Strep A Screen (Rapid) Throat Culture Collection

Principle

A throat culture sample (throat swab) is used to diagnose a throat infection. Most throat cultures are intended to rule out the presence of Group A Beta-hemolytic Streptococcus. There is little chance of detecting nonstreptococcal pathogens from swabs collected for culture of beta-hemolytic strep, so communication between clinician and laboratory is a necessity if detection of nonstreptococcal organisms is desired. Covenant HealthCare Laboratory Microbiology Department utilizes the Signify Strep A Rapid Strep Kit by Abbott Diagnostics for the detection of the Strep A antigen. The importance of careful specimen collection cannot be overemphasized.

Equipment
  1. Gloves, mask, gown (optional)
  2. Tongue depressor
  3. Flashlight or other bright light that can be focused into the patient's mouth
  4. Sterile collection swab: BBL Cultureswab Plus Collection and Transport System from Becton Dickenson (NOTE: This is not a gel bottom swab)
Procedure
  1. Review test requisitions
  2. Introduce self to patient and explain procedure
  3. Identify patient according to Patient Identification Procedure
  4. Assemble equipment and supplies
  5. Put on gloves and mask
  6. Position the patient for procedure and ask patient which areas of throat hurts (this will help locate best areas to swab)
    1. Patient is usually sitting upright
    2. Have patient tilt head back with the mouth open wide
    3. Small children may be held on lap and infants should be lying down
  7. Perform swab
    1. Gently depress the tongue with the tongue depressor
    2. Inspect the back of the throat with the flashlight (or other suitable bright light) to examine the posterior pharynx, tonsils, and uvular mucosa to locate areas of inflammation (redness) and/or white patches.
    3. Instruct patient to breathe deeply and say "ah" which serves to lift the uvula and aids in reducing the gag reflex
    4. Gently depress the tongue with the tongue depressor and extend the swab between the tonsils into the posterior pharynx
    5. Gently and quickly sweep the swab back and forth across the posterior pharynx and tonsil area
      1. Speed is essential, because the patient may gag involuntarily
      2. Be careful not to contaminate the swab by touching the tongue, inside or the cheek, or lips (if this occurs a new swab must be collected)
  8. Immediately reinsert BBL Cultureswab in the plastic holder
  9. Label according to labeling protocol
  10. Properly dispose of all biohazard materials
  11. Remove gloves and wash hands
  12. Thank patient and ask if you can provide further assistance
  13. Transport specimens

References

Howard, B.J., et al , Clinical and Pathogenic Microbiology, Second Edition, 1994, Pg. 234, Mosby

Koneman, E.W., et al, Color Atlas and Textbook of Diagnostic Microbiology, Second Edition, pg.12, J.B. Lippincott, Co.

C. Sommer, S.R. and Warekois, R.S., Phlebotomy Worktext and Procedures Manual, First Edition, 2002, pgs.265-267, W.B.Saunders Company

 

 

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