BACTERIAL CULTURE (OCME)

Laboratory: Microbial Reference

Test Description: Cultivation and identification of bacteria from postmortem specimens received from the Office of the Chief Medical Examiner (OCME)

Order Approval Required? No

Specimen Type: Cerebral Spinal Fluid (CSF), Blood, Other Body Fluids (e.g., joint, pleural, peritoneal, pericardial, amniotic), Tissue, Swab, Urine, Stool

Collection Container:

• Blood- Wampole ISOLATOR Tube or a blood culture bottle
• CSF- sterile container, preferably a sterile red top vacutainer tube
• Tissues, body fluids, and swabs (dry or in appropriate transport media)- sterile containers
• Urine- sterile cup or a red top vacutainer tube
• Stool- Cary-Blair Transport Media or rectal swab in gel transport media or in Cary-Blair Transport media

Optimal Volume:

• Blood- >3ml for adult; >1ml for pediatric
• CSF- Minimum 1ml
• Urine- >1ml
• Stool- Enough stool sample should be collected to bring the Cary-Blair media level up to, but not exceeding, the fill line

Collection Guidelines: Samples should be cultured as soon as possible for best organism recovery, but no longer than 48 hours after collection

Storage Instructions:

• Blood- Isolator tube stored at room temperature, blood culture bottle stored at 35-37°C
• CSF- Store at room temperature
• Tissues, body fluids, and swabs (dry or in appropriate transport media)- Store at 2-8°C
• Urine- Store at 2-8°C
• Stool- Store at 2-8°C

Transportation Instructions:

• Blood- room temperature
• CSF- CSF for bacterial culture should be transported at room temperature. CSF for viral culture should be transported with cold packs. If a CSF specimen requires both bacterial culture and viral culture, but cannot be split into 2 tubes, the CSF should be transported with cold packs.
• Tissues, body fluids, and swabs (dry or in appropriate transport media)- Transport with cold packs
• Urine- Transport with cold packs
• Stool- Transport with cold packs preferred (room temperature is also acceptable)

Test Methodology: Conventional culture techniques, MALDI-TOF for identification

Additional Information: Due to agonal invasion of sterile tissues with skin, fecal or normal respiratory flora, the OCME may be contacted to direct identification of isolates. Patient history information provided by the OCME assists the laboratory to determine if the cause of death may be related to an infection, which would lend more weight to workup of an organism that might otherwise be considered invasion from normal flora.

Causes for Rejection:

• Any sample rejections must be approved by the Group Manager, Director of Laboratory Operations, or Laboratory Director after consultation with the OCME
• Samples with no name or identifier, mismatched samples and test request forms
• Media that has expired prior to inoculation
• Incorrect or broken transport media
• Improper transport temperature
• The specimen containers must be labelled with two unique patient identifiers that exactly match two unique identifiers on the test request form

Reference Value