Note
1、Nasopharyngeal swabs are not recommended for general bacterial culture, except for specific bacteria, such as Bordetella pertussis and Neisseria meningitidis.
2、If B. pertussis infection is suspected, the laboratory should be notified in advance and special transfer medium (Regan-Lowe) should be prepared. Inoculation medium can be provided when conditions permit
3、Transfer to the laboratory after receiving bedside inoculation.
4、Nasopharyngeal swabs cannot be used to test for the pathogenic bacteria of sinusitis.
Sample sampling
Collection of nasopharyngeal swabs from patients
The samples currently used for H7N9 testing are mainly nasopharyngeal swabs from patients.
To collect a nasal swab, the patient's head is kept as still as possible, the polyester-tipped swab is gently rotated and slowly inserted into the patient's nostril to the jaw, left for a few seconds to absorb the secretion, the swab is gently rotated and removed, placed in the sampling tube, the plastic handle at the hand contact area is broken so that the swab is immersed in the sampling solution, and the cap is screwed on tightly.
When collecting the pharyngeal swab, remind the patient to relax and make "ah" sound, press the front 2/3 of the patient's tongue with the tongue depressor, and wipe the posterior pharyngeal wall of the posterior part of the uvula (palatal lobe or uvula) and the bilateral tonsils with moderate force with the polyester head swab, avoiding touching the tongue, place it in the sampling tube after removal, break the plastic handle of the hand contact area, and soak the swab into the sampling solution. The tube should be removed and placed in the sampling tube, the plastic handle of the hand contact area should be broken, the swab should be immersed in the sampling solution, and the cap should be tightened.
Transport process
Sealed and refrigerated storage
The samples should be sealed and frozen during transportation to ensure the safety of the samples and to avoid loss and leakage to the environment.
Experts said that the extracted samples need to be sealed and generally placed in special transport boxes for refrigerated storage, the temperature between 4 ℃ ~ 8 ℃.
It is reported that the transport of highly pathogenic viruses need to obtain a permit, to ensure the safety of transport staff need to carry out the relevant assessment before they are licensed to work.
Isolation management
Suspected patient epidemiological investigation
Isolation measures should be taken in a timely manner for suspected or confirmed patients, suspected and confirmed patients should be housed separately; suspected patients are isolated in a single room, patients with the same type of infection confirmed by pathogenesis can be housed in the same room, and epidemiological investigation to collect information before the onset of the patient, to understand the patient's productive life in the last 7 days, for example, whether there has been close to the possible source of infection with the H7N9 avian influenza virus contact, or whether they have been to Shanghai, Jiangsu and other areas where the outbreak occurred, etc.
Testing reagents
Thumb-sized body containing primers and probes
As part of the testing process, the H7N9 test reagents that arrived in Chengdu on April 3 were also unveiled during yesterday's inspection: sealed transparent test tubes the size of an index finger containing primers and probes for H7N9-specific nucleic acid fragments. These reagents were placed in a special kit and kept refrigerated in a reagent-specific refrigerator. Rapid test 3-5 hours to get results
