Specimen Requirements

First-morning “deep cough” specimens are preferred. For optimum tumor detection, a series of 3 first-morning specimens (collected on 3 consecutive mornings) should be obtained. Post bronchoscopy sputum specimens are potentially richest in cellular material and thus high in diagnostic value.

Expectorated

1. Collect an early-morning specimen on at least 3 consecutive days in a screw-capped container (fresh specimen) or with 50% ethyl alcohol 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 of birth, date and actual time of collection, type of specimen, and specimen number if from a series of collections.
3. Maintain sterility and forward promptly.  Fresh specimens must be refrigerated until deliver to lab.
Note:  1. Complete a “Request for Specimen Analysis” in “Request Forms” in “Special Instructions” including patient’s name (first and last), date of birth, date and actual time of collection, source of specimen, specimen number if from a series of collections, pertinent clinical history, and billing information. Forward it with the specimen.

2. Do not collect specimen in alcohol if culture is desired on same specimen.

Induced
1. Collect an early-morning specimen on at least 3 consecutive days in a screw-capped container (fresh specimen) or with 50% ethyl alcohol 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 of birth, date and actual time of collection, type of specimen, and specimen number if from a series of collections.
3. Maintain sterility and forward promptly.
Note:  1. Avoid sputum contamination with nebulizer reservoir water.
2. Indicate on request form if specimen is induced sputum, as these watery specimens resemble saliva and risk rejection as inadequate.
3. Complete a “Request for Specimen Analysis” in “Request Forms” in “Special Instructions” including patient’s name (first and last), date of birth, date and actual time of collection, source of specimen, specimen number if from a series of collections, pertinent clinical history, and billing information. Forward it with the specimen.

4. Do not collect specimen in alcohol if culture is desired on same specimen.