A Guide to Specimen Management in Clinical Microbiology. J. Michael Miller

and Prevention (CDC) for 35 years until he retired in 2011. He received his BS and MS at Northwestern State University in Louisiana and a PhD at the University of Texas Health Science Center at San Antonio. He is a Diplomate of the American Board of Medical Microbiology, a Fellow of the American Academy of Microbiology and former member of the Board of Governors, former dean of the American College of Microbiology, and holds a Clinical Laboratory Director License in Georgia and Microbiology Laboratory Director License for New York and New Jersey.

      

Shelley A. Miller completed a clinical and public health microbiology postdoctoral fellowship at UC Los Angeles and has since stayed on as a clinical instructor, assisting with clinical teaching duties and translational research projects. Dr. Miller received her BS at UC Santa Barbara and went on to complete a one-year Emerging Infectious Disease fellowship at the Arkansas Department of Health Laboratory, sponsored by the Association of Public Health Laboratories and CDC, prior to attending graduate school at UC Irvine. She is a Diplomate of the American Board of Medical Microbiology and is licensed as a technologist in both clinical and public health microbiology. Unfortunately, she has no genetic relation to the great Mike Miller.

How To Use This Book

      Since this text is intended to be used by all members of a health care team, some parts are more useful than others to particular members of the team. The book has four major sections.

      Communicating Laboratory Needs

      For physicians, nurses, specimen collectors, and laboratorians

      This section details the premises on which quality microbiology specimen management processes depend. It introduces the concepts of specimen quality and of the relationship of specimen quality to clinical relevance, but it does not detail methods for specimen management. It also outlines some of the criteria that must be adhered to by the microbiology laboratory in the interest of good laboratory practice.

      Specimen Management Policies and Rationale

      For physicians, nurses, and laboratorians

      This important section details why the microbiology laboratory must be involved in each part of the testing process, including the preanalytical, analytical, and postanalytical steps (Fig. 1). It gives the rationale for stringent standards for specimen quality and explains some of the reasons why microbiologists may reject a specimen or insist on additional information.

Figure 1 The total laboratory testing process. Laboratorians must involve themselves in all aspects of specimen management, not just the analytical process.

      Specimen Collection and Processing

      For all specimen collectors and laboratorians

      This “how to collect . . .” section is written in the Clinical and Laboratory Standards Institute format for laboratorians and is intended to help them prepare the collection portion of their procedure manuals. This section also provides instructions for any member of the medical staff involved in selecting, collecting, storing, and transporting specimens to the laboratory for analysis. Each procedure can become a part of a laboratory or nursing procedure manual on specimen collection. Included in this section are specific directions for pediatric needs.

      Specimen Management Summary Tables

      For all personnel involved with specimen management

      This section contains summary information in tabular form for specimen management practices for bacteria, viruses, fungi, and parasites. It is to be used as a quick reference guide that can answer most questions regarding the laboratory needs for a particular specimen.