It is not just the clinical details that are important in how a microbiology sample is worked up. It is also where the sample was taken from, as you will be perfectly aware.

However sometimes the site labelling can be a bit too “generic”.

For example an “ear swab” could potentially mean a swab from the auditory canal (i.e. in someone with otitis externae), or it could mean a swab from the skin on the outer ear (i.e. in a patient with impetigo lesions).

The same can apply to “nose swab”. This could mean the skin covering the outer nose as opposed to the inner nose or nostril.

As a final example a “penile swab” could mean a swab from the urethra or it could mean the skin on the outside of the penis.

and there are others.

But why does this matter?

You have probably worked this out already. The microbiological work up from the two different options on each “site” is completely different. We are looking for different microbes, using different media or tests, and even the reporting procedure, susceptibility testing and comments are all different.

It is therefore critical that the requestors (and sample takers as these are not always one and the same) are educated to be as specific as possible when describing the sampling site e.g. outer ear, ear canal, nostril, outer nose, urethra, penile skin, so that the scientist is in no doubt as to where the sample has been taken from so that correct processing can take place. The education needs to also explain why it is so important from a lab perspective.

Another solution is to define the sites in detail as tick boxes on the request form, but tick box request forms have their own set of problems….

The more useful the information that comes into the lab, the more useful the result is to the patient.

Michael