Throat, eyes, ears, nose and mouth swab Microscopy Culture & Susceptibility

Patient Preparation

NB: Sending actual pus is preferable to swabs if present

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

Throat swab for M,C&S

• Ask patient to sit upright facing a strong light, tilt head backwards, open mouth and stick out tongue.
• Depress tongue with a spatula.
• Ask patient to say ‘Ah’.
• Quickly but gently roll the swab over any area of exudate or inflammation or over the tonsils and posterior pharynx.
• Carefully withdraw the swab, avoiding touching any other area of the mouth or tongue.

Eye swab for M,C&S

• Ask patient to look upwards.
• Using aseptic technique, hold the swab parallel to the cornea and gently rub the conjunctiva in the lower eyelids from nasal side outwards.
• Swab any pus or exudates as well as any lesion of interest.
• If both eyes are to be swabbed, label swabs ‘right’ and ‘left’ accordingly.
• NB: Separate samples must be collected into appropriate transport media for detection of viruses, chlamydia or Neisseria gonorrhoeae.

Ear Swab for M,C&S

• Ensure no antibiotics or other therapeutic drops have been used in the aural region three hours before taking the swab.
• Using aseptic technique, rotate swab gently once at the entrance of the auditory meatus to collect any pus or exudates.

Nose swab for M,C&S

• Ask patient to tilt head backwards.
• Moisten swab with sterile saline.
• Insert swab inside the anterior nares with the tip directed upwards and gently rotate. Swab any pus or exudates.
• Repeat the procedure with the same swab in the other nostril.

Mouth swab for M,C&S

• Sample pus if present, otherwise sample any lesions or inflamed areas. A tongue depressor or spatula may be helpful to aid vision and avoid contamination from other parts of the mouth.