Superficial Sample Collection Techniques

Superficial Sample Collection

• Superficial samples of substances reflecting pathological processes are commonly obtained
• Simple and non-invasive methods facilitate sample acquisition without invasive procedures
• Superficial sample locations: upper respiratory tract, mouth, rectum, genitourinary tract distal portions, eyes, ears, and skin lesions

Collection Techniques

• Common techniques: swabbing, aspiration, and scraping
• Alternative techniques: hair cutting/pulling, direct deposition on slides (like breast secretions), or adhesive tape for desquamation samples

Swabbing

• Swabbing commonly collects exudate and skin lesion samples
• Swabs consist of a stick and absorbent tip (a toruntda)
• Suitable for collecting small biological material volumes, like exudates for microbiological study
• Samples can dry quickly because they are small
• Swab material suits the microorganism under study, as some materials interfere with analysis

Swab Types

• Varies by manufacturing material and support type
• Materials: cotton, calcium alginate, dacron, or rayon, based on the microorganism being analyzed
• Alginate swabs shouldn't be used for studying viruses
• Cotton swabs are avoided for endocervical exudates due to containing unsaturated fatty acids that inhibit Neisseria gonorrhoeae growth, which is systematically studied in exudates
• Avoid cotton for fungi study because fibers confuse with filaments
• Some swabs are rigid plastic, others are flexible wire aluminum, they are used to take samples of the nasopharyngeal

Transport Medium

• Its fundamental to preserve the sample for microbiological study and preventing microorganism proliferation
• Transport media are solutions that stabilize microorganism concentrations during transportation
• Swabs and transport media are often in bags with a swab and tube containing the medium
• Transport medium depends on the studied microorganism

Transport Medium specifics

• Stuart-Amies medium is most common for aerobic bacteria
• Systems avoiding oxygen entry like Cary-Blair or PRAS are employed in anareobic bacteria
• Viral transport media include stabilizers, antibiotics against bacteria/fungi, & buffers for neutral pH
• Stuart medium, a semi-solid agar, commonly transports fungi

Transport Media Preparation

• Labs/hospitals prepare some or all transport media even though it's common to use commercial tubs
• Transport medium Stuart is semisolid, presented in powder to prepare in laboratory
• Dissolve the powder indicated by manufacter in a liter of water, mixing well frequently.
• Boil during one minute to dissolve well
• Dispense in tubs with a tap ready to screw
• Sterilize in autoclave at 121°C during 15 mins
• Label

Aspiration

• Aspiration collects exudate samples in body ducts or on surfaces; Useful in the trachea, bronchi, or duodenum
• Aspiration is done two ways:
  • A catheter connected to a suction system extracts fluid from affected areas
  • A syringe and needle collect vesicle liquid, transferring the sample to a tube.
    • Safety syringes are important

Scraping

• Scraping is used for dry cutaneous lesions
• A scalpel scrapes lesion and collects scales in a Petri dish for microorganism identification

Basic Precautions

• Strict protocols prevent contamination for microbiological analysis of superficial samples, as it invalidates the study
• Confirm patient identity to ensure the sample matches the clinical case
• Use proper labelled collection containers
• Preparing needed material before collection is needed
• Inform patients about procedure and discomfort
• Position the patient correctly for correct collection
• Using personal protection elements (PPE)

Exudate Samples

• Exudate is liquid filtered from blood vessels into tissues due to inflammation, it's a sign that the body responds to aggression
• Inflammation is the body's nonspecific response to harmful biological, physical, or chemical agents
• Biological agents include bacteria, viruses, parasites, and fungi
• physical agents include radiation/extreme temperatures
• chemical agents include toxins.
• Inflammation also results from trauma, vessel obstruction, immune reactions, or body malfunction
• Transudate is a low-protein plasma filtrate, not associated with inflammation, it occurs generally with excess fluid cause edema

Exudate Sampling

• Exudate is critical for microbiological and immunological studies to identify infections/inflammations
• Samples come from accessible areas like the respiratory/digestive tracts
• Proceedures obtain exudates

Upper Respiratory Tract Samples

• Exudate samples include the faringoamygdalin, nasopharyngeal and nasal
• safety and hygiene: gloves and masks for cross-contamination/disease prevention, the patient positioned is seated comfortably, head tilted back with lighting

Faringoamygdala

• This sample detects antigens & microbiological studies, commonly identifying Streptococcus pyogenes for pharyngitis
• It also isolates other bacteria include Neisseria gonorrhoeae, Haemophilus influenzae, Corynebacterium diphtheriae
• Its proceedure following:
  • Prepare the tongue depressor and swab
  • No transport needed for antigen detection, but it does if culture
  • Two samples if we seek both tests
  • Place the depressor on the tongue base, swab any exudate, membrane, or inflammation, smear tonsillar ridges and back throat with same swabs.
  • Don't use the swab into the oral mucosa

Nasopharynx

• Nasopharyngeal exudates studies are mainly microbiological, and are collected by swabbing/aspiration
• Frotis: samples are indicated for identification of Neisseria meningitidis, & isolation Bordetella pertussis virus, the SARS Cov-2 virus is detected

Nasopharynx Swabbing procedure

- Two flexible swabs with polyester, rayon, or nylon tips and transport medium for the microorganism in study
- Insert gently the swab into the nose floor with the intention for mantaining it right to the auricular pavilion
- If entered first 5 or 6 cm is it OK
- After that, get to the nasopharynx if resistance is noticied
- Retire the swab and try once more if initial introduction resits a range of 2-3 cm. Don't force it.
- Swab the nasopharynx during 10 seconds spinning to collect sample

Nasopharynx Aspiration proceedure

• Used for the study of pathogens like: Neisseria meningitidis, Bordetella pertussis, Corynebacterium diphtheriae, and Streptococcus pyogenes, and syncytial virus
  • Select which nose floor is the one affected with the injury
  • If no deviation happens, you can introduce the teflon tube cateter to the floor wuth a fine precision but without pushing so hard to the nasopharynx

Nasal

• Nasal samples investigate Staphylococcus aureus; common to test asymptomatic
• Procedure:
  • Prepare a flexible swab with suitable transport medium
  • Moisten the swab in sterile saline, inserting 2 cm into the nose, swirling and removing the smear on nose mucose
  • Alternate the process in the other nose floor.

Digestive Tract Samples

• Samples include areas like oral and rectal
• Its possible to do microbiological or immunological studies without invase proceedures

Oral cavity smaples

• Used to diagnose infections like oral candiasis, or gingitivis
• Apply to the next proceedire -Prepare a cotton or cotton y medium tranportable swab
  • With coton swab, rub with it the lesions avoiding secrets and celular remainings. And then place the swab en its receptor
  • With the other swab, place the mucose lesion
  • Place into the tube the swab

Rectal

• For diagnose with infections like Neisseria gonorrhoeae or Chlamydia
• Patient place in a gynecologic position, or incline to the camille supported
• The proceedire is putting 3 cm of the end of cotton uretral into the cryptal rectals, and turn it down dependeing of the microorganism

Genitourinary Tract Samples

• Key to collecting exudate samples, including urethral, balanopreputial, vaginal, and endocervical samples

Urethral Samples procedure

• Uretral exudate is prefferably to take before morning miccion
• Next follow pacientes instructions before collecting, like avoid urinating 1 hour before sampling, and never do washing proceedures or any cleaning
• Depends on how much exudate it presents. If abudant is collected with swab
• If inadecuate we can give swabes to the patient of alginate calcic.
• If you see C.Trachomatis put your 3-5 cm into the hole.
• Place it into a tube, maintaining it on a temperature oestufa during a procesation of 6hrs

Balanoprepucial exsud

• To the exsudate a patient must prepare by non urinating 2 hrs before the picking
• Never get clean that area one day before sampling., Asexual abstenence is recommendable
• You prepare the b swab of algodon to swab it carefully circular and in both ways.
• Seal tub and try to deliver as soon as possible, integrity must be protected

Vaginal Exudate

• Are cause by microorganisms like Candida sp, Trichomonas vaginalis, Gardnerella Vaginalis.
• The patient cant be under menustration
• Cannot use aseptic solutions or any desinfection cleaning
• She shoyld be placed on a gynecological position. Two alginate swabes should be prepared to sample the maior exudate zone, or the last bag vaginal site
• The sample is for microscope testing, so with another swab we prepare the microbiologic test. The samples should be kept as room temperature

Endocervical Sample

• For the identification of those like * Neisseria Gonorrhoeae, chlamydia trachomatis ,micoplasma hominis y urealitium*
• the position consist in putting the pacient into ginecolological position With introducting an espetrulo on the vagina Despues se limpia el exocervix de secreciones con hisopo y se desecha el mismo And continuacion introhcir el Alginato Calcico and do a gentle rotary movement to extract the sample as the sample is mainly for microspic exam En unos casos de que sospechemos de el Micoplasma se recogera otro hisopo en una zona especifica Es importantisisisim no utilizar hiosos de algodon para esta muestra dado a que sus acidos grasos pueden inhibir el crecimiento de Neisseria Gonhorrea

Pathological mammary secretions samples

• Mammary glands present abnormal secretions outside of breastfeeding,
• Milky secretions in the breast from breastfeeding is called galactorrhea, and pathologics like blodd sera and pus
• Analysis is crucial to diagnose those infections
• Usually in microbiological cultures some mama inflamations or masters its due to bacterial infection
• Is taked directly intoa porta objects with a gentle massage to the organ
• the laminate will put into a box, and label it

Eyes & Ears exudate Samples

• Conjuntiva and ottic part is often times good to locate samples
• The conjutival illnesses found at the Conjuntival are trachoma C Trachomatis, la gonococia en neonatosN. G, causadas por moraxella lacunata Conjutiva its a mucosa membrane who has a clear zone the one who has contact to the world is covering to the bulb ocular of the eyes

Eyes & Ears Exudate - Sampling Instructions

• To get the sample u should put to the person sat in the chair but with the head inclined in position to the light Follow those indications: -prepare the hibisies and the one like S.A -Humedece hisopo physiological suero keep the eyelids separate in one palm -Paste it in front of eyelids -Put the hispise on the tube and previously put it in the box -Repeat the process un the other side of the eye.

The sample should be processed less of 2 before delivering it, important to take samples both of the parts for comparison

The otitis is taken to have a good samples of good process of exudates - The anatomic end its mainly into three parts: -Extern part -has auricular part and the auditive duct at the end where is the timpánica membrane, who has limited external auditive side Internal part also including el caracol caracol

###Outside Ears Exudate - Sampling Instructions

• The head must be placed in the oposite side, the process goes as follows: put preaparar 2 hisopos Stuart Amies Cleaning the area with a soft antiseptic Take the exudado with hisopo put the hisoponinto a box labelled REpete the process into the other side

  The sample is prepared to kept for hours so try no put too muuy in contaminable part or make pressure to the timpánica which is delicate

###Inner Ear Exudate - Sampling Instructions

• The sample is call Timpanocentessits, the procedure is puting the otoscopio to the pass the instruments

Skin Lesion Sampling

• Areas exposed to the outside world are protected by a barrier (skin and mucous membranes) that prevents external agents

• The sampling procedure go as such, the one its affected the process goes by such -Lesion should be clear by humidity with a sterile gas distilled

• Recollect de sampling goes follows:

  • U can have the seca zone, so you scrap with the bisturies and put into petri - In lesion u can put a sticky part into objects
  • U can put afected peels with hair who are quebraos decolorads u put the peeling skin -U can have H. Lesions so u put hystop and take it easily there

• Sampling should be take with 2 hrs since the extraction, ensure that should be the right one and with a direct process

###Hair Samples - Sampling Instructions

• it identify the microsys with hairs the proce goes by: - Selected zones with pelos opacos quebradisos decolorizads Rocolleccionar muestra : u cut minino cinco cabellos to petri disc The Muestras should be take it fast, no +30hr

###Nails - Sampling Instructions

• In case they use nail painted these they shouldnt have this so
• u should put in a humi with a disstilled sterile water with no alghoo
• take the samples to petry with the b, take some sample to see how it goies, in