Bacteria - Culture & Sensitivities – Aspirate/Tissue/Biopsies/Sterile Fluids/Drainages/Devices

Alternative Names/Synonyms	Culture-based detection of bacterial pathogens from aspirates/tissues/biopsies/sterile fluids/drainages/devices
Laboratory	Microbiology
Sub-section	Bacteriology
Specimen Type	○ Abscess contents ○ Aspirates ○ Tissues ○ Biopsy material, including fine needle aspirate ○ Sterile fluids (e.g. peritoneal fluid, peritoneal dialysis fluid, pleural fluid, synovial fluid, amniotic fluid, tympanocentesis fluid, intraocular fluid, othe

Other Information

○ Tubes and tips are not suitable for culture from drainage bags; instead collect a sample of any fresh fluid draining from the device

○ If collected from a device, indicate the type of device and location on body (if applicable).
○ Do not send swabs if aspirates or tissues can be collected.
○ Only microscopy will be done on IUD.

○ When prosthetic joint infection is suspected, multiple tissue samples are recommended from the area surrounding the infected joint

Specimen Requirements (Tube Type)

○ Aspirates/tissues/biopsies/sterile fluids/drainages (except peritoneal dialysis fluid): sterile container (min volume 2 mL)
○ Peritoneal dialysis fluid: BD BACT/ALERT® adult FA FN bottles

Collection Requirements

Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine. Aspirate fluid by percutaneous aspiration using aseptic technique to avoid contamination and a syringe and needle. Dispense in sterile container and transport to laboratory.
Abscess contents/aspirates/sterile fluids
○ Samples should be collected aseptically through decontaminated skin using a syringe and needle and placed in a sterile container and submitted to the laboratory ASAP. Collecting swabs of fluids/abscess contents/aspirate has lower yield and should NOT be done.

Tympanocentesis fluid:
○ Clean external ear canal with mild detergent. Use a syringe to aspirate fluid from the eardrum. Dispense fluid into a sterile container and transport to laboratory.
○ If anaerobic culture required, dispense some of the aspirated fluid into an anaerobic transport medium

Intraocular fluids (aqueous, vitreous):
○ Collect an aspirate of vitreous fluid or paracentesis of anterior chamber using a needle aspiration technique. Dispense fluid into sterile container.

Tissue/Biopsies
○ Collect 5-10 mm3 tissue/bone aseptically using surgical technique/punch biopsy. Place in a clean, sterile container with a small amount of sterile saline. Do not wrap tissue in gauze. Sample viable infected tissue rather than superficial debris. Collect tissues from areas within and adjacent to infected area.
○ If lesion is cutaneous, collect biopsy from periphery of lesion or aspirate material under lesion margin
For fine needle aspirates, insert needle into tissue in different directions. Aspirate specimen into container.
Drainages
○ Samples should be collected aseptically through the drain and placed in a sterile container and submitted to the laboratory ASAP.

Sample Stability

Refer to section Sample Processing / Delivery

Referral Laboratory

In-house

Routine Turnaround Time

○ up to 7 days

Laboratory Contact Information

416-586-4800 extension 4448

Approval Required

Sample Processing / Delivery

○ Label specimen container. Place specimens in biohazard bag and seal.

○ Specimens can be held at room temperature (20-25C˚) after collection but need to be refrigerate (2-8 C˚) if there is more than a 2h-delay in transport, EXCEPT peritoneal dialysis effluent which should be kept at room temperature (20-25˚C) and transported to the UHN/SH Microbiology Laboratory ASAP after collection.