TEST DIRECTORY

Result interpretation criteria for common bacteria

Test results for items listed below will be reported in the following manner, according to the following SRL criteria:
(Reference: Clinical Microbiology Procedures Handbook - 4th edition)

Criteria for harvesting bacterial colonies in major samples

The process of collecting bacteria for the identification of common bacteria by culture will be performed according to the following SRL criteria:

• Bacteria	Sputum, throat	Urine	Vaginal secretion	Blood, cerebrospinal fluid
  Staphylococcus aureus	○	○	○	◎
  Staphylococcus species, coagulase-negative	◆ Note 1	○	○	◎
  β-hemolytic streptococci	◎	○	◎	◎
  Streptococcus pneumoniae	◎	○	○	◎
  Enterococcus	◆ Note 1	○	○	◎
  Enterobacteria	◆ Note 2, Note 3	○	○	◎
  Pseudomonas aeruginosa	○	○	○	◎
  Non-fermentative bacteria	◆ Note 1	○	○	◎
  Haemophilus	◆ Note 2	－	○	◎
  Branhamella	◆ Note 2	－	－	◎

• Symbols and interpretations

  ◎：Collected if 1 colony is detected
  ○：Collected if 1+ colonies are detected
  ◆：Collected if 2+ colonies are detected
  －：Not collected
  Note 1：Not collected unless there is significant growth
  Note 2：Collected if there is significant growth even with 1+ colonies
  Note 3：Collected in the case of Klebsiella pneumoniae even with 1+ colonies

Other bacteria will be collected only when a target is specifically requested for. (Please see below for the list of target bacteria.)
If specifically requested, a target bacteria will be collected even if there is only 1 colony.

Target bacteria

• CODE	Target bacteria
  M000060	Diarrheagenic Escherichia coli (including O157)
  M000004	Escherichia coli O157
  M000011	Yersinia enterocolitica
  M000074	Bordetella pertussis
  M000078	Neisseria gonorrhoeae
  M000065	Neisseria meningitidis
  M000015	Campylobacter
  M000058	Legionella
  M000026	Corynebacterium diphtheriae

• CODE	Target bacteria
  M000066	Shigella
  M000024	Salmonella
  M000069	Vibrio parahaemolyticus
  M000023	Vibrio cholerae
  M000076	Pseudomonas aeruginosa
  M000051	Haemophilus
  M000042	Staphylococcus
  M000003	MRSA
  M000072	Streptococcus pneumoniae

• CODE	Target bacteria
  M000001	Group A streptococci
  M000002	Group B streptococci (GBS)
  M000021	Clostridium difficile
  M000022	Clostridium perfringens
  M000014	Candida
  M000016	Cryptococcus
  M000007	Aspergillus
  M000073	Trichophyton
  M000063	Filamentous fungi

List of dedicated transport containers and transport media for microbiological tests

Category	Specimen	Specimen requirement (mL)	Storage conditions	Collecting container
Oral cavity / Airway / Respiratory organs	Sputum	2 - 3		X00	Sterile sputum collection container
	Throat swab	As appropriate		VS1	Seed-Swab γ-1
Digestive organs	Stool	As appropriate		F01	Stool container with Cary Blair medium
	Bile	5 - 10		ARR	Sterile tube (10mL)
	Gastric juice	2 - 3		ARR	Sterile tube (10mL)
Urinary / Reproductive organs	Midstream urine	5 - 10		ARR	Sterile tube (10mL)
	Catheter urine	5 - 10		ARR	Sterile tube (10mL)
	vaginal secretion	As appropriate		VS1	Seed-Swab γ-1
	Pus	As appropriate		VS1	Seed-Swab γ-1
Blood / Aspirate	Venous blood	Optimum 8 - 10		CBG CBS	Blood culture bottle
	Arterial blood			CBG CBS	Blood culture bottle
	Cerebrospinal fluid	2 - 3		C10	Anaerobic porter
	Pleural fluid	5 - 10		C10	Anaerobic porter
	Ascites	5 - 10		C10	Anaerobic porter
	synovial fluid	5 - 10		C10	Anaerobic porter
Other sites	Otorrhoea	As appropriate		VS2	Seed-Swab γ-2
	Eye discharge	As appropriate		VS1	Seed-Swab γ-1
	Skin	As appropriate		ARR	Sterile tube (10mL)
	Nail	As appropriate		ARR	Sterile tube (10mL)
	tissues	As appropriate		ARR	Sterile tube (10mL)
	Pus	As appropriate		C10	Anaerobic porter
Others	Environmental material	-		C30	Medium for stamp method (for hospital environmental test)
		-		VS1	Seed-Swab γ-1
	Gastric biopsy tissues	As appropriate		C20	Seed Tube HP (for culture and identifi cation of Helicobacter)
	Stool	1.0g		F00	Stool container

ARR　Previous container symbol r

Sterile polyethylene test tube

Storage conditions: Room temperature

C10　Previous container symbol n

C20　Previous container symbol n2

C30　Previous container symbol n3

CBG　Previous container symbol m1

CBS　Previous container symbol q1

F00　Previous container symbol U

Stool container

Storage conditions: Room temperature

F01　Previous container symbol d3

VS1　Previous container symbol k

VS2　Previous container symbol k1

X00　Previous container symbol l (Small letter L)

Sterile sputum collection container

Storage conditions: Room temperature

Collecting samples for bacteria testing

• Make sure that sample is clearly labeled with the name of testing material or the harvest site.
• If the target bacterium is Neisseria gonorrhoeae or Neisseria meningitidis, store them at room temperature.
• Collect materials for the anaerobic culturing in an anaerobic porter.
• Please note that the number of days required for testing varies depending on the target bacteria, etc.

Handling an anaerobic porter

(A) For a fluid specimen　(e.g., pleural fluid, ascites, urine, aspirate)

(B) For a solid specimen　(Stool, pus, tissues, etc)

Specimen handling methods for culture and identification of Helicobacter

Handling method of Seed Tube HP

1. 1. Immediately after obtaining “ gastric biopsy tissues,” place it into a collecting container (C20) under the black line.
2. 2. Place the sample in the storage within 30 minutes from sampling, and put in your request on the same day.

Collecting samples for environmental test for wiping

Hospital environmental test (wiping method)

Wipe an area (typically 10 × 10 cm) on the analyte with a cotton swab included in Seed Swab γ-1, which has been damped by placing it in a culture medium. Place it back in the culture medium before submitting for testing.

Hospital environmental test (stamping method)

Remove the cap from the stamp medium (C30), and gently press the surface of the medium onto the surface of the analyte, taking care not to touch the medium surface with a finger, etc. After approximately 5 seconds, replace the cap and send it in for testing.

• Test value range for emergency reporting