Microbiology specimens and requests

 

Request forms

Request forms should be completed as fully as possible as this allows more detailed interpretation of results.

Patient details should include:

  • full name
  • DOB
  • hospital number (if applicable)
  • General Practitioner/Consultant requesting test
  • GP address/Ward
Specimen details should include:
  • type of specimen
  • site (if applicable)
  • date and time of collection
Clinical details should include:
  • current diagnosis with relevant symptoms
  • past, current and intended antimicrobial therapy
  • any known allergies
  • onset date of illness (particularly important for serological investigations)

Certain clinical situations may require additional information e.g. diarrhoea: recent travel abroad, food handler, outbreak details, recent antibiotic therapy etc.

If the sample may contain high-risk pathogens such as vCJD or TB, then the request form MUST be clearly labelled so to allow the safe handling of the specimen by laboratory staff.

For suspected viral haemorrhagic fever see below.

All request forms should be signed by the requesting physician with a contact address and/or telephone or bleep number for urgent results to be communicated.

Specimens

All specimens must be labelled with full patient identification and be accompanied by a request form giving full clinical details and signed by a doctor, in accordance with BSUH Pathology Specimen and Request Form Labelling Requirements (downloadable here).

Any unlabelled or leaking specimen will not normally be processed. In the case of unrepeatable specimens (e.g. blood cultures, CSF, aspirates) the clinician requesting the test will be contacted.

Ebola and other Viral Haemorrhagic Fevers.

Click here* to review the processes to be followed if any patients fulfil the clinical criteria for suspected Ebola and other Viral Haemorrhagic Fevers within our Trust. Please direct any concerns or comments to Dr Mohammed Osman Hassan-Ibrahim, Consultant Virologist and Microbiology Laboratory Lead.

* Actions For Clinical Teams and the Pathology Laboratory in the Investigation of Ebola (and other Viral Haemorrhagic Fevers) (rev 2), last updated 12.2.2018

Protect patients
Protect lab staff
Protect yourselves
  • Always fill in the clinical details section of your Pathology request forms.
  • Including travel history and possible exposure to high-risk pathogens can improve the quality of test results, reduce delays and prevent unnecessary risks to NHS staff.
 

Tests

Please use the test index at the top of the page for information on individual tests, or links below.

Biopsy specimens (microbiology)

Blood cultures

Blood for serology

Body fluid microbiology

CSF microbiology

Faeces microbiology

Pus

Scrapings/ clippings for mycological investigation

Sputum microbiology

Swabs (microbiology)

Pertussis

MRSA screening swabs

Meningococcal and diphtheria screening swabs

TB culture

T-SPOT TB assay

Urine microbiology

 

Quoted turnaround times are the time from receipt of specimen into the laboratory to 90% of reports leaving the laboratory. Stated times are based on normal working hours, Monday to Friday, excluding statutory bank and public holidays.

Specimen collection and transportation

Routine specimens

There are regular collections from all clinical areas within the hospitals during working hours and from the specified collection sites in the community.

Outside normal working hours: at PRH samples will be placed in the reception area in the designated boxes. At RSCH all samples will be placed in the hatchway at pathology reception or transported by air tube.

This includes specimens from General Practice which will be processed routinely. However, please note that taking routine specimens from patients at the weekend is best avoided whenever possible. Fresh specimens for investigation during the normal opening times are preferable.

Urgent specimens

During normal laboratory hours, urgent specimens should be transported as rapidly as possible to the Pathology Specimen Reception. Please also telephone the laboratory to notify us that the specimen is expected (ext. 4620 for RSCH, ext 8228 for PRH).

Outside normal working hours please contact the duty Biomedical Scientist via the RSCH switchboard. Click here for details of on-call service.

Please ensure that the specimen is correctly labelled and clearly marked URGENT as this can avoid a great deal of wasted time.

Requests for additional examinations

Bacteriology

Additional requests will be accepted up to 24 hours after the receipt of the specimen.

Virology

Serum samples are saved for a minimum of 1 year.

Viral PCR specimens are kept for approximately 3 months.

Needlestick serum is kept indefinitely.

Chlamydia samples kept for 1 week.

HIV viral load serum is kept indefinitely

Results

All positive results from cultures of blood, CSF, other normally sterile sites and stool samples will be telephoned immediately to the Ward / Practice / Doctor caring for that particular patient (except positive stool samples from GP practices - these are not routinely telephoned).

Other results which are considered of clinical importance on the basis of clinical details supplied will also be telephoned and their significance discussed.

Results are viewable on ICE Desktop or on GP systems as soon as they are available. For information on how to access ICE Desktop click here.

Factors affecting test performance and interpretation of result

In order for the laboratory to perform the correct tests and provide the appropriate results it is important for requesting clinicians to be aware of the factors which can affect test performance and the interpretation of results.

For example:

  • Wrong sample container/swab used, e.g. a pernasal swab must be used for B.pertussis culture.

  • Wrong sample type for investigation required, e.g. a urine containing boric acid may not be used for TB culture.

  • Delay in transportation, i.e. rapid transportation results in greater likelihood of recovering pathogens.

  • Volume of specimen, e.g. blood cultures.

  • Timing of specimen, e.g. prior administration of antimicrobials (if possible send specimens before commencing antimicrobial therapy).

  • Poor quality specimens, e.g. blood cultures contaminated with skin flora due to inadequate skin disinfection, submission of saliva rather than sputum.

  • Insufficient supply of clinical details, e.g. symptoms, travel, test required.

  • Insufficient supply of treatment details, e.g. intended, recent or current antibiotics.

If in any doubt, please contact the laboratory for advice.