Specimen Requirements

Submit only 1 of the following specimens:

Bronchoalveolar Lavage or Bronchial Washings
1. Aseptically collect a minimum of 5 mL of bronchoalveolar lavage or bronchial washings in a screw-capped, sterile container.

2. Avoid contaminating bronchoscope with tap water.
3. Saprophytic mycobacteria may produce false-positive culture or smear results.
4. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
5. Maintain sterility and forward promptly.
Note:  Specimen source is required on request form for processing.

Bronchial Brushings

1. Submit bronchial brushings in a screw-capped, sterile container or in sterile saline.
2. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
3. Maintain sterility and forward promptly.
Note:  Specimen source is required on request form for processing.

Gastric Lavage Fluid

1. Gastric lavage specimens should be reserved for those circumstances where specimens cannot be obtained by other methods, such as pediatric patients.
2. Collect a fasting, early-morning (soon after patient awakes in order to obtain sputum swallowed during sleep) specimen at least 8 hours after patient has eaten or taken oral drugs as follows:
A. A disposable gastric tube is inserted and gastric contents aspirated. Place specimen in a screw-capped, sterile container.

B. Patient then ingests 20 mL to 30 mL of sterile water. This is aspirated and added to first specimen.

3. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
4. Maintain sterility and forward promptly.
Note:  Specimen source is required on request form for processing.

Spinal Fluid
1. Submit maximum amount of spinal fluid available in a screw-capped, sterile vial. (Less than 0.5 mL of spinal fluid is not acceptable.)
2. Label vial with patient’s name (first and last), date and actual time of collection, and type of specimen.
Note:  Specimen source is required on request form for processing.

Sputum
Sputum, Expectorated

1. Collect an early-morning specimen on at least 3 consecutive days in a screw-capped, sterile container as follows:
A. Instruct patient to brush his/her teeth and/or rinse mouth well with water to minimize contaminating specimen with food particles, mouthwash, or oral drugs which may inhibit the growth of mycobacteria.
B. Have patient remove dentures.
C. Instruct patient to take a deep breath, hold it momentarily, then cough deeply and vigorously into container, and collect 5 mL to 10 mL of discharged material. (Nasal secretion, saliva, or 24-hour collection is not acceptable.)
2. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
3. Maintain sterility and forward promptly.
Note:  Specimen source is required on request form for processing.

Sputum, Induced
1. Collect an early-morning specimen on at least 3 consecutive days in a screw-capped, sterile container as follows:
A. Induce cough by inhalation of sterile, hypertonic saline. Collect 5 mL to 10 mL of expectorated material.
2. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
3. Maintain sterility and forward promptly.
Note:  1. Avoid sputum contamination with nebulizer reservoir water.
2. Saprophytic mycobacteria in tap water may produce false-positive culture or smear results.
3. Indicate on request form if specimen is induced sputum, as these watery specimens resemble saliva and risk rejection as inadequate.
4. Specimen source is required on request form for processing.

Tissue
1. Aseptically collect 1 g of tissue, if possible, in a screw-capped, sterile container without fixative or preservative avoiding indigenous microbiota. (Specimen submitted in formalin is not acceptable.) Select caseous portion if available.
2. Do not immerse in saline or other fluid or wrap in gauze.
3. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
4. Maintain sterility and forward promptly at ambient temperature only. Freezing decreases yield.
Note:  Specimen source is required on request form for processing.