Influenza virus A, B and RSV – detection

Nasopharyngeal swab
○ Insert tip of swab into nostril aiming along the floor of nasal cavity until posterior wall of nasopharynx is reached. Resistance will be felt when reached. Rotate swab for 10-30s. Place swab into transport medium and close tube. Repeat collection with second nostril.
Throat swab:
○ Collect the specimen using a clean, sterile swab by swabbing the posterior oropharynx vigorously and placing it in universal transport medium.

BAL
○ Pass bronchoscope transnasally or transorally (if patient is not intubated) or via endotracheal tube (if patient is intubated). Instill a large volume of 0.85% sterile saline (nonbacteriostatic) into the airway lumen. Discard the initial fluid recovered (likely contaminated). Collect remaining fluid in a clean, sterile container via suction.

Bronchial washing/brush specimens
○ Pass bronchoscope transnasally or transorally (if patient is not intubated) or via endotracheal tube (if patient is intubated). For washings, inject aliquots of approximately 20 to 30 mL of 0.85% sterile saline (nonbacteriostatic) for adults or 5 mL for children. Suction washings into a sterile container.
○ For brushings, instill brush to collect cellular material from bronchial epithelial wall. Place protected brush sample (cut off approximately 30-40mm from the end of the brush) in sterile container with 1 mL of saline.

Lung aspirates
○ 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.

Pleural fluid
○ Decontaminate skin. Insert needle into pleural space, aspirate fluid into syringe OR collect pleural fluid directly from drain if chest tube has been inserted to drain pleural space. Transfer specimen into sterile, leakproof container

Tissue (Respiratory tract)
○ Collect 5-10 mm3 tissue aseptically using surgical technique. Place in a clean, sterile container with a small amount of sterile saline.