Pertussis Testing Video: Collecting a Nasopharyngeal Swab Clinical Specimen

Uploaded by CDCStreamingHealth on 16.02.2011


NARRATOR: It is essential to use correct technique
when collecting and transporting specimens
for laboratory testing.
This video will demonstrate how to correctly collect
and transport a nasopharyngeal, or NP, swab.
Before performing the procedure,
make sure you have the following materials on hand...
a paper surgical mask for covering your nose and mouth --
there is no need for an N95 mask...
a biohazard bag for disposals...
facial tissues for patient use...
eye protection to protect you
from coughs, sneezes, or splashes...
a shipping container with cold packs, and a biohazard label.
Swab specimens should be obtained
from the posterior nasopharynx.
Throat swabs and anterior nasal swabs
have unacceptably low rates of recovery,
and these specimen samples should never be collected
for pertussis diagnosis.
Ideally, you should collect two NP swabs --
one to be used for culture and one to be used for PCR.
One swab for culture and PCR is also acceptable.
The swab shaft should be aluminum or flexible plastic.
Cotton-tipped or calcium alginate swabs
are not acceptable,
as residues present in these materials
may inhibit PCR assays.
When collecting NP swabs, you'll also need a tube
containing semisolid Regan-Lowe transport agar.
Once you have the necessary supplies on hand,
you can collect the specimen following these steps.
First, put on your mask and eye protection.
Following hand-washing, put on your gloves.
Ask the patient if he or she has a deviated septum
or nasal obstruction
and then ask them to blow their nose
to remove any excess mucus from the nasal cavity.
Gently insert the swab straight back into a nostril,
aiming posteriorly along the floor of the nasal cavity
until reaching the posterior wall of the nasopharynx,
being careful not to insert it upwards.
The distance from the nose to the ear gives an estimate
of the distance the swab should be inserted.
Do not force the swab.
If an obstruction is encountered,
try the other nostril.
Leave swab in place for up to 10 seconds
and then remove slowly.
After collection, place one NP swab
in a Regan-Lowe transport tube for culture
and the other NP swab in an empty tube for PCR.
It is important to use Regan-Lowe transport agar,
which contains the antibiotic cephalexin
to prevent overgrowth of normal nasopharyngeal flora.
Depending on the brand of swab used for collection,
the shaft may need to be bent slightly, cut,
or broken off at the score mark
to fit the swab into the transport tube.
If only one swab can be obtained,
place it in the Regan-Lowe transport tube,
which can be used for both culture and PCR.
Store tubes at 4 degrees Celsius
and transport to the lab within 24 hours of collection
in a cooler with ice packs to maintain 4 degrees Celsius.
Plating for culture will need to be completed
within 24 hours of specimen collection,
so timely transportation to the laboratory is essential.
A message from the U.S. Department
of Health and Human Services
and the Centers for Disease Control and Prevention -- CDC.