Whole blood or serum:
○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine. Collect at least 5 mL of blood if multiple tests will be ordered
Biopsy tissue (e.g. spleen, liver):
○ Collect 5-10 mm3 tissue aseptically using surgical technique/punch biopsy. Place in a clean, sterile container with a small amount of sterile saline. Do not wrap in gauze. Select caseous portion if available.
○ If submitting tissue from lymph nodes, place a small amount of sterile saline in the container and do not freeze
CSF:
○ Decontaminate skin, collect at least 0.5 mL of CSF by lumbar puncture
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
○ 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.
Blood cultures
See: Bacterial culture and sensitivities – Blood culture