|
Test ID: Genital culture
|
|
Genital culture
|
|
Bacterial and Fungal Culture of Genital samples
|
|
Useful For
|
The detection of genital tract infection.
|
|
Method name and description
|
- Wet mount: Direct wet smear preparation
- Microscopy: Gram's stain
- Culture: Conventional aerobic and anerobic bacterial culture
NOTE: No wet mount examination is done for Semen, Prostatic secretions, penile discharge, IUCD
|
|
Clinical information
|
Bacterial vaginosis is so named because bacteria are the cause and an associated inflammatory response is lacking. It results in an increase in thin, gray, homogeneous vaginal discharge and vaginal malodor and is caused by a change in the vaginal flora. Bacterial vaginosis is a synergistic polymicrobial infection not caused by a specific organism. The standard scoring system termed the "Nugent score" is a technique for assessing bacterial vaginosis using microscopic examination of a Gram-stained smear of vaginal discharge.
Urethritis is inflammation of the urethra, the tube that carries pee from the bladder out of the body. It's usually caused by an infection. The term non-gonococcal urethritis (NGU) is used when the condition is not caused by the sexually transmitted infection gonorrhoea.
Cervicitis is an inflammation of the cervix, the lower, narrow end of the uterus that opens into the vagina. Possible symptoms of cervicitis include bleeding between menstrual periods, pain with intercourse or during a pelvic exam, and abnormal vaginal discharge.
|
|
Aliases
|
- Genital Culture
- Culture Genital
- HVS Culture
- Cervical Culture
- LVS Culture
- Urethral Culture
- Genital Microscopy
|
|
|
Specimen type / Specimen volume / Specimen container
|
Specimen type:
- Cervical/Urethral swabs
- Cervical cerclage thread
- Genital ulcer swab
- High vaginal swabs (HVS)
- Low vaginal swabs (LVS)
- Intra-uterine contraceptive device (IUCD)
- Lochia
- Penile discharge
- Prostatic secretions
- Semen
Specimen container:
- Amies transport medium (Blue top) for swabs
- Sterile leak proof container for all other specimens
 
|
|
Collection instructions / Special Precautions / Timing of collection
|
Collection instructions:
HVS
- Take with the aid of a speculum.
- Swab should be rolled firmly over the surface of the vaginal vault.
- It is important to avoid vulval contamination of the swab.
LVS
- Carefully insert swab into the inside opening of the vagina, the length of your finger or about 5cm, and gently rotate swab for 10 to 30 seconds.
- Make sure the swab touches the walls of the vagina so that moisture is absorbed by swab.
Cervical swabs
- Take with the aid of a speculum.
- The swab should be rotated inside the endocervix.
- It is important to avoid vulval contamination of the swab.
Urethral swabs (male patients only)
- Contamination from the foreskin should be avoided.
- The patient should not have passed urine for at least one hour.
- If a discharge is not apparent, attempts should be made to "milk" exudate from the penis.
- The swab is gently passed through the urethral meatus and rotated.
Semen:
Collect directly in a sterile container.
Prostatic secretions
- For collection, please refer to relevant organization protocols
NOTE:
More relevant results may be obtained by sending a urine specimen collected immediately before and after prostatic massage along with the prostatic secretions, to indicate urethral and bladder organisms.
Timing of collection:
- Collect specimens before antimicrobial therapy.
|
|
Relevant clinical information to be provided
|
- Patient clinical details
- Antimicrobial therapy
- Anatomic site
Note: Culture for HVS is only done if the following criteria are met. Therefore please provide the relevant clinical information when HVS specimens are sent.
- 1.In-patient
- 2.Moderate to profuse PMN (Polymorphonuclear Leucocytes).seen on microscopy
- 3.Predominant Gram positive cocci in pairs and chains seen n microscopy
- 4.Clinical details of:
- i.Leaking
- ii.PROM/PPROM (Premature rupture of membranes/ preterm premature rupture of membrane)
- iii.SROM (Spontaneous rupture of membranes)
- iv.PID (Pelvic Inflammatory Disease)
- v.Septic abortion
|
|
Storage and transport instructions
|
≤ 2 hours at room temperature. If delay is unavoidable, store swabs at room temperature for a maximum of 24 hours. All other specimens-refrigerate at 2-8 C for a maximum of 24 hours
NOTE: Specimens for gonorrhea investigation should not be refrigerated
|
|
Specimen Rejection Criteria
|
- Duplicate specimen in 72 hrs.
- Unlabeled or mislabeled specimen
Note: LVS is acceptable for Genital culture in: Pre-pubertal females less than 10 years old OR single and unmarried women OR pregnant with evidence of discharge when HVS cannot be taken.
- No relevant clinical details provided with the request. (Please note that where applicable, the relevant clinical details should reflect those on the patient’s electronic record at the time the order was placed).
|
|
|
Biological reference intervals and clinical decision values
|
Microscopy:
Wet Preparation for Trichomonas (performed at HGH, AWH and TCH microbiology laboratories)
Negative: “No Trichomonas vaginalis seen.”
Positive: “Trichomonas vaginalis seen”
Gram's stain:
- Semi-quantitative report of WBCs, types of bacteria and yeast/fungi seen
- Clue cells and Bacterial vaginosis if present
Culture:
Negative:
- Normal genital flora
- No growth
- Normal skin flora
Positive:
- Significant isolates are reported along with susceptibility result when appropriate
Note: AAH microbiology laboratory performs a commercially available nucleic acid probe test for vaginitis/vaginosis instead of culture. This includes Candida, Trichomonas vaginalis and Gardnerella vaginalis (bacterial vaginosis). Results are reported as negative or positive for each organism.
|
|
Factors affecting test performance and result interpretation
|
- Improper collection technique
- Improper container
- Improper transportation
- Improper processing
|
|
Turnaround time / Days and times test performed / Specimen retention time
|
Turnaround time:
- Microscopy/ Wet Mount: 24 hrs
- Culture: 2-4 days (2-10 days for IUCD)
- Nucleic acid probe test for vaginitis/vaginosis:: 24-48 hrs
Days and times test performed:
- Daily (7am to 3pm). Note: In HGH microbiology laboratory, test timings are from Sun to Fri 7am to 3pm.
Specimen retention time:
- 48 hrs. after final report
|
|
|
