Identification, susceptibilities and serogrouping will be performed on all microbiology isolates considered by the laboratory to be significant.

Swab:

ESwab standard tip collection kit (white)

Fluid:

A.C.T. I culture transport

Tissue:

ESwab standard tip collection kit (white) in the liquid without the swab

Anaerobes are part of the endogenous flora of the body, so it is important to culture only specimen from sites that do not have normal anaerobic flora (refer to reasons for rejection).

Sources appropriate for anaerobic culture include: Abscess aspirate (including rectal, oral and vaginal), body fluid, bronchoscopy, Cerebral spinal fluid (CSF), IUD for Actinomyces species, placental tissue from C-section delivery, sinus aspirate/swab, surgical specimens not contaminated with bowel flora, tissue, transtracheal aspirate or urine collected by suprapubic aspirate.

Swab Collection

1. Open and remove the tube and swab applicator.
2. Collect specimen. Do not touch the area below the red breakpoint line.
3. Aseptically remove cap from tube.
4. Insert swab into tube and bend shaft against tube at colored line to break shaft.
5. Replace cap on the tube and secure tightly.
6. Label specimen with patient’s name, ID#, specimen source, and date and time of collection.

Needle Aspiration

1. Disinfect the rubber stopper of vial of the A.C.T. I culture transport tube with 70% alcohol prep.
2. Using aseptic technique, aspirate specimen with a sterile syringe and needle. Expel air from syringe.
3. Inject fluid slowly through rubber stopper into the A.C.T. I culture transport tube
4. Label specimen with patient’s name, ID#, specimen source, and date and time of collection.

Tissue Collection

1. Open and remove the ESwab transport tube. The ESwab applicator is not needed.
2. Aseptically remove cap from tube.
3. Using aseptic technique, place the tissue in the liquid in the transport tube.
4. Replace cap on the tube and secure tightly.
5. Label specimen with patient’s name, ID#, specimen source, and date and time of collection.

Specimen MUST be in ESwab or anaerobic transport media.

Allina Health metro hospital collections may be sent directly to the lab in a capped syringe (no needles) with air expressed out within one hour of collection.

Notes:

• If specimen quantity is limited, the entire specimen can be placed in the anaerobic container. Aerobic, anaerobic, fungus and AFB cultures can all be performed on specimens in anaerobic transport containers.
• Order Anaerobic Culture and the appropriate aerobic culture (ex, Body Fluid Culture, Tissue Culture, etc.)

Swab:

ESwab transport tube

Fluid:

A.C.T. culture transport

Tissue:

ESwab transport tube in the liquid without the swab

Swab:

ESwab flexible mini-tip collection kit (blue)

ESwab mini-tip collection kit (green)

Tissue:

E swab mini-tip collection kit (blue or green) in the liquid without the swab

Swab:

ESwab transport tube (blue or green)

Tissue:

ESwab transport tube (blue or green) in the liquid without the swab

A.C.T. I culture transport tube:

Ambient - 48 hours

ESwab:

Ambient (preferred) - 48 hours

Refrigerated - 48 hours

• Improper label (unlabeled or mislabeled)
• Time delay between time of collection and receipt of specimen
• Inappropriate timing of collection
• Improper transport container
• Improper transport temperature
• Interfering substances
• Inappropriate specimen type
  • Colostomy discharge
  • Decubitus ulcer
  • Fecal/rectal swab
  • Foley cath tips
  • Lochia
  • Oral swab
  • Placenta from a vaginal delivery
  • Skin swab
  • Sputum
  • BAL or bronchoscopy specimens NOT collected by protected brush
  • Prostatic or seminal fluid
  • Specimens from sites contaminated with fecal flora
  • Superficial wound specimens
  • Throat, nasal or nasopharyngeal (NP) swabs
  • Urethral secretions
  • Vaginal/cervical swabs
  • Voided or catheterized urine 
  • Swabs not in anaerobic transport media
• Leaking container

Culture

Anaerobic organisms are involved in a variety of infections. Specimens from appropriate sites are cultured to isolate potential pathogens. Anaerobes are part of the endogenous flora of the body, thus it is important to culture only specimens from sites that do not have normal anaerobic flora. When possible, tissue specimens or specimens collected by needle and syringe are preferred.

Most anaerobic infections are polymicrobial and involve anaerobic, aerobic and facultative anaerobic organisms.

The identification of anaerobic organisms is based on, colony morphology, gram stain morphology, growth in the presence of bile, susceptibility to antibiotics, biochemical tests and other available testing methods.