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SPECIMEN COLLECTION

Virology

Common Collection Errors | AutoCyte Prep | Biopsy Tissue | Blood Cultures | Coagulation | CSF | Cytogenetics | Cytopathology | Fecal | Pap Smears | Throat Culture | Urine Collection | Viral | Wound Sample

Special collection materials and transport media are available in Room 5.175 McCullough Building. When the laboratory is closed, they may be obtained from Microbiology Specimen Receiving, Room 5.137 McCullough.  Specimens must be collected as soon as possible after the onset of illness. Culture specimens should be immediately transported to the laboratory on ice to insure virus viability. Specify suspected viral agents on request slip.

Direct Viral Antigen Detection

Rapid Direct Viral Antigen Detection for Respiratory Specimens

Viral culture can detect most of the viral agents associated with respiratory disease but may require several days to a week to become positive. Direct detection of viral agents using rapid test methods, i.e. immunofluorescent stains or enzyme-linked assays, can dramatically speed detection of specific viral agents.

The most critical factor in the direct detection of respiratory viruses is collection of a proper specimen containing adequate numbers of infected cells. The specimen of choice is a nasal wash.

Collection of a Nasal Wash:

  1. Materials: 5 mL phosphate buffered saline (PBS); Rubber bulb (30 mL ear syringe)

  2. Aspirate the PBS into the bulb. Tilt the tube. Use all the PBS. For young infants, use 3-5 mL. Empty the tube of excess PBS to avoid diluting the specimen.

  3. Hold the patient's face chin up. A sitting position will work best. Fit the tip of the bulb into a nostril.

  4. Quickly squeeze the bulb. Immediately aspirate the PBS back into the bulb.

  5. Transfer the specimen back to the empty PBS tube. Label the tube.

  6. Transport the specimen on ice. Place the specimen in the ice bucket.

  7. Return the rubber bulb to the holding area or laboratory along with the specimen.

External Lesions - Herpes simplex virus or Varicella zoster

  1. Select a fresh vesicle (<3 days old). Scabs, vesicular fluid, bloody specimens, or pus are unsatisfactory for FA examination.

  2. Incise the vesicle peripherally with the beveled edge of a sterile needle and gently lift back the top of the vesicle.

  3. Blot the excess fluid with a sterile culturette swab and submit for virus isolation in viral transport medium (M4).

  4. Roughly scrape the base of the lesion with the scalpel blade to obtain epithelial cells. Do not induce bleeding. It is important to obtain a sufficient quantity of basal epithelial cells.

  5. Thinly spread the collected material over the 2 wells and label the slide with patient's name. Allow to air dry.

  6. Place the slide in slide holder provided and label with the patient's name and UT number.

  7. Transport to the laboratory along with the specimen for culture. A culture backup is required for HSV.

Table of infections and common virus/agent involved with suggested specimens.

Infection and Common Virus/Agent Involved

Suggested Specimens

Arthralgias/Myalgias

 

Arboviruses

Routine culture not available; serologies suggested.

Coxsackie A and B

Throat swab, stool/rectal swab

EBV

Routine culture not available; serologies suggested.

Rubella

NP swab, urine

Central Nervous System

 

Arboviruses

Routine culture not available; serologies suggested.

Enteroviruses

Throat, stool/rectal swab, CSF

Herpes simplex (HSV)

CSF, vesicle fluid, brain tissue (temporal lobe)

Influenza

Nasal secretion/washing, throat

LCM

Routine culture not available; serologies suggested.

Mumps

Throat, CSF, urine

Congenital infection

 

CMV

Urine, blood (4 mL/7 mL), throat

Herpes simplex

Vesicle fluid, throat, eye, CSF

Rubella

NP swab, urine, throat

CMV

Blood-buffy coat (7 mL/EDTA purple-topped tube), urine, bronchoalveolar lavage (BAL), lung, throat, sputum, trach suction, bronch brush/wash

Exanthems-Maculopapular

 

Enteroviruses

Throat, stool/rectal swab

Measles

Throat, NP swab, blood (7 mL green-topped tube)

Rubella

NP swab, throat

Exanthems-Vesicular

 

Coxsackie A

Throat, stool/rectal swab, vesicle fluid

Herpes simplex (HSV)

Vesicle fluid/swab

Varicella-zoster (VZ)

Vesicle fluid/swab

Eye infections, conjunctivitis

 

Adenovirus

Conjunctival swab (culture)

Chlamydia trachomatis

Conjunctival swab (culture), slide (DFA)

Herpes simplex (HSV)

Conjunctival swab, corneal scraping

Varicella-zoster (VZ)

Conjunctival swab, corneal scraping

Gastrointestinal syndromes

 

Enteroviruses

Stool/rectal swab

Adenovirus 40/41

Stool/rectal swab

Adenoviruses

Stool/rectal swab

Rotavirus

Stool/rectal swab

Hepatitis

 

CMV

Blood (2-7 mL EDTA, purple top), urine, throat

EBV

Routine culture not available; serologies suggested.

HAV

Routine culture not available; serologies suggested.

HBV

Routine culture not available; serologies suggested.

Immunocompromised patients

 

CMV

See "CMV" specimen list.

EBV

Routine culture not available; serologies suggested.

HAV

Routine culture not available; serologies suggested.

Herpes simplex (HSV)

Throat, vesicle fluid/swab

Varicella-zoster (VZ)

Vesicle fluid/swab

Mononucleosis

 

CMV

Throat, urine, blood (2-7 mL/EDTA, purple-topped tube)

EBV

Routine culture not available; serologies suggested.

Mycocarditis, pericarditis

 

Coxsackie A and B

Throat swab, stool/rectal swab

Echovirus

Swab, pericardial fluid/tissue

Respiratory Syndromes

 

Adenoviruses

Throat, NP swab

Cytomegalovirus (CMV)

See "CMV" specimen list

Enteroviruses

Nasal washing/secretion, throat

Influenza

Nasal washing/secretion, throat or NP swab, sputum

Mumps

Throat or NP swab, urine, serology

Parainfluenza

Nasal washing/secretion, NP swab, throat

Rhinovirus

Nasal or NP swab

RSV

Nasal washing/secretion

 
 

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