HOW TO REFER SAMPLE

Specimen collection is a significant initial step in laboratory diagnosis. Generation of accurate laboratory results require careful attention to the source of specimen, collection method, storage, transport and handling of the collected specimens.

This guide is intended as a guide for physicians, nurses, medical technologists, and other health personnel responsible of ordering, selecting and collecting specimens from patients. This manual can also be used as a guide for our clients/customers who want to avail of our services.

For additional information, please call us at the numbers provided below. The NRL staff will be glad to assist you. Our goal is to fervently support the Department of Health in reducing morbidity and mortality of sexually transmitted infections through provision of accurate, precise and timely laboratory results.

SPECIMEN HANDLING

Samples should be collected into appropriate tubes before labeling with patient identifier (Name of Patient and NRL Laboratory Code). For referred samples, tubes or cryovials should be labeled with Patient Name and Date of Birth.

For referred samples, specimens must be properly labeled, accompanied by a completed NRL-SLH/SACCL referral laboratory form, and NEC Form-A (for hiv only). Specimens that are improperly labeled or do not match the accompanying requisition will not be accepted.

1. Fill-up accompanying forms completely.

2. Separate serum from clot within 24 hrs. Transfer serum at least 1-2 ml in volume in a cryovial (primary container).

3. Wrap the cryovial in an absorbent material (paper towel or gauze). The cryovial with serum must be placed in a second sturdy and leak-proof container (Figure 5). This container must be placed in a styrobox and put the ice gel or cold dog on top of it

4. Place cryovial in a sturdy secondary container.

5.Place in a styrobox with cold dog.

6. Place the Form-A (for HIV) and Confirmatory test request in an envelope. Place envelope in a Zip lock plastic for protection. Attach the envelope outside the Styrobox

Note: Specimens in cryovials requiring storage before shipping to the NRL-SLH/SACCL should be stored no longer than three (3) days at room temperature, or no longer than seven (7) days at 4°C. For longer storage periods, the serum or plasma must be separated and stored at -20°C. Samples should be maintained in a cold environment from referring laboratory up to receiving in the NRL-SLH/SACCL by transporting it with cold dog or ice gel pack. For HIV referrals, diagnostic specimens must be properly labeled, accompanied by a completed NRL-SLH/SACCL referral laboratory form, and NEC Form-A. Specimens that are improperly labeled or do not match the accompanying requisition will not be accepted.

SPECIMEN TRANSPORT

  • Transport of blood, and other body fluid specimens from the collection site to the laboratory is an important component of processing.
  • Avoid agitation of blood specimens to minimize hemolysis. Broken or leaking specimens are a biohazard to those who may come in contact and require re-collection of a new specimen: this can delay treatment of the patient and add to the cost.
  • Specimens requiring refrigeration must be maintained in cold environment and can be appropriately carried in an insulated container.
  • All specimens from NRL receiving area should be transported to the NRL-laboratory using a sturdy transport container twice a day at 11:30AM and 3:00 PM.

Receipt of Specimens:

  • Receiving of specimens is from Monday to Friday, 8:00 AM up to 3:00 PM except holidays.
  • Improperly labeled tubes and request form will not be accepted.
  • All information on the request form must be complete, accurate, and legible.
  • Specimens must be sufficient in volume and in a proper container required for the test
  • Specimens must not be clotted when drawn in an anticoagulant tube.
  • Specimens must be kept at ambient temperature to maintain integrity and CD4 testing must arrive in the laboratory within the specified time frame.

Sample preparation and Transport

HBV, HIV, HCV Quantitative PCR

Method : Real time PCR (Cobas Taqman)

Specimen required: 2x5ml EDTA tube or minimum of 1ml plasma

HBV DNA: serum or plasma

  • Should be collected in serum collection tube or in sterile tube using EDTA. Store whole blood at 2-25oC for no longer than 6 hours. Separate serum/plasma from red cell within 6 hours of collection by centrifugation at 800-1600xg for 20 minutes.
  • Whole blood must be transported 2-25oC and processed within 6 hours of collection. Plasma maybe transported at 2-8oC or frozen.
  • Plasma/serum specimens maybe stored at room temperature for up to 3 days, at 2-8oC for up to 7 days or frozen at –20oC to –80oC.

HCV RNA: serum or plasma

  • Should be collected in serum collection tube or in sterile tube using EDTA. Store whole blood at 2-25oC for no longer than 6 hours. Separate serum/plasma from red cell within 6 hours of collection by centrifugation at 800-1600xg for 20 minutes.
  • Whole blood must be transported 2-25 oC and processed within 6 hours of collection. Plasma maybe transported at 2-8oC or frozen.
  • Plasma specimen maybe stored at 2-8oC for up to 72 hours or frozen at –70oC or colder.

HIV RNA: plasma only

  • Should be collected in sterile tube using EDTA. Store whole blood at 2-25oC for no longer than 6 hours. Separate plasma from red cell within 6 hours of collection. Separate plasma from whole blood within 6 hours of collection by centrifugation at 800-1600xg for 20 minutes.
  • Whole blood must be transported 2-28oC and processed within 6 hours of collection. Plasma maybe transported at 2-8oC or frozen.
  • Plasma specimen maybe stored at room temperature for up to 1 day, at 2-8oC for up to 5 days or frozen at –20 oC to –80oC.

For referred samples, specimens must be properly labeled, accompanied by a completed NRL-SLH/SACCL laboratory request form. Specimens that are improperly labeled or do not match the accompanying requisition will not be accepted.

Method Used: Flowcytometry

Sample requirement: whole blood (2x5ml EDTA)

Should be collected in sterile tube using EDTA. Store at 20-25oC until processing begins. (Do not refrigerate). For off-site extraction, samples should be delivered to NRL-SLH/SACCL within 6 hours after collection.

Running schedule: every Tuesday and Thursday (cut-off time: 11:00 AM)

For referred samples, specimens must be properly labeled, accompanied by a completed NRL-SLH/SACCL Immunophenotyphing laboratory request form. Specimens that are improperly labeled or do not match the accompanying requisition will not be accepted.