Investigation of fluids from normally sterile sites

Microbiology

Preparation of patient: Collect specimens before antimicrobial therapy where possible.

Precautions: Specimens should be transported and processed as soon as possible. Sputum may be refrigerated for up to 2-3 h without an appreciable loss of pathogens. Any delay beyond this time may allow overgrowth of Gram-negative bacilli, and Haemophilus species and S. pneumoniae may be rendered non-viable. Where transport is difficult, specimens may be cultured up to 48 h after collection. If specimens are not processed on the same day as they are collected, interpretation of results should be made with care.For sputum specimens the material required is from the lower respiratory tract, expectorated by deep coughing. When the cough is dry, physiotherapy, postural drainage or inhalation of an aerosol before expectoration may be helpful. Saliva and pernasal secretions are not suitable.

If processing is delayed, refrigeration is preferable to storage at ambient temperature. Delays of over 48hr are undesirable.

Sample Type:

Sputum - Ideally, a minimum volume of 1 mL.

BAL - It is difficult to be specific on volume required; in principle, as large a volume as possible is preferred.

Temperature: 2-8°C

Turnaround Time:

5d for a negative result.

6d for a positive result.

Preliminary results available on request.

*Excludes Sundays and Bank Holidays except in cases of prior clinical agreement

Recovery and recognition of organisms responsible for pneumonia depends on:

The adequacy of the lower respiratory tract specimen.
Avoidance of contamination by upper respiratory tract flora.
The use of microscopic techniques and culture methods.
Current and recent antimicrobial treatment.

Distinction between tracheobronchial colonisation and true pulmonary infection can prove difficult.

The expression lower respiratory tract infection (LRTI) includes pneumonia, where there is inflammation of the lung parenchyma, and infections such as bronchiolitis that affect the small airways. Lung abscess, where the lung parenchyma is replaced by pus filled cavities, and empyema, where pus occupies the pleural space, are less common manifestations of LRTI.

PLEASE NOTE: Samples and accompanying relevant patient/ isolate data maybe referred for confirmatory or further laboratory testing to Reference laboratories. Relevant Public Health departments may also be notified IF a notifiable disease is identified under the Infectious Diseases Regulations https://www.hpsc.ie/notifiablediseases/listofnotifiablediseases/

NOTE: Samples for the investigation of mycobacterial disease, parasitic infection and fungal infection should be clearly marked as such, as these samples are not processed in Eurofins Biomnis in Ireland.

Sample Stability:

2 days @ 2-8ºC

Instrument / Procedure:

Manual Gram Stain Microscopy & Culture

Units:

Reference Range:

Precautions:

Preparation of patient: Collect specimens before antimicrobial therapy where possible.

Precautions: Ideally, a minimum volume of 1 mL is required.

Large volume - specimens such as peritoneal fluid and ascitic fluid may contain very low numbers of organisms which are usually received in adequate quantities and require concentration to increase the likelihood of successful culture.

Small volume - fluids such as synovial fluids may be received in inadequate volumes, which may impede the recovery of organisms.

If processing is delayed, refrigeration is preferable to storage at ambient temperature. Delays of over 48hr are undesirable.

Download full Primary Sample Management Document

Source:

Accreditation Status:

Accredited

Non-Accredited

SAMPLE REQUIREMENTS FOR COAGULATION TESTS

PROCEDURE

Sample Requirements and Collection

Patients should be relaxed pre-venepuncture. Excessive stress and exercise will increase FVIII, vWF antigen and fibrinolysis. Venous occlusion should be avoided.
Difficult venepuncture with trauma may lead to platelet activation with release of PF4 from alpha granules.
Venous blood should be collected into coagulation tubes containing Sodium Citrate 3.2%, 0.105M.
Specimens must be mixed immediately post venepuncture to avoid clot activation, by GENTLY inverting the tubes 5 to 10 times.
The ratio of whole blood to anticoagulant is crucial to clotting times. A target blood to anticoagulant ratio of 9:1 is optimal. Under- or over- filled specimens will not be processed this can adversely affect results.
Any warfarin treatment should be mentioned on the request form.
Sample rejection Criteria: Clotted sample, grossly hemolyzed sample, underfilled/overfilled specimen, unlabeled sample, mismatched patient ID, aged samples, wrong sample tube (citrate tube only).

Transportation and Storage

PT/INR specimens should be transported to the laboratory at room temperature.
Coagulation specimens should ideally be analysed within 4 hours of collection. Where this is not possible, centrifuge specimens at room temperature (RT) @ 1500RCF for at least 15 minutes, and then carefully remove the plasma from the cells, transfer to a fresh plastic plain tube and freeze at -20oC.
Non-frozen coagulation specimens should be transported at RT ASAP to avoid deterioration of labile factors V and VIII.
Collection of blood through intravenous lines that have been previously flushed with heparin should be avoided. In the event blood is drawn from an indwelling catheter, the line should be flushed with 5ml of saline, and the first 5ml of blood or 6 times the line volume be drawn off and discarded before coagulation tube is filled.
Effect of freezing on Coagulation Specimens.
A 14days in-house study on the effect of freezing, on coagulation specimens at -20oC, showed that there was negligible and clinically non-significant effect of freezing on coagulation specimen results. Therefore frozen citrated coagulation samples are stable for 14 days at -20oC, post centrifugation. This study is available in-house for reference.

ESR Ref Ranges

Units of Measurement

MALE

FEMALE

>50 Years

mm/hr

0 - ≤12

0 - ≤15

<50 Years

mm/hr

0 - ≤8

0 - ≤10

Download Brochure

Download Sample Report

Download Request Form

Analyte

Units of Measurement

MALE

FEMALE

WBC

10^9/L

4.0–10.0

4.0 - 10.0

RBC

10^12/L

5.0 ± 0.5

4.3 ± 0.5

g/dL

15.0 ± 2.0

13.5 ± 1.5

HCT

L/L

0.45 ± 0.05

0.41 ± 0.05

MCV

92 ± 9

MCH

29.5 ± 2.5

MCHC

g/dL

33.0 ± 1.5

PLT

10^9/L

280 ± 130

MPV

N/A

RDW

11.6 - 14.0

#Neut

10^9/L

2.0 – 7.0 (40 - 80%)

#Lymph

10^9/L

1.0 – 3.0 (20 - 40%)

#Mono

10^9/L

0.2 – 1.0 (2 - 10%)

#Eos

10^9/L

0.02 – 0.5 (1 - 6%)

#Baso

10^9/L

0.02 – 0.1 (<1 - 2%)

Analyte

Units of Measurement

MALE & FEMALE

WBC

10^9/L

Birth: 18 ± 8
Day 3: 15 ± 8
Day 7: 14 ± 8
Day 14: 14 ± 8
1 Month: 12 ± 7
2 Months: 10 ± 5
3–6 Months: 12 ± 6
1 Year: 11 ± 5
2–6 Years: 10 ± 5
6–12 Years: 9 ± 4

RBC

10^12/L

Birth: 6.0 ± 1.0
Day 3: 5.3 ± 1.3
Day 7: 5.1 ± 1.2
Day 14: 4.9 ± 1.3
1 Month: 4.2 ± 1.2
2 Months: 3.7 ± 0.6
3–6 Months: 4.7 ± 0.6
1 Year: 4.5 ± 0.6
2–6 Years: 4.6 ± 0.6
6–12 Years: 4.6 ± 0.6

g/dL

Birth: 18.0 ± 4.0
Day 3: 18.0 ± 3.0
Day 7: 17.5 ± 4.0
Day 14: 16.5 ± 4.0
1 Month: 14.0 ± 2.5
2 Months: 11.2± 1.8
3–6 Months: 12.6 ± 1.5
1 Year: 12.6 ± 1.5
2–6 Years: 12.5 ± 1.5
6–12 Years: 13.5 ± 2.0

HCT

L/L

Birth: 0.60 ± 0.15
Day 3: 0.56 ± 0.11
Day 7: 0.54 ± 0.12
Day 14: 0.51 ± 0.12
1 Month: 0.43 ± 0.10
2 Months: 0.35 ± 0.07
3–6 Months: 0.35 ± 0.05
1 Year: 0.34 ± 0.04
2–6 Years: 0.37 ± 0.03
6–12 Years: 0.40 ± 0.05

MCV

Birth: 110 ± 10
Day 3: 105 ± 13
Day 7: 107 ± 19
Day 14: 105 ± 19
1 Month: 104 ± 12
2 Months: 95 ± 8
3–6 Months: 76 ± 8
1 Year: 78 ± 6
2–6 Years: 81 ± 6
6–12 Years: 86 ± 9

MCH

Birth: 34 ± 3
Day 3: 34 ± 3
Day 7: 34 ± 3
Day 14: 34 ± 3
1 Month: 33 ± 3
2 Months: 30 ± 3
3–6 Months: 27 ± 3
1 Year: 27 ± 2
2–6 Years: 27 ± 3
6–12 Years: 29 ± 4

MCHC

g/dL

Birth: 33.0 ± 3.0
Day 3: 33.0 ± 4.0
Day 7: 33.0 ± 5.0
Day 14: 33.0 ± 5.0
1 Month: 33.0 ± 4.0
2 Months: 32.0 ± 3.5
3–6 Months: 33.0 ± 3.0
1 Year: 34.0 ± 2.0
2–6 Years: 34.0 ± 3.0
6–12 Years: 34.0 ± 3.0

PLT

10^9/L

Birth: 100 – 450
Day 3: 210 – 500
Day 7: 160 – 500
Day 14: 170 – 500
1 Month: 200 – 500
2 Months: 210 – 650
3–6 Months: 200 – 550
1 Year: 200 – 550
2–6 Years: 200 – 490
6–12 Years: 170 – 450

Reticulocytes

10^9/L

Birth: 120 – 400
Day 3: 50 – 350
Day 7: 50 – 100
Day 14: 50 - 100
1 Month: 20 – 60
2 Months: 30 – 50
3–6 Months: 40 – 100
1 Year: 30 – 100
2–6 Years: 30 – 100
6–12 Years: 30 – 100

#Neut

10^9/L

Birth: 4 – 14
Day 3: 3 – 5
Day 7: 3 – 6
Day 14: 3 – 7
1 Month: 3 – 9
2 Months: 1.0 – 5
3–6 Months: 1 – 6
1 Year: 1 – 7
2–6 Years: 1.5 – 8
6–12 Years: 2 – 8

#Lymph

10^9/L

Birth: 3 – 8
Day 3: 2 – 8
Day 7: 3 – 9
Day 14: 3 – 9
1 Month: 3 – 16
2 Months: 4 – 10
3–6 Months: 4 – 12
1 Year: 3.5 – 11
2–6 Years: 6 - 9
6–12 Years: 1 - 5

#Mono

10^9/L

Birth: 0.5 – 2.0
Day 3: 0.5 – 1.0
Day 7: 0.1 – 1.7
Day 14: 0.1 – 1.7
1 Month: 0.3 – 1.0
2 Months: 0.4 – 1.2
3–6 Months: 0.2 – 1.2
1 Year: 0.2 – 1.0
2–6 Years: 0.2 – 1.0
6–12 Years: 0.2 – 1.0

#Eos

10^9/L

Birth: 0.1 – 1.0
Day 3: 0.1 – 2.0
Day 7: 0.1 – 0.8
Day 14: 0.1 – 0.9
1 Month: 0.2 – 1.0
2 Months: 0.1 – 1.0
3–6 Months: 0.1 – 1.0
1 Year: 0.1 – 1.0
2–6 Years: 0.1 – 1.0
6–12 Years: 0.1 – 1.0

Reference Ranges:

Age

Absolute Reference Range

Age

% Reference Range

0 - 1 day

324 - 617 x10⁹/L

0 - 1 day

1.72 - 8.62%

1 - 5 days

85 - 400 x10⁹/L

1 - 5 days

1.9 - 9.1%

5 days - 1 mth

34.2 - 724 x10⁹/L

5 days - 1 mth

0.1 - 6.9%

1 - 3 mths

21.3 - 205 x10⁹/L

1 - 3 mths

0.1 - 6.27%

3 - 12 mths

8.0 - 171 x10⁹/L

3 - 12 mths

0.1 - 4.7%

1 - 3 yrs

55.6 - 120 x10⁹/L

1 - 3 yrs

0.35 - 2.95%

3 - 7yrs

16.4 - 120.7 x10⁹/L

3 - 7yrs

0.25 - 2.57%

Adult

35.2 - 122.8 x10⁹/L

Adult

0.75 - 2.7%

Test Request Forms

Access Online Results

Test Guide

Book a Collection - only for Blackthorn Road Site

Bank Holidays

Related Tests

Haemochromatosis

Related Tests

HLA-B27

Related Tests

No items found.

Investigation of fluids from normally sterile sites

Related Tests

Blood Film Review

Sickle Cell Screening Test

Reticulocytes

D-Dimer

Blood parasitology - malaria

Activated partial thromboplastin time

Prothrombin time

Fibrinogen (Clauss method)

Infectious mononucleosis

Erythrocyte sedimentation rate

Full blood count

Related Tests

6MAM heroin metabolite

Alanine amino transferase alt

Albumin

Albumin/ creatinine ratio (ACR)

Alkaline phosphatase

Alpha-1 antitrypsin A1AT

Alpha-fetoprotein AFP

Amikacin

Amphetamine/meth amphetamine - urine

Amylase

Angiotensin converting enzyme (ace)

Anti-TG

Anti-TPO

Aspartate amino transferase AST

Barbiturates, semiquantitative

Benzodiazepines semiquantitative

Beta-2-microglobulin

Bile acid

Bilirubin 2 total

Bilirubin direct

Bilirubin, indirect

C-peptide

C-reactive protein - high sensitivity

CA 125 ii

CA 15-3

CA 19-9

Calcium

Calcium, calculated

Calcium-urine

Cannabinoids, semiquantitative

Carbon dioxide/ bicarbonate

Carcino embryonic antigen CEA

Ceruloplasmin

Chloride

Chloride-urine

Cholesterol, LDL (direct)

Cholesterol, total

Cholesterol, ultra HDL

Cocaine, semiquantitative

Complement C3

Complement C4

Cortisol

Cortisol - urinary

Creatine kinase CK

Creatinine enzymatic

Creatinine enzymatic-urine

Dhea-S

Digoxin

EDDP methadone metabolite

EGFR

Ecstasy, semiquantitative

Estradiol

Ethanol

Faecal immunochemical test (FIT)

Ferritin

Folate

Follicle stimulating hormone FSH

Free T3

Free T4

Free androgen index FAI

Gamma-glutamyl transferase

Gentamicin

Globulin

Glucose

Haemoglobin A1C (Ifcc)

Homocysteine