1. Collection & Transport of Clinical Specimens

2. Sore throat A swab from tonsils or pharynx to be cultured on the day of sampling for B-haemolytic streptococci & C. diphtheriae. If delay is unavoidable transport media should be used; e.g.: Stuart’s or Ames media.

3. Streptococcal & Staphylococcal Carriers @ Nose & throat swabs are required. The nasal swab should be rubbed gently on the mucosa of both anterior nares.

4. Meningococcal carriers A nasopharyngeal swab must be seeded immediately on warm blood agar or sent in Stuart’s transport medium.

5. Whooping cough @ Nasopharyngeal or pernasal swabs are seeded directly on to Bordet- Gengou medium @ The inoculated medium is sent to the lab. as soon as possible. @ Cough Plate: Directly in front of patient

6. Enteric fever or P.U.O (a) 1 st. week: (i)Blood culture: Blood is best taken before treatment. (ii) Blood for serology: Clotted blood is taken for agglutination tests. (iii) Feces culture: A small sample of feces (with pus or mucus) is sent in screw- capped bottle & cultured on day of collection.

7. (b) 2 nd. & subsequent weeks: (i) Blood culture: A positive result becomes progressively less likely. (ii) Faeces culture: as above. (iii) Agglutination test (Widal): 5-10 ml of clotted blood are collected to test for enteric fever & brucellosis. (iv) Urine culture: A clean specimen is sent in sterile, screw- capped bottle for culture on the day of voiding

8. Tuberculosis (i) Samples of sputum are sent for microscopic examination on 6 consecutive days. They can be collected separately, refrigerated or kept in a cool place & sent together. (ii) Containers need not be sterile if sputum is sent for microscopy only. (iii) Samples of sputum or any other discharge for culture of T.B. must be received on the day of sampling.

9. (iv) Gastric lavage must either be received within a few hours or be neutralized with alkali & refrigerated. (v) Laryngeal swabs should be received on the day of sampling or the patient sent to the lab. (vi) Urine: 3 morning specimens submitted together to the lab.

10. Dysentery @ Faeces or rectal swabs must be received on the day of sampling. Swabs must not be allowed to dry & moistened before use. @ Cary-Blair transport medium is used for stool transport

11. Pleural effusion For complete examination 2 samples are required : @ one in a sterile bottle for culture, @ the other in a large sterile jar containing citrate for examination & culture of T.B.

12. Pus & infected tissue @ This should arrive as soon as possible Ames transport medium & thioglycolate medium may be used @ Biopsy specimens for culture should be placed in a sterile screw-capped bottle without adding a fluid. @ When actinomycosis or T.B. is suspected & no biopsy is taken,whole inner wound dressing is sent in a large sterile jar.

13. Meningitis @ C.S.F. should be taken with a dry sterilized puncture needle using extremely careful aseptic precautions. @ It should arrive while still warm. Incubate if there is delay.

14. Conjunctivitis @ Swabs should be seeded at the bedside or patient sent to lab. Puerperal Sepsis @ Cervical swabs are either cultured within half hour, or placed in Stuarts transport medium. @ Blood for culture is collected before treatment

15. Venereal Diseases @ Urethra & cervix are sampled with swabs & placed in Stuarts transport medium; or collected at bedside. @ Fluid from a chancre is collected in a capillary tube & sealed with plasticine & examined as soon as possible for treponemes by D.G. microscopy. @ Blood for serology is delivered into a sterile bottle & allowed to clot. A sterile sample is essential for treponemal immobilization test. Patient must not have received antibiotics within the previous 48 hours.

16. Leptospirosis @ Fresh blood & alkaline urine, still warm, are examined under D.G. microscope for spirochaetes, inoculated into animals & into fluid media for culture. @ In 2nd week of disease blood is sent for agglutination tests.

17. Acute lung infection @ A sample of sputum for bacterial culture should be received on day of collection. @ If virus infection is suspected, sputum should be collected into a screw-capped bottle as early as possible. @ Or freeze & taken to lab. within the next day or two in a special cold box.

18. Body fluids for antibiotic assay @ These should be transmitted to lab. as soon as possible. @ Postal specimens are not accepted. Viral infections 2 samples of blood are required for serology. @ One taken immediately & the other 14-21 days later.

19. Urinary tract infections @ A mid-stream urine is best collected. @ Genitalia ( specially females) must be washed with soap & water before passing the urine. @ Catheterization must be avoided. @ Urine is collected in sterile screw-capped bottles & sent as soon as possible for culture on same day. If there is delay, transport in ice & keep in fridge.