PLEURAL, PERITONEAL, PERICARDIAL AND SYNOVIAL FLUIDS CULTURE D. M. M. Lab.
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Transcript of PLEURAL, PERITONEAL, PERICARDIAL AND SYNOVIAL FLUIDS CULTURE D. M. M. Lab.
PLEURAL, PERITONEAL, PERICARDIAL AND SYNOVIAL FLUIDS CULTURE
D. M. M. Lab.
Body Fluid Culture
Aim of the test Isolate and identify pathogenic organisms from normally sterile
body fluids and perform sensitivity test
Types of specimen Aseptically aspirated body fluid (e.g., , synovial, peritoneal
fluid).
Criteria of specimen rejection Inappropriate specimen transport device; mislabeled
specimen; unlabeled specimen; specimen received after prolonged delay (usually more than two hour); specimen received in expired transport media.
Infection Of Sterile Body Fluidall body fluid are sterileCommon Pathogenic of Precarditis And Myocarditis
Pleural Fluid
Mycoplasma pneumoniae Staphylococcus aureusChlamydia trachomatis Streptococcus pneumoniae Mycobacterium tuberculosis Haemophilus influenzaeStaphylococcus aureus EnterobacteriacaeStreptococcus pneumoniae Pseudomonas spp.Enterobacteriacae and other gram negative Bacilli
Anaerobic bacteria
Fungi Mycobacterium tuberculosis
Coccidoides immitis Actinomyces spp.
Aspergillus spp. Peritoneal fluidCandida spp. Streptococcus pneumoniaeCryptococcus neoformans Group A streptococciHistoplasma capsulatum Enterobacteriacae Bones and joints Other gram negative bacilli
Staphylococcus aureus Staphylococci Streptococcus pyogenes Neisseria gonorrheaeHaemophilus influenzae Chlamydia trachomatis
Streptococcus pneumoniae FungiEnterobacteriacae Coccioides immitis
Mycobacterium spp Candida sppNeisseria gonorrheae
Pre specimen processing
Who will collect the specimen Physician
Quantity of specimen 1-5 mL is adequate, a larger quantity of fluid is better.
Time relapse before processing the sample Body fluids should be treated as CSF specimens and should
processed immediately.
Storage Maintain specimen at room temperature. Do not refrigerate.
Specimen processing
Specimen processing
Body fluids for culture should be concentrated by either filtration or high speed centrifugation.
Filtration of fluid through a 0.45-mm poresize membrane filter allows a greater volume of fluid to be processed and usually yield better results, then the filter should be cut aseptically into pieces,
one of which is placed on chocolate agar for incubation in 5% carbon dioxide, one on MacConkey agar, on blood agar plate for
aerobic incubation, and the last on a blood agar plate for anaerobic incubation.
Specimen processing
If fluid has been concentrated by centrifugation, the resulting sediment should be incubated to inoculated to an enrichment
broth, blood, chocolate and MacConkey agars.
All fluids should be processed for direct microscopic examination, in general if one organism is seen per oil
immersion field at least 105 organisms per milliliter of specimen are present.
Specimens for fungi should be examined by direct wet preparation or by preparing 10% KOH for visualization of fungi
element from a wet preparation.
Acid Fast stain for Mycobacterium spp.
Post specimen processing
Interfering factors: Patient on antibiotic therapy. Improper sample collection.
Result reporting:Report Gram stain, KOH, and AFS finding as an initial report.Report the isolated pathogen and its sensitivity pattern as a final
report.
Turn around time:Gram stain and wet mount results should be available 1 hour
after specimen receipt. Isolation of a possible pathogen can be expected after 2-4 days. Negative culture will be reported out 1-2 days after the receipt of
the specimen.