Factors that affect accuracy of specimens
- Specimen contamination
- Delay in sending specimen in laboratory
- Obtaining specimen with inappropriate container or culture media
- Incorrectly identified or mislabeled specimens
- No identification of source of specimen
- Not reporting any antibiotics or other medications that patient is taking that patient is taking that may impact specimen analysis
Where can cultures be obtained using a sterile swab?
- Throat
- Wound
- Body cavity/fluid
- Fistula
- Rectal
- Vaginal
Indications for wound/fistula culture
- Identification of organism and potentially infectious agent of wound drainage
- Determine appropriate treatments and interventions based on culture results
Indications for sputum culture
- Bacterial, viral, fungal infections and acid-fast bacillus for mycobacterium tuberculosis
Indications for body cavity/fluid culture
Signs and symptoms of inflammation and infection
Indications for stool culture
- Bacterial, fungal, parasitic infections, ova and parasites.
- C. diff
Indications for urine/urinalysis culture
- Presence of urinary tract infection
- Check for kidney and endocrine function, urine pH, color, specific gravity, ketones, protein, glucose, red blood cells, white blood cells
Indications for throat culture
Presence of strep throat
Common organism found in throat cultures
Strep
Common organisms found in wound cultures
Staph, strep, pseudomonas (usually from poor technique in dressing change), klebsiella
Common organisms found in rectal cultures
Vancomycin, resistant enterococcus, c-diff
Common organism found in vaginal cultures
Chlamydia
Common organism found in nose/skin cultures
MRSA
Procedure for obtaining a throat culture
Have patient say “Ahh” and swab back of throat with sterile cotton swab from culturette packaging
Procedure for obtaining a wound culture
- Use sterile swab in drainage of wound or in the center of wound
- Do not swab the outer edge or crusts near skin
- Can cleanse with normal saline
- Redress per orders
Procedure for obtaining mid-stream urine collection
- Have patient wash hands
- Open three towelettes
- Open sterile container, place lid with inner side up. Do not touch rim of cup.
- Cleanse each side of labia from front to back (women) or swiping motion away from meatus (men) using separate towel for each side holding labia open
- Cleanse down middle with 3rd (women) or from meatus out (men)
- Void a little urine into toilet
- Continue to urinate into cup. Women should keep labia pulled apart as they void
- Place lid on urine without touching inside cup or lid
Indication for 24-hour urine collection
Check for total protein and creatinine clearance
