Dried blood spot: Specimen storage & transport

Dr.t.sundararajan mdAsst professorDept of microbiologyGmkmc,Salem-30.

Dried blood spot: Specimen storage & transport

Specimen handling, storage, packaging and transport procedure for Dried Blood Spot (DBS) specimens for HIV DNA PCR testing

Introduction

•This presentation describes a procedure for handling, storage, packaging and transport of a dried blood spot (DBS) specimen obtained from an infant below 18 months of age for the purpose of conducting a HIV DNA-PCR test on the collected specimen.

•This is critical to ensure the safety of the procedure and to assure the quality of the test results obtained thereof.

• Anyone who has collected the sample - MO/ Technicians/ Nurse in charge

Dried blood spots (DBS) should be handled only by persons who have been appropriately trained in the handling of dried blood spots and in standard work precautions:

Responsibility

Materials required

•Gloves (powderless)

•Glassine paper

•Plastic zip lock packets

•Desiccant sachets

•Humidity indicator cards

•Biohazard labels

•Plain paper envelopes

•Padded paper envelopes

•Stapler

•Pen

Preparation

•Observe Standard work precautions at all times by wearing gloves and lab coat.

•Lay out all the supplies you will need.

•Ensure that all the DBS specimens are of acceptable quality and well dried. Drying time will vary from 4 hours to overnight depending on the relative humidity at your location

Packaging and storage

• When packaging DBS into zip lock bags, separate each card with a sheet of weigh /glassine paper.

• You can store up to 10 cards in a single zip-lock bag.

Packaging and storage – cont’d

• Place DBS cards inside the ziplock bag gently.

•Add 8-10 silica packets per zip-lock bag and push the silica sachets to the bottom of the bag.

Packaging and storage – cont’d

•Add a humidity indicator card such that the circles are visible through the ziplock bag.

•Push as much air out of the bag as possible.

•Seal firmly and double check that the bag is sealed completely.

•Apply a biohazard sticker to the outside of this zip lock bag

Packaging and storage- cont’d

•In case, the specimen is not to be immediately transported, keep DBS packaged in sealable plastic bags refrigerated until transported to testing lab. Do not freeze

•Check the color of the humidity indicator card twice a week. Anytime during storage or before packaging for handing over to the courier/mailing, if you notice a pinkish tinge in the blue circles on the humidity indicator card, change the card and replace the moist silica sachets with fresh dry silica sachets.

•Dry the older sachets and card at 650C in a hot air oven for reuse

•In case the specimen is to be handed over to the courier or mailed, pull out the stored package from the refrigerator 1 hour before the next steps of final packaging

•When contents have come to air conditioned room temp (20-250C), place the zip-lock bag containing the DBS inside an envelope.

Transportation – cont’d

•Place the ziplock bag with the packaged specimens inside a plain paper envelope

•Place the above envelope inside a padded labeled envelope to avoid damage to the DBS during postage/ courier transportation.

•Place the test requisition forms and the compiled delivery checklist in a separate zip lock bag and place it in this padded envelope

•Staple the envelope shut.

•Ensure that the outer envelope is carrying the correct address with pin code of the testing site

Storage of Dried Blood Spots

•Studies performed indicate that completely dried specimens maybe stored refrigerated at 2-8 ºC for at least six months under low humidity conditions. •DBS can be kept at 20-250C for short term storage- upto 2 weeks

•Storage under elevated temperature conditions (room temperature 37ºC or more) leads to increased degradation of analytes over time.

•Storage of DBS specimens at room temperature or higher is not to be done

•Do not expose the DBS to sunlight and high temperatures (do not leave DBS in your vehicle in the hot sun).

Transport of DBS specimens

•Use a reliable and tested courier/ mailing system for transportation of the specimen packages

•The DBS specimens can be collected and stored through the week but the center must dispatch these collected specimens to the testing laboratory on Tuesday of the coming week.

•Take care to keep the DBS free from moisture and humidity.

•Postal and local transport regulations must be followed if using the postal or courier services.

Documentation

•Document information of every specimen collected, packaged, stored, and dispatched in the designated register.

•Include the test requisition forms and a compiled delivery checklist that carries a list and requisite information of all the specimens being dispatched from the collection site to the testing laboratory with all couriered/mailed packages.

•Instruct the courier agency to obtain the signatures of the personnel receiving the samples at the testing site on a copy of the delivery checklist and return the same to the dispatching site for records.

Linkages of specimen collection centers (statewide) to NACO testing labs for HIV DNA PCR testing on infant samples

Linkages of specimen collection centers (statewide) to NACO testing labs for HIV DNA PCR testing on infant samples

Linkages of sample collection centers (statewide) to NACO testing labs for HIV DNA PCR testing on infant samples

Linkages of specimen collection centers (statewise) to NACO testing labs for HIV DNA PCR testing on infant samples

Linkages of specimen collection centers (statewise) to NACO testing labs for HIV DNA PCR testing on infant samples

Linkages of specimen collection centers (statewise) to NACO testing labs for HIV DNA PCR testing on infant samples

Linkages of specimen collection centers (statewise) to NACO testing labs for HIV DNA PCR testing on infant samples

Linkages of specimen collection centers (statewide) to NACO testing labs for HIV DNA PCR testing on infant samples

SUMMARYSUMMARYStandard Operative Procedure (SOP) for Packaging, Storing and Transport of DBS Specimens

• When packaging DBS into zip lock bags separate each card with a sheet of weigh /glassine paper and store maximum 10 cards in a single zip-lock bag.

• Add 8-10 silica packets per zip-lock bag and push the silica sachets to the bottom of the bag.

• Add a humidity indicator card such that the circles are visible through the zip lock bag.

• Push as much air out of the bag • Seal firmly and double check that the bag is sealed

completely

(SOP) contd.,(SOP) contd.,

• Apply a biohazard sticker to the outside of this zip lock bag

• Keep DBS packaged in sealable plastic bags refrigerated until transported to testing lab. Do not freeze

• Check the color of the humidity indicator card twice a week

• If you notice a pinkish tinge in the blue circles on the humidity indicator card, change the card and replace the moist silica sachets with fresh dry silica sachets.

Standard Operative Procedure (SOP) for Standard Operative Procedure (SOP) for Packaging, Storing and Transport of DBS Packaging, Storing and Transport of DBS

SpecimensSpecimens

• When contents have come to air conditioned room temp (20-25°C), place the zip-lock bag containing the DBS inside an envelope

• Place the above envelope inside a padded labeled envelope to avoid damage to the DBS during postage/ courier transportation.

• Place the test requisition forms and the compiled delivery checklist in a separate zip lock bag and place it in this padded envelope

• Staple the envelope shut.