Bacillus anthracis (Please notify laboratory if suspected)

Culture, molecular or serologic detection of Bacillus anthracis (anthrax)
Microbiology
Bacteriology
○ Whole blood ○ CSF ○ Tissue ○ Serum (exposure only)
Other Information
○ Serology is only performed in cases of suspected exposure, not recommended if post-exposure prophylaxis has been administered

○ Contact UHN/SH medical microbiologist on-call if anthrax is suspected
○ Whole blood: EDTA-blood tube (lavender top)
○ CSF/tissue: sterile container (with small amount of saline if tissue)
○ Serum: serum separator tube

Whole blood/serum:
○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine, collect at least 5 mL of blood.

CSF:
○ Decontaminate skin, collect at least 5 mL of CSF by lumbar puncture for each test into a sterile container. Microbiology laboratory receives first tube when only one tube of fluid is available; if more than one tube, microbiology laboratory should receive the second or third tubes (less bloody)

Tissue:
○ Collect 5-10 mm3 tissue aseptically using surgical technique/punch biopsy. Place in a clean, sterile container with a small amount of sterile saline.

Refer to section Sample Processing / Delivery
Confirmation of isolate, PCR and Serology PHOL
○ Culture
○ PCR
○ Enzyme-linked Immunosorbent Assay (ELISA) – IgG
○ Culture: up to 72 hours
○ PCR: Preliminary result: 4 days, final result 14 days
○ Serology: 14 days
416-586-4800 extension 4432
YES
○ Label specimen container. Place specimens in biohazard bag and seal.

○ Specimens should be stored at refrigeration temperature (2-8˚C) after collection EXCEPT CSF which should be kept at room temperature (20-25˚C) and transported to the UHN/SH Microbiology Laboratory ASAP.

○ UHN/SH Microbiology Laboratory will culture plates on site and refer the original specimen to the National Microbiology Laboratory for PCR and serology