Mycobacterium – Detection – CSF, Fluids, Bone or Tissue
| Detection of acid fast bacilli from CSF, fluids, bone or tissues | |
| Microbiology | |
| Bacteriology | |
| ○ CSF (0,5 mL) ○ Fluids (5 mL) ○ Tissue or bone (1-2 g |
Other Information
○ CSF volume equal to 0,5 mL won’t have smear perform. Submit maximum volume attainable for culture and smear
○ Multiple tissues submitted from the same surgical site should be limited to 3 specimens.
○ Multiple tissues submitted from the same surgical site should be limited to 3 specimens.
○ CSF: sterile container
○ Fluids: sterile container
○ Tissue or bone: sterile container with a small amount of sterile saline
○ Fluids: sterile container
○ Tissue or bone: sterile container with a small amount of sterile saline
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.
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.
CSF
○CSF by lumbar puncture: Decontaminate skin, collect at least 0,5 mL of CSF by lumbar puncture into a sterile container; if more than one tube can be successfully collected, the microbiology laboratory should receive the second or third tubes (whichever is less bloody) to avoid contamination by skin flora or blood.
If CSF by shunt/drain:
○CSF by shunt/drain: Clean reservoir site with antiseptic solution and alcohol prior to removing fluid. Collect CSF from drain/shunt attached to intracranial device into sterile container. If device is an Ommaya reservoir, aspirate CSF using a sterile needle and syringe; label accordingly (e.g. CSF from shunt or Ommaya reservoir as opposed to simply “CSF”)
○ 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.
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.
CSF
○CSF by lumbar puncture: Decontaminate skin, collect at least 0,5 mL of CSF by lumbar puncture into a sterile container; if more than one tube can be successfully collected, the microbiology laboratory should receive the second or third tubes (whichever is less bloody) to avoid contamination by skin flora or blood.
If CSF by shunt/drain:
○CSF by shunt/drain: Clean reservoir site with antiseptic solution and alcohol prior to removing fluid. Collect CSF from drain/shunt attached to intracranial device into sterile container. If device is an Ommaya reservoir, aspirate CSF using a sterile needle and syringe; label accordingly (e.g. CSF from shunt or Ommaya reservoir as opposed to simply “CSF”)
Refer to section Sample Processing / Delivery
Public Health Ontario Laboratory (PHOL)
○ Microscopy: 1 day
○ Culture: Up to 49 days; a positive culture is reported within 24h of growth
○ Culture: Up to 49 days; a positive culture is reported within 24h of growth
416-586-4800 extension 4432
No
○ Label specimen container. Place specimens in biohazard bag and seal.
○ Transport specimens to the UHN/SH Microbiology Laboratory ASAP at refrigeration temperature (2-8oC), EXCEPT for CSF (room temperature).
○ UHN/SH Microbiology Laboratory will refer specimen to Public Health
Ontario Laboratory for testing
○ Transport specimens to the UHN/SH Microbiology Laboratory ASAP at refrigeration temperature (2-8oC), EXCEPT for CSF (room temperature).
○ UHN/SH Microbiology Laboratory will refer specimen to Public Health
Ontario Laboratory for testing