The microbiologist receives a sputum specimen that upon preliminary Gram staining review of direct smear, contains numerous squamous epithelial cells and an excessive amount of contami-nating normal flora. Based on the microbiologists knowledge, the microbiologist rejects the spe-cimen and requests a new sample. The physician insists that the microbiologist culture the sample as received. The

Question

microbiologist should:

a. disregard the physicians request and dis-card the specimen.
b. notify their supervisor and write-up the physician.
c. set-up the culture as ordered noting the lack of specimen integrity that may com-promise culture results.
d. the microbiologist should have not called the physician and process the sample as received.

Answer 1

C
The microbiologist is responsible for assessing the quality of the specimen in order to eliminate unnecessary and inappropriate testing on suboptimal specimens. Although it is the microbiologists responsibility to call and request a specimen, the attending physician may request set-up of the sample due to circumstances such as inability to recollect or difficulty in collection from the patient, as well as follow-up to previous cultures. In such cases, the microbiologist should note that the physician was called and that the integrity of the sample may compromise the patient results and should be interpreted with caution.