or preservative avoiding indigenous microbiota. (Specimen submitted in formalin is not acceptable.) Select caseous portion if available.

3. Label 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.

Urine, Midstream
Collect 30 mL to 50 mL from a random urine collection in a screw-capped, sterile container or use a Midstream Collection Kit. Do not exceed 2 hours. Collect specimen as follows:

Males

1. Thoroughly clean glands area with soap and water/Towelettes®.

2. While holding foreskin retracted, begin voiding.

3. After several mLs have passed, collect midstream portion without stopping flow of urine.
4. Label 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.

Females
1. Thoroughly clean urethral area with soap and water/Towelettes®.

2. While holding labia apart, begin voiding.

3. After several mLs have passed, collect midstream portion without stopping flow of urine.
4. Label 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.

Negative for AFB stain