Collection Instructions

Submit only ONE of the following specimens:

Container/Tube: APTIMA Multitest (Vaginal) Swab

Collection Instructions:

1. Partially peel open the swab package.  Do not touch the soft tip or lay the swab down.
2. Hold the swab so that the thumb and forefinger are positioned in the middle of the shaft covering the score line.  Do not hold the swab shaft below the score line.
3. Carefully insert the swab into the vagina about 2 inches past the introitus and gently rotate the swab for 10 to 30 seconds.  Make sure the swab touches the walls of the vagina so that moisture is absorbed by the swab.  Withdraw the swab without touching the skin.
4. While holding the swab in the same hand, unscrew the cap from the tube.  Do not spill the contents of the tube.  Do not touch the top of the cap.
5. Immediately place the swab in the transport tube so that the score line is at the top of the tube.
6. Carefully break the swab shaft at the score line against the side of the tube.
7. Discard the top portion of the swab shaft.
8. Tightly screw the cap onto the tube, being careful not to touch the top of the cap.
9. Record the patient’s name and date of birth on the vial.

Important Note: Collect the specimen using only the APTIMA Multitest (Vaginal) Swab Collection Kit when requesting APTIMA STI NAAT testing.  Other swabs are not acceptable for use with this assay when testing a vaginal specimen.

Important Note: For females, a vaginal swab is the preferred specimen type due to higher clinical sensitivity for detecting M. genitalium than other specimen types; however, female urine or endocervical swabs may be used as alternative specimens when vaginal swab specimens are not available. If female urine or endocervical swab specimens test negative for M. genitalium, testing with a vaginal swab may be indicated, if M. genitalium infection is suspected.

Transport Temperature: After collection, the mutlitest (vaginal) swab is transported and stored at room temperature or refrigerated until tested.

Reject due to:

• Improper collection of the specimen may result in invalid results.  If the lab receives a swab specimen transport tube with no swab, two swabs, a cleaning swab, or a swab not supplied by Hologic the specimen must be rejected.
• If specimens are bagged together and a specimen leaks, all specimens in the bag will be cancelled and a request for recollection will be made.
• Improper labeling of specimen - Spectrum Health Laboratory requires 2 patient identifiers (Name and Date of Birth or SH MRN)

Laboratory Retention: Swab specimens will be stored at room temperature for 14 days from collection.

Container/Tube: APTIMA Unisex Swab for Endocervical Specimens

Collection Instructions:

1. Peel open the swab package.  Do not touch the soft tips or lay the swabs down.
2. Remove excess mucus from the cervical os and surrounding mucosa using the cleaning swab with the white shaft.  Discard this swab.
3. Carefully insert the specimen collection swab (with the blue shaft) into the endocervical canal.  Gently rotate the swab for 10 to 30 seconds in the endocervical canal to ensure adequate sampling.
4. Withdraw the swab carefully; avoid any contact with the vaginal mucosa.
5. While holding the swab in the same hand, unscrew the cap from the tube.  Do not spill the contents of the tube.  Do not touch the top of the cap.
6. Immediately place the swab in the transport tube so that the score line is at the top of the tube.
7. Carefully break the swab shaft at the score line against the side of the tube.
8. Discard the top portion of the swab shaft.
9. Tightly screw the cap onto the tube, being careful not to touch the top of the cap.
10. Record the patient’s name and date of birth on the vial.

Important Note: Collect the specimen using only the APTIMA Unisex Swab Collection Kit for Endocervical Specimens when requesting APTIMA STI NAAT testing.  Other swabs are not acceptable for use with this assay when testing an endocervical specimen.

Transport Temperature: After collection, the endocervical swab is transported and stored at room temperature or refrigerated until tested.

Reject due to:

• Improper collection of the specimen may result in invalid results.  If the lab receives a swab specimen transport tube with no swab, two swabs, a cleaning swab, or a swab not supplied by Hologic the specimen must be rejected.
• If specimens are bagged together and a specimen leaks, all specimens in the bag will be cancelled and a request for recollection will be made.
• Improper labeling of specimen - Spectrum Health Laboratory requires 2 patient identifiers (Name and Date of Birth or SH MRN)

Laboratory Retention: Swab specimens will be stored at room temperature for 14 days from collection.

Container/Tube: APTIMA Unisex Swab for Male Urethral Specimens

Collection Instructions:

1. The patient should not have urinated for at least 1 hour prior to sample collection.
2. Peel open the swab package.  Do not touch the soft tips or lay the swabs down.
3. Carefully insert the specimen collection swab (with the blue shaft) 2 to 4 cm into the urethra.  Gently rotate the swab clockwise for 2 to 3 seconds in the urethra to ensure adequate sampling.
4. Withdraw the swab carefully.
5. While holding the swab in the same hand, unscrew the cap from the tube.  Do not spill the contents of the tube.  Do not touch the top of the cap.
6. Immediately place the swab in the transport tube so that the score line is at the top of the tube.
7. Carefully break the swab shaft at the score line against the side of the tube.
8. Discard the top portion of the swab shaft.
9. Tightly screw the cap onto the tube, being careful not to touch the top of the cap.
10. Record the patient’s name and date of birth on the vial.

Important Note: Collect the specimen using only the APTIMA Unisex Swab Collection Kit for Male Urethral Specimens when requesting APTIMA STI NAAT testing.  Other swabs are not acceptable for use with this assay when testing a male urethral specimen.

Transport Temperature: After collection, the urethral swab is transported and stored at room temperature or refrigerated until tested.

Reject due to:

• Improper collection of the specimen may result in invalid results.  If the lab receives a swab specimen transport tube with no swab, two swabs, a cleaning swab, or a swab not supplied by Hologic the specimen must be rejected.
• If specimens are bagged together and a specimen leaks, all specimens in the bag will be cancelled and a request for recollection will be made.
• Improper labeling of specimen - Spectrum Health Laboratory requires 2 patient identifiers (Name and Date of Birth or SH MRN)

Laboratory Retention: Swab specimens will be stored at room temperature for 14 days from collection.

Container/Tube: Sterile urine cup

Preferred Volume to Collect: 20 to 30 mL

Minimum Volume to Collect: 4 mL

Collection Instructions:

1. The patient should not have urinated for at least 1 hour prior to specimen collection.
2. The patient should be directed to provide a first-catch urine (approximately 20 to 30 mL of the initial urine stream) into a sterile urine cup free of any preservatives.  Female patients should not clean the labial area prior to providing the specimen.
3. Record the patient’s name and date of birth on the cup.
4. Detailed Instructions (link): Patient Collection Instructions
5. Detailed Instructions (link): Urine Collection Guide for Staff

Transport Temperature: Urine specimens in the sterile urine cup must be transported to the laboratory stored at room temperature or refrigerated within 24 hours of collection.

Reject due to:

• Improper collection of the specimen may result in invalid results.
• If specimens are bagged together and a specimen leaks, all specimens in the bag will be canceled and a request for recollection will be made.
• Invalid specimen types
• Improper labeling of specimen - Spectrum Health Laboratory requires 2 patient identifiers (Name and Date of Birth or SH MRN)

Laboratory Retention: Urine specimens in the sterile urine cup will be stored at room temperature or refrigerated for 24 hours from collection.

Container/Tube: APTIMA Urine Transport Tube

Preferred Volume to Collect: 20 to 30 mL collected in a sterile urine collection cup          

Minimum Volume to Collect: 4 mL collected in a sterile urine collection cup

Collection Instructions:

1. The patient should not have urinated for at least 1 hour prior to specimen collection.
2. The patient should be directed to provide a first-catch urine (approximately 20 to 30 mL of the initial urine stream) into a sterile urine cup free of any preservatives.  Female patients should not clean the labial area prior to providing the specimen.
3. Remove the cap of the APTIMA urine specimen transport tube.
4. Transfer 2 mL of urine from the collection cup to the urine specimen transport tube using the disposable pipette provided.  The correct volume of urine has been added when the fluid level is between the black fill lines on the urine specimen transport tube label.
5. Re-cap the urine specimen transport tube tightly.
6. Record the patient’s name and date of birth on the vial.
7. Detailed Instructions (link): Patient Collection Instructions
8. Detailed Instructions (link): Urine Collection Guide for Staff

Transport Temperature: Urine specimens transferred to the APTIMA Urine Transport Tube within 24 hours of urine collection are transported and stored at room temperature or refrigerated until tested.

Reject due to:

• After 2 mL of urine has been added to the APTIMA urine transport tube, the liquid level MUST fall between the two black indicator lines on the tube label. Otherwise, the specimen will be rejected.
• Improper collection of the specimen may result in invalid results.
• If specimens are bagged together and a specimen leaks, all specimens in the bag will be canceled and a request for recollection will be made.
• Invalid specimen types
• Improper labeling of specimen - Spectrum Health Laboratory requires 2 patient identifiers (Name and Date of Birth or SH MRN)

Laboratory Retention: Urine specimens transferred to the APTIMA Urine Transport Tube are stored at room temperature for 14 days from collection.

Important Note: Urine specimens should be submitted using only a sterile urine cup or the APTIMA Urine Transport Tube when requesting APTIMA STI NAAT testing.  Other urine collection tubes are not acceptable for use with this assay.

Important Note: APTIMA STI NAAT testing is not approved for patients under the age of 14. For APTIMA Chlamydia NAAT, APTIMA Gonococcus NAAT and APTIMA Trichomonas NAAT, please order a Reference Miscellaneous test (LAB848) on these patients so the specimen can be forwarded to a reference laboratory to perform the testing. Indicate complete test name(s) when pediatric testing is necessary. APTIMA Mycoplasma genitalium testing will not be performed on patients in this age group.

APTIMA mutitest (vaginal) swabs, APTIMA endocervical unisex swabs, APTIMA male urethral unisex swabs and male and female urine specimens are approved for testing.  Other specimen types are not acceptable.

Best practice to avoid specimen contamination: Do not touch top of cap, make sure all caps are secured, individually bag specimens and change gloves if they become contaminated.

A negative test result does not preclude the presence of a C. trachomatis, N. gonorrhoeae, T. vaginalis or M. genitalium infection because results are dependent on adequate specimen collection, absence of inhibitors, and sufficient rRNA to be detected.

Results for the APTIMA STI panel will be reported as Positive or Negative (presumed negative for rRNA). For specimens receiving a result of Invalid or Equivocal, a new specimen should be collected.

Self-collected vaginal swabs may be used as opposed to provider-collected swabs. Self-collected swabs are supported by current clinical guidelines as recent studies have shown their equivalence, if not superiority, in quality and their association with increased patient satisfaction.

NOTE: Self-collection must still take place in a healthcare setting and is not approved for at-home collection.

LINK: Self-Swab for Testing

LINK: References