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Handbook of specimen collection and handling in microbiology

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  • English

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    • Description:
      This handbook was designed to be used by laboratory and other medical personnel responsible for collecting and transporting specimens to the bacteriology laboratory. The handbook should also be of value to personnel responsible for hospital epidemiology and nosocomial infection control. The microbiology laboratory plays a critical role in successful patient care, but the value of its reports is dependent upon the first step in specimen handling—that is, selecting, collecting, and transporting the specimen to the bacteriology laboratory. In the final analysis, the clinical bacteriology laboratory can be of little value to the physician and thus offer only minimal service to patient care if specimens are improperly collected and submitted for the isolation and identification of microorganisms. Microbiologists must be aware also that misleading or insignificant information reported to a physician can be as harmful as incorrect results.

      Laboratory policy should be formulated WITH THE PATIENT IN MIND. Laboratorians recognize that many patients cannot be expected to do exactly what is asked of them. The specimens received may be less than optimal but should not be accepted if the specimen is obviously inappropriate or meets one of the criteria for rejection. The guidelines suggested herein are not meant to be inflexible. The very nature of both patient and organism variability necessitates intelligent decisions and appropriate measures to provide significant information to the clinician; what may be “normal flora” in a “normal” individual may be a potential pathogen in an immunocompromised host.

      This handbook is a compendium of facts arranged in outline and tabular form and lists basic principles of specimen handling along with the rationale supporting each principle. Use the following pages as guidelines only. It might be further suggested that the principles and procedures outlined in this handbook should be presented and discussed with the infection control committee or other hospital committees to elicit feedback for any changes or additions that must be made to satisfy local practice needs. Once the document has been approved by the appropriate committees, it should become part o f the laboratory policy manual for the hospital. Hospital size should never be a factor in whether or not proper specimen collection and handling are carried out. If microbiology reports are a part of patient care, the procedures used to provide those reports must guarantee that the information given to the physician is, indeed, significant.

      Portions of this handbook were taken from an excellent “Teledialog” series by Elmer W. Koneman, M.D., published by the Colorado Association for Continuing Medical Laboratory Education.1 Other sections were taken from a three-part series o f the Centers for Disease Control (CDC) Laboratory Updates (CDC 80-94; CDC 80-96) written by the author. These and other CDC Laboratory Updates are available from State Public Health Laboratories.

    • Content Notes:
      On cover: CDC Lab manual.

      Bibliography: p. 51.

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