Patients presenting with symptoms for Respiratory syncytial viral infection

Please have patient blow their nose prior to NP and nasal collections. Excessive mucus is known inhibitor/interfering substance for molecular testing.

For Allina Health Clinic Ambulatory patients only:

Hologic Direct Load Tube

For all other patients:

Universal Transport media (UTM) 

For Allina Health Clinic Ambulatory patients:

The Hologic Direct Load Tube allows for Nasal/OP collection using the pink proprietary swab.

Nasal collection

1. Insert swab in one nostril 1/2”-3/4” until swab tip is no longer visible.
2. Rotate the swab using moderate pressure along the nostril wall at least 4 times.
3. Complete the collection by swabbing the other nostril in the same fashion.
4. Uncap the transport media, insert the swab into the media, break swab against the tube at the score line, recap.

OP Collection

1. Carefully swab both sides of the posterior pharyngeal wall while rotating the swab.
2. Avoid touching the cheek(s) or tongue.
3. Uncap the transport media, insert the swab into the media, break swab against the tube at the score line, recap.

For all other patients:

Nasopharyngeal (NP) swab collection:

Use the mini-tip NP swab included in the Influenza PCR collection kit.

1. Tip the patient’s head back.
2. Gently insert the NP swab into the nostril parallel to the palate (not upwards) until resistance is encountered or the distance is equivalent to that from the ear to the nostril of the patient, indicating contact with the nasopharynx.   
   • If any resistance is met in the passageways, do not force the swab; back off and try reinserting it at a different angle, closer to the floor of the nasal canal, or try the other nostril.
3. Gently rub and roll the swab for 10-15 seconds while the swab is in contact with the nasopharyngeal wall.
4. The CDC recommends leaving the swab in place for several seconds to absorb secretions.
5. Slowly remove the swab and place in the transport medium.
6. Break the swab shaft so that it fits into the medium container and recap tightly.
7. Label the specimen appropriately. Document the source “NP” on the label.

New England Journal of Medicine video on NP swab collection: Nasopharyngeal Swab Collection Video

Universal Transport media (UTM)

1. Break swab off in UTM container
2. Cap tightly

Hologic Direct Load Tube - Allina Health Clinic Ambulatory Patients only

Universal Transport media (UTM)

Phosphate Buffered Saline (PBS)

Phosphate Buffered Saline (PBS)

Hologic Direct Load Tube - (Allina Health Clinic Ambulatory)

• Refrigerated - 6 days
• Ambient - 6 days

Universal Transport media (UTM)

1. Refrigerated (2-8°C) – 7 days

• Improper label (unlabeled or mislabeled)
• Swabs other than nasopharyngeal (NP)
• NP swabs not in UTM or PBS
• NP bacterial culture swabs (Amies or Stuarts medium)
• Nasopharyngeal aspirates and washes
• Dry nasopharyngeal swab
• Nasal swab
• Oropharyngeal swab or unflocked swabs
• Time delay between time of collection and receipt of specimen
• Improper transport container
• Improper transport temperature
• Interfering substances
• Inappropriate specimen type
• Leaking container

Real-Time Polymerase Chain Reaction (RT-PCR)

Negative

Excessive mucus is a known inhibitor/interfering substance for molecular tests. Review specimen tab for patient preparation.