Microbiology

Genital and Related Specimens

Cervical and high vaginal swabs must be taken with the aid of a speculum. It is important to avoid contamination of the swab with vulval secretions.

Separate samples should be collected into appropriate transport media for the detection of viruses or Chlamydia.

High vaginal swabs

After the introduction of the speculum, the swab should be rolled firmly over the surface of the vaginal vault.

Low vaginal swabs

A vaginal swab taken without use of a speculum. These are poor quality specimens and should not be taken except under exceptional circumstances where a speculum cannot be used.

Cervical swabs

After the introduction of the speculum, the swab should be rotated inside the endocervix. These swabs are required to increase the isolation of Neisseria gonorrhoea when investigation for STI is required.

Penile swabs

Request should specify which part it is taken from – glans, meatus or shaft. Penile swabs are not examined for Neisseria gonorrhoeae.

Prepuce swabs

This should be a sub-prepucial swab, taken with the foreskin retracted.

Urethral swabs

Contamination with micro-organisms from the vulva or the foreskin should be avoided. Thin wire swabs are available for collection of specimens. The patient should not have passed urine for at least 1 hour. For males, 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.

Rectal swabs for sexually transmitted diseases

Rectal swabs should be taken via a proctoscope,  culture for Neisseria gonorrhoeae should be clearly requested.

Throat swabs for sexually transmitted diseases

Throat swabs should be taken from the tonsillar area and/or posterior pharyngeal wall avoiding the tongue and uvula.

Fluids, pus and semen

Surgical specimens may be taken from the fallopian tubes, tubo-ovarian and Bartholin’s abscesses etc. Specimens should be submitted in a white screw capped 60ml container. These specimens are examined for Neisseria gonorrhoeae in addition to the routine culture. Specimens of pus and exudates are always preferable to swabs.

A separate specimen should be sent for virology. (See Virology section.)

Intrauterine contraceptive devices (IUCD)

The entire device should be sent in a dry sterile container.