CSF Microscopy, Culture & Susceptibility

Patient Preparation

For taking CSF samples we recommend that users follow either their local protocols or “The Royal Marsden Manual of Clinical Nursing Procedures”.

CSF samples for microbiology/virology

• Collect specimens preferably before antimicrobial therapy is started, but this must not be delayed unnecessarily pending lumbar puncture and CSF culture.
• CSF is normally collected sequentially into three or more separate containers which should be clearly numbered consecutively on the sample pots (i.e. 1, 2 and 3).
• In adults, we recommend sending samples 1 and 3 for microbiology and sample 2 for biochemistry (protein).
• Ideally a minimum volume of 1mL is needed for each tube but when sample volume is below this it is possible to pool samples.
• For culture for Mycobacterium species (including TB), at least 10mL is preferred where possible as the larger the volume, the greater the culture yield.

Notes

All CSF samples should be considered as urgent, please notify the laboratory (0121 424 3256). Microscopy telephoned within 1 hour of receipt. Positive cultures telephoned. Out of hours do not use pod system please use porters.  CSF samples requiring investigations for TB must request this on the forms.  Please send >3mls for Tb investigations.

PLEASE NOTE: CSF samples should be packaged separately from routine samples, and clearly marked as ‘urgent CSF’ on outer packaging.