A General Guide to Requesting and Sampling

This is a draft protocol being piloted in the Trust & will be subject to review.

GUIDELINES FOR TAKING ROUTINE SPECIMENS

(* Does not include MRSA specimens) *Routine specimens (see specific protocols for Urology, Gynaecology, ITU, HDU etc)

URINE

• Do not take urine samples just because urine is cloudy, smelly or offensive. Send urine samples if the patient has signs or symptoms of UTI (e.g. pyrexia). 
• Obtain specimen before commencement of antibiotics, as results are difficult to interpret once antibiotics have been commenced.
• Do not take routine specimens at catheter changes, do not send catheter tips.
• Use boric acid red top urine sample tubes and fill to line.

FAECES

• Send specimen on patients with diarrhoea where an infective cause is suspected. Do not send a specimen if one has been sent in the last seven days as this will not be processed.

CLOSTRIDIUM DIFFICILE

• Do not send repeat specimens to see if negative as decision not to isolate is made on the cessation of diarrhoea not microbiology results.

SWABS

• Only take specimens from postoperative wounds if there is a purulent discharge i.e. the wound is discharging pus.

PRESSURE SORES

• Only take a swab if there is inflammation in the surrounding area and a purulent discharge. N.B An offensive smell alone is NOT AN indication to take a swab.

SPUTUM

• Sputum specimens should only be sent on patients with a diagnosis of pneumonia and only if they are productive and they have not yet commenced on antibiotics. If already on antibiotics, this MUST be recorded on the request form. Samples from COPD patients need to be specifically requested by medics. TB specimens should be requested by medics and 3 early morning specimens are required.

If sample is urgent please telephone the laboratory so that it is expected and can be processed as quickly as possible.

N.B Tips, Catheters and drains are not useful specimens as they are often contaminated or colonised and do not provide useful information.