Microbiological studies
Materials subject to bakobsledovaniyu, collected in sterile dishes, accompanied by a label with the name of the subject and the name of the material. In the accompanying document( direction), it is necessary to indicate which department is sending the material,and the age of the patient, the presumptive diagnosis, antibacterial therapy, the date and hour of sampling.
The material is delivered in containers, excluding their tilting. During transportation, wetting of cotton plugs and freezing of the material are not allowed. The material is delivered within 1-2 hours after taking. If it is impossible to deliver in the specified time, the biomaterial is stored in the refrigerator( except blood and the material being examined for the presence of meningococcus).If the delivery time of samples is increased to 48 hours, transport media should be used.
Sampling procedures should be described by a microbiologist in a special instruction. Laboratory staff conduct initial training of all personnel for compliance with sampling.
Samples delivered to the laboratory should be placed in a specially designated place for receiving the biomaterial. At the laboratory, the reception is responsible for monitoring the proper delivery of samples. It is strictly forbidden to deliver material to the laboratory by the surveyed persons.
In case of non-observance of the conditions, samples can not be processed - this is reported to the attending physician, and the research is repeated.
General requirements for the procedure for sampling and transport of samples:
• knowledge of the optimal timing for taking material for the study;
• taking the material taking into account the location of the maximum localization of the pathogen by its release into the environment;
• selection of the material for investigation in the required and sufficient volume, with the provision of conditions that exclude the contamination of samples;
• If possible, take the material before applying antibiotics and other chemotherapeutic drugs, or after the abolition of antibiotics after 2-3 days.
Microbiological blood test
A procedural nurse or laboratory assistant takes blood from a patient in a treatment room or in a ward, depending on the patient's condition. It is recommended to take blood for sowing before the beginning of antibiotic therapy or 12-24 hours after the last injection of the drug to the patient.
Sowing is carried out during the temperature rise. Blood is recommended to be taken 2-4 times a day, with acute sepsis - 2-3 takes from different places within 10 minutes. If the patient has a permanent subclavian catheter or a system in the vein, they can be used to receive blood only for 3 days, since the catheter is contaminated. A small amount of blood is allowed to flow freely into a test tube, then blood is siphoned into the syringe for seeding. The blood culture is carried out over a spirit lamp.
Blood is taken in adults in the amount of 5-20 ml, and in children - 1-15 ml, from a syringe without a needle over an alcohol lamp is sowed in bottles with a nutrient medium in a ratio of blood and medium 1:10.Vials with blood are delivered to the laboratory immediately.
Microbiological examination of urine
As a rule, the morning portion of urine is examined. Before taking the toilet toiletry of the external genitalia. When urinating, the first portion of urine is not used. In the second urination, beginning with its middle, the urine is collected in sterile dishes in an amount of 3-10 ml, tightly closed with a sterile stopper. It is desirable to deliver urine samples to the laboratory immediately. If this is not possible, urine can be stored at room temperature for 1-2 hours, but not more than 24 hours( at 4 ° C) after collection.
Microbiological examination of stool
For infectious diseases( typhoparathyphoid, OCI, dysentery) and nosocomial infections of the gastrointestinal tract, the material is taken from the first hours and days of admission to the beginning of antibiotic therapy. Samples are taken at least 2 times.
Stools for sowing are taken immediately after defecation. The collection is carried out from a vessel, a pot, diapers, which are thoroughly disinfected and repeatedly washed with hot water. From the dishes, feces are taken with a sterile spatula or a stick in sterile jars with a lid, test tubes. Selected samples include pathological impurities( pus, mucus, flakes).If it is impossible to obtain stool, the material is taken directly from the rectum with the help of rectal tampons. The tampon is soaked in saline and injected at 8-10 cm, and then placed in sterile test tubes. Cal is delivered to the laboratory no later than 1-2 hours after collection. The material may be stored at 2-6 ° C for 24 h
Microbiological examination of the cerebrospinal fluid CSF
Taking preferably carried out before the beginning of antibiotic treatment -. In a sterile tube with a cap in an amount of 1-3 ml. The material is delivered to the laboratory, where immediately, while the cerebrospinal fluid is warm, it is subjected to analysis. When this is not possible liquor can be stored at a temperature of 37 ° C incubator for 2-3 h.
During transport liquor carefully prevented from cooling, using heaters, thermos.
Microbiological examination pus, biopsy wall abscess
test material in a maximum amount taken with a sterile syringe and it is closed needle is delivered into the lab immediately or may be stored in a refrigerator for 2 hours.
Microbiological examination of sputum
patient before expectoration brushing teeth,rinsing the mouth and throat with boiled water. Sputum is collected in a sterile jar or vial with a lid;if it is separated badly, it is recommended to prescribe on the eve of expectorants or the patient is given a 25 ml 3-10% saline solution through a nebulizer.
Sputum can be stored for 2 hours at room temperature and for 24 hours in the refrigerator. When collecting sputum, the patient should not mix slime and saliva in the mouth. Sputum, consisting of saliva and food particles, is not investigated. Microbiological examination
nasopharyngeal mucus, purulent tonsils, discharge from the nose
capture material is carried on an empty stomach or not earlier than 2-4 hours after a meal. The root of the tongue is pressed down with a spatula. The material is taken with a sterile swab, without touching the tongue, mucous cheeks and teeth.
In the study of nasopharyngeal mucus on meningococcus use a curved sterile cotton swab. It is injected end-to-end over the soft palate into the nasopharynx and conducted 3 times along the back wall. In patients with suspected angina diphtheria material taken from the tonsils dry swab, in the presence of the raids - should be taken with a border of healthy and diseased tissue, lightly clicking on them swab. The material on dry tampons is delivered to the laboratory for 2 hours in bags with heaters.
In pertussis and paracottus, nasopharyngeal mucus, nasopharyngeal flushing, transtrachelal aspirates are examined. Fixing the patient's head, the swab is introduced into the nostril to the most posterior nares and left there for 15-30 seconds, then removed and placed in a sterile tube. When collecting material from the mouth, a tampon is inserted behind the soft palate, trying not to touch the tongue and tonsils. Remove mucus from the back of the pharynx, carefully remove the tampon, which is placed in a sterile tube.
When material is collected on nutrient media, the material is obtained by substituting a patient with a petri dish with the medium vertically during coughing and holding it at a distance of 5-10 cm for several seconds to catch 5-6 cough shocks. The cup with sowing is quickly closed with a lid, wrapped in paper and cotton wool. The material is delivered to the laboratory immediately at a temperature of 22-37 ° C.In winter, warmers are placed in a container( 35-40 ° C).Storage of the material is possible at a temperature of 37 ° C for 2-3 hours.