Collection instructions

Abscess (pus) and aspirates:

• Collect using aseptic technique as per organizational procedures
• Transfer the recommended volume into the appropriate container.

Scotch tape: Collected for detecting Enterobius vermicularis ova

• Cut a piece of clear scotch tape approximately 10cm long.
• Wind clear transparent tape around end of a tongue depressor, sticky side outward. NOTE: Avoid touching sticky side of tape.
• Wear gloves and spread the child’s buttocks (may require an assistant).
• Press tape against anus, rolling from side to side.
• Detach tape from tongue depressor.
• Attach tape sticky side down onto length of microscopic slide and smooth down with cotton ball.
• Place glass slide in disposable petri dish.
• Label the pertidish and the glass slide

Bone marrow aspirate

• Bone marrow is aspirated using  syringe  aseptically from the sternum or iliac crest. (Please refer to unit specific protocol).

Adult worm or proglottid or maggot

• Collected in a clean container or petridish
• Do not use ethanol or formalin to preserve the specimen

Sputum

• Early morning sputum samples is preferable
• Sputum should be the result of deep cough (not saliva) or should be induced by an aqueous aerosol.
• Collect into clean leak proof container

Broncheoalveolar lavage

• Collected by physicians in the bronchoscopy unit 
• Collect into clean container. The general principle is that as much volume as possible should be sent.

Stool:

1.Adults and older children

• Wash hands before collection , put on gloves if necessary.
• Urinate before collecting stool.
• Collect specimen in a clean bed pan or use plastic wrap placed between the toilet seat and the bowl ( to prevent feces falling into toilet water).
• Collect the stool into the labelled container using the spoon provided with container or any disposable spoons (Sample areas of the specimen which appear bloody, slimy or watery).
• Close the lids tightly and place in biohazard bags provided
• Flush the remaining stool down the toilet and dispose the plastic wrap or pan
• Wash hands after collection

2. Infants and Toddlers

Infants - Take the stool out of the diaper. If the infant has loose or runny stools, put the plastic side of the diaper next to the skin long enough to collect stool from it.

Toddlers - If the toddler is toilet trained, a clean, dry training potty, training pants, or a diaper can be used to collect the stool. 

Urine: For detection of S.haematobium

Collect the last 20ml of the urine (terminal urine).

Special precautions

• Before antiparasitic therapy where possible·       
• Collect specimens before laxatives or as soon as possible after onset of symptoms (During acute stage of infection)
• Do not mix stool with urine , soap or toilet water
• Do not collect stool from the toilet bowl.
• Do not defecate directly into stool container as this may contaminate the outside of the container         
• Do not use toilet paper to collect stool. Toilet paper may be impregnated with barium salts, which are inhibitory for some fecal pathogens.

·         Ideally three stool specimens collected over no more than a 10-day period. It is usually recommended that specimens are collected every other day. Unless the patient has severe diarrhoea or dysentery as shedding of cysts and ova tends to be intermittent.

·         For Food handlers: Collect three samples on three consecutive days

Timing of collection

Stool

• Ideally a total of three stool specimens should be collected over a 10-day period. If the initial specimen is negative, then send 2 more specimens,  keeping at least one day between collection. Unless the patient has severe diarrhoea or dysentery,  shedding of cysts and ova tends to be intermittent.

Scotch tape for E.vermicularis

• It is recommended that samples should be taken for at least four to six consecutive days. If the results of all these are negative the patient can be considered free from infection. 
• Ideal time of collection: Between 10 pm and midnight, or early in the morning, before defecation or bathing.

Urine for S.haematobium

• Ideally colected from 10 am to 2 pm