Specimen Collection, Labelling, Storage, Preservation, Transportation, Processing and Referral for Sexually Transmitted Disease Panel

To accurately diagnose genital infections, proper specimen collection should focus on the patient’s symptoms. The preferred specimen collection methods for females with a vaginal STI infection are a.) an endocervical swab; b.) vaginal swab collecting as much of the exudate as possible and c.) urine sample. For males, the preferred specimen collection is a swab of the urethra. The use of a properly collected urine specimen may also be acceptable as an alternate method. When there is sufficient exudative material visible upon examination, a urine specimen that flows over the external genitalia may capture the exudate. Clean catch urine samples are not recommended for STI testing.

General Specimen Handling:

When there are visible ulcerations in suspected STI infections, a carefully collected swab of the lesion is preferred. A urine collection in females can be useful if the flow successfully captures fluids from ulcerations. In males, however, urine flow may not always allow the capture of STI from ulcerations that are not located in the path of urine void. This occurs when the ulcerations are not associated with the foreskin or contiguous with the urethra.

Collection from female patients:

Endocervical Swab

  1. Samples are collected using the Copan ESwab™ Liquid Amies Collection Kit.
  2. Insert the flocked tip of the specimen swab into the endocervical canal.
  3. Gently turn the swab and allow it to absorb the secretions of the endocervix.
  4. Withdraw the swab carefully to avoid contamination.
  5. Place swab(s) into the sterile vial containing 1.0 ml of Liquid Amies transporting medium.
  6. Break the swab at the scored line on the shaft. Discard the shaft.
  7. Recap the transport tube carefully to ensure that the cap seals tightly.
  8. Label the vial with the patient’s first and last name, date of birth, the date and time of collection and the specimen type. Additional comments may also be added.

Vaginal Swab

  1. A vaginal swab is the appropriate specimen if a characteristic discharge is present. When ulcerations suggestive of STI’s are seen, careful attention should be given to swabbing the base of the ulceration as well as collecting any secretions that are present.
  2. Samples are collected using the Copan ESwab™ Liquid Amies Collection Kit.
  3. Insert the flocked tip of the specimen swab approximately 2 inches (5 cm) into the vaginal opening
  4. Gently turn the swab and allow it to absorb the secretions.
  5. Directly swab the base of any visible lesions.
  6. Withdraw the swab carefully to avoid contamination.
  7. Place swab(s)s into the sterile vial containing 1.0 ml of Liquid Amies transporting medium.
  8. Break the swab at the scored line on the shaft. Discard the shaft.
  9. Recap the transport tube carefully to ensure that the cap seals tightly.
  10. Label the vial with the patient’s first and last name, date of birth, the date and time the sample was collected, and the specimen type. Additional comments may also be added.

Urine Sample

  1. If multiple etiologies are suspected, a “dirty” urine collection that incorporates the contents of the urethra as well as the “wash-off” of the labia and vaginal canal may

be useful. Do not use wipes to cleanse the external genital surfaces before collecting the specimen.

  1. Using a sterile, plastic, preservative-free collection container, collect the voided urine specimen by allowing the urine to flow over the external genitalia during the collection. Do not overfill the collection container.
  2. Use the urine vacutainer tube containing preservative (Greiner Bio-one GmbH-Ref-454486) to transfer 4 ml of urine from collection container as described by manufacturer.
  3. Label the vial with the patient’s first and last name, date of birth, the date and time the sample was collected, and the specimen type. Additional comments may also be added.