Specimen Requirements

Please contact Microbiology Laboratory at 207-753-5484 before specimen collection.

 

Submit only 1 of the following specimens:

 

Preferred

Vesicular Stage (The organism is best demonstrated at this stage):

Body Fluid

1. Submit 1 mL of body fluid in a screw-capped, sterile container.

2. Label container with patient’s name (first and last), hospital identification number or date of birth, date and time of specimen collection, source of specimen, and that it is for for anthrax testing.

3. Maintain sterility and forward promptly.

4. Causes for rejection:

A. Inadequately labeled specimen
B. Improper container

C. Insufficient specimen volume
Note: Specimen source is required.

 

Alternate:

Eschar Stage

Blood
1. Draw blood at times indicated on order.

2. Apply tourniquet, palpate, and choose vein to be drawn by touching skin before it has been disinfected.

3. Loosen tourniquet and prepare site.
4. Cleanse skin over venipuncture site with Chlorascrub Swabstick, using an up and down motion and let air dry. Cover an area of 3 inches to 4 inches in diameter. Do not palpate the prepared area after cleaning. Do not allow excess solution to pool on the skin, let it dry. (On children <2 months, using an up and down motion prep the site with Povidone-Iodine swab for 30 seconds. Let dry.

5. Remove flip cap from the top of the Bactec blood culture bottles, clean the top of the blood culture bottles with an alcohol swab, and allow it to dry. Bottles should remain in upright position during collection.

6. Reapply the tourniquet, perform venipuncture using a butterfly set up. Fill to the designated volume guides (approximately 10 mL) on the bottle. When filled, move the adaptor cap from aerobic (blue) bottle to the anaerobic (yellow) culture bottle, and press down and continue blood collection.

7. When blood culture collection is complete, if more blood tests are required, draw at this time.

8. When all blood specimen collection is completed, remove the needle from the patient, and activate safety device or adaptor by pushing forward with thumb.

9. Discard butterfly set with needle attached in SHARPS container.

10. Mix blood and broth by inverting bottles 4 to 5 times.

11. Multiple blood specimens can be drawn with the same venipuncture providing the blood culture is taken first.

12. Label container with patient’s name (first and last), hospital identification number or date of birth, date and time of collection, source of specimen, and that it is for anthrax testing.

13 Maintain sterility and forward promptly.

14 Causes for rejection:

A. Inadequately labeled specimen

B. Improper container

C. Insufficient specimen volume
Note: Specimen source is required.

 

Volume Requirements
Children have more bacteria circulating per mL than adults. Collect specimens using aerobic (blue-top) and anaerobic (yellow-top) Bactec blood culture bottles according to chart below.

 

 

 

 

 

Volume Requirement Chart
Weight	Color of Bottle Top	Optimal Volume Required
<9 pounds	Pink Pedi-plus bottle	1 mL in tube
9 pounds to 30 pounds	Pink Pedi-plus bottle	1 mL to 3 mL in tube
30 pounds to 55 pounds	Blue (aerobic) plus yellow (anaerobic)	5 mL in each tube
>55 pounds	Blue (aerobic) plus yellow(anaerobic)	5 mL in each tube

Note: The yield of positive cultures is directly related to the amount of blood obtained, as proven by evidence-based medicine. Optimal volume will enhance results.

The laboratory must be notified if fastidious organisms such as Brucella or Francisella are suspected so that blood cultures can be held for 21 days.

 

Lesion

1. Obtain specimen from infected site.
2. Insert culture swab into lesion.
3. Return swab to sterile culture transport container.

4. Label container with patient’s name (first and last), hospital identification number or date of birth, date and time of specimen collection, source of specimen, and that specimen is for anthrax testing.

5. Maintain sterility and forward promptly at ambient temperature only.

6. Causes for rejection:

A. Inadequately labeled specimen
B. Improper container

C. Insufficient specimen volume
Note: Specimen source is required.

 

Sputum
1. Collect a first-morning, “deep-cough” sputum specimen in a screw-capped, sterile container. Do not add alcohol or preservatives.
2. Instruct patient to brush his/her teeth and/or rinse mouth well with water to minimize contaminating specimen with food particles, mouthwash, or oral drugs.

3. Instruct patient to take a deep breath, hold it momentarily, then cough deeply and vigorously into container, and collect 5 to 10 mL of discharged material.

4. Label container with patient’s name (first and last), hospital identifcation number or date of birth, date and time of specimen collection, source of specimen,and that specimen is for anthrax testing.

5. Maintain sterility and forward promptly at ambient temperature only.

6. Causes for rejection:

A. Inadequately labeled specimen
B. Improper container

C. Insufficient specimen volume

D. Multiple specimens collected same day

E. Sputum specimen consisting entirely of saliva

F. Delay in transport to laboratory
Note: 1. Specimen source is required.

2. If multiple specimens are required, collect specimens on separate days. Individual specimens must be sent to laboratory on day of collection.

 

Stool

1. Submit 5 g of stool in a screw-capped, sterile, leakproof container.

2. Label container with patient’s name (first and last), date and actual time of collection, diagnosis, physician’s name, type of specimen, and hospital identification number and department, and as for anthrax testing.

3. Maintain sterility and forward promptly at ambient temperature only.

4. Causes for rejection:

A. Inadequately labeled specimen
B. Improper container

C. Insufficient specimen volume
Note: Specimen source is required.