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Shipping Specimens to Texas AR Laboratory

Submitter Responsibilities in Handling and Shipping Specimens to Texas AR Lab

Swabs and isolates submitted to the AR Laboratory are classified as infectious substances. To minimize the likelihood of exposing mail handlers and carriers, specimens must be shipped to the laboratory according to Category B Biological Substance, UN3373 requirements.

As a submitter, you have legal responsibilities regarding the handling, labeling, and shipping of Biological Substances, Category B UN3373. Per 49 CFR §173.199: Handling and Transporting Infectious Substances, personnel responsible for handling and packing Category B biological substances must be trained on correct specimen handling and correct submission protocols. “Personnel” includes anyone who handles or prepares specimens for transport, procures specimen carriers, and or transports specimens. In addition, per IATA regulation, a dangerous goods certificate of training is required for any person who submits dangerous goods to a public carrier for transportation.

Additional information on shipping infectious substances to the DSHS Austin Laboratory may be found at the laboratory’s general specimen shipping and mailing guidance pages.

Before shipping your specimens, make sure you have

  1. the patient’s name, date of birth, and date of specimen collection.
  2. completed the correct specimen submission form for the organism/requested test.
  3. attached a copy of previous lab results.
  4. affixed all required shipping labels to the outer mailer.
  5. packed cold packs, not dry ice with chilled specimens.

AR Laboratory Specimen Shipping Guidance by Organism

Use the table of contents below for quick links to AR organism-specific shipping guidance.

Shipping CRO Swabs

The Texas AR Laboratory began accepting CRO rectal swabs for testing in January 2023. The Laboratory will provide swabs, mailing boxes, and UN3373 labels to submitters upon request from an HAI epidemiologist.

Swabs for CRO colonization testing are classified as infectious substances. To minimize the likelihood of exposing mail handlers to the infectious substance, C. auris swabs must be transported to the laboratory according to Category B Biological Substance, UN3373 shipping requirements.

CRO specimen tube. Image Source: DSHS (2022)

  • CRO swabs may be shipped at ambient temperatures.
  • If shipping temperatures are likely to exceed 28°C (~82°F), as might be expected during Texas summers, swabs should be packed with enough cool packs to keep them cold for up to 48 hours. Do not use dry ice.
  • Ship labeled swab specimens with their completed G-2E forms and copies of previous lab results in an appropriate mailing container following Category B Biological Substances, UN3373 requirements.

Detailed guidance on the collection and shipping of CRO swab specimens is available here.

Shipping CRO Isolates

To ship any CRE, CRPA or CRAB isolates, place your

  • labeled CRO isolate slant or plate,
  • completed G-2E form, and
  • a copy of previous lab results

in an appropriate mailing container following Category B Biological Substances, UN3373 shipping guidelines (FedEx guidelines). Category B Biological Substances shipping guidance is also available at DSHS shipping guidelines.

Using the AR Laboratory FedEx Account to Ship CROs

Use the Texas AR Laboratory FedEx account to ship CRO specimens. Please contact the TexasARLN@dshs.texas.gov for instructions for logging into the FedEx account. 

NOTE: Packages containing biohazards should NEVER be dropped off at a FedEx Express® Drop Box!

When you log in to the FedEx site. please follow these steps:

  1. Ignore the "My Shipment" profile if this is your first time to use this account.
  2. Under "From", click "Edit" and enter your facility information. Check "save new sender in address book" so that you can use the same information in the future.
  3. Under "To", please select contact name "Tamara Baldwin". The Texas DSHS Laboratory address will auto populate for you.
  4. Enter information under package and shipment details.
  5. Please make sure to double check the "Special Service" section. If you are shipping chilled with cold packs, please make sure "dry ice" is not checked in the form. Dry ice should not be used as a refrigerant.
  6. The FedEx system should auto populate the lab address. If it does not, please use:

Texas Department of State Health Services 
Laboratory Services Section 
1100 W. 49th Street 
Austin, TX 787S6-3199 
 

Shipping Candida spp. Swabs

Swabs for C. auris colonization testing are classified as infectious substances. To minimize the likelihood of exposing mail handlers to the infectious substance, C. auris swabs must be transported to the laboratory according to Category B Biological Substance, UN3373 shipping requirements.

Additional information on shipping infectious substances to the DSHS Austin Laboratory may be found at the laboratory’s general specimen shipping and mailing guidance pages.

"Equipment and Materials Needed Swabs for C. auris testing are temperature sensitive and must be shipped within one day of collection at refrigeration temperatures, 2°C–8°C (36°F–46°F). 1. Shipping Materials must be compliant with Category B Biological Substance, UN3373 shipping requirements. a. Sturdy cardboard shipping box b. Insulated shipping box that fits snugly inside the cardboard box c. Clear, sealable biohazard specimen transport bag o The biohazard bag must have enough absorbent material inside to absorb leaks in their entirety d. Refrigerant such as ice packs (do not use dry ice) e. Absorbent packing materials f. Sealable plastic bag to protect paperwork 2. Place one ESwabTM tube into each clear sealable plastic biohazard specimen transport bag with an absorbent pad. Firmly seal the biohazard bag."
 

Copan Candida spp. ESwabTM specimen tube. Image Source: DSHS (2022)

Equipment and Materials Needed

Swabs for C. auris testing are temperature sensitive and must be shipped within one day of collection at refrigeration temperatures, 2°C–8°C (36°F–46°F).

1. Shipping Materials must be compliant with Category B Biological Substance, UN3373 shipping requirements.

  • Sturdy cardboard shipping box
  • Insulated shipping box that fits snugly inside the cardboard box
  • Clear, sealable biohazard specimen transport bag  
    • The biohazard bag must have enough absorbent material inside to absorb leaks in their entirety
  • Refrigerant such as ice packs (do not use dry ice
  • Absorbent packing material
  • Sealable plastic bag to protect paperwork 

2. Place one ESwabTM tube into each clear sealable plastic biohazard specimen transport bag with an absorbent pad.

Firmly seal the biohazard bag.

 

 

 

 

 

 

 

 

 

 

 

PLEASE NOTE:

  • Biohazard specimen transport bags must include an absorbent pad to absorb possible leaks.
  • If an ESwabTM tube is accidentally spilled, recollect sample with a new ESwabTM. If unable to recollect the sample, ship the swab as is. Do NOT add liquid to the ESwabTM tube or attempt to retrieve spilled liquid.
  • Do not tape the ESwabTM tubes or biohazard bags shut.
  • If bag is damaged, exchange it for a new, intact one.
  • Ship Candida swabs within 1 day of collection.

3. Line an insulated shipping box with ice packs. Place the ESwabTM specimen(s), individually sealed in resealable bags, onto the ice packs

.

Fill any remaining space in the box with absorbent material to secure the specimens. Place lid on the box and secure it.

Note: If using ice packs, please make sure they will not leak and damage the shipping box.

4. Place completed G-2B submission form(s) and an itemized list of the box contents in a sealed plastic bag to keep them dry. Affix this bag to the outside of the insulated box lid. 

5.   Close the lid of the outer cardboard shipping container and seal it.

6.   In a visible location on the outside of the shipping container

  • Write “Diagnostic Specimens”
  • Write submitter’s name and street address, and contact telephone number of the person responsible for the specimen
  • Affix UN3373 label

DO NOT AFFIX BAG WITH SUBMISSION FORMS TO THE EXTERIOR MAILER!

7.   Use the AR Laboratory FedEx account to ship specimen to the Laboratory.

Using the AR Laboratory FedEx Account to Ship Candida spp. Swabs

Use the Texas AR Laboratory FedEx account to ship Candida colonization specimens. Please contact the TexasARLN@dshs.texas.gov for instructions for logging into the FedEx account. 

NOTE: Packages containing biohazards should NEVER be dropped off at a FedEx Express® Drop Box!

When logging in to the FedEx site. please follow these steps:

  1. Ignore the "My Shipment" profile if this is your first time to use this account.
  2. Under "From", click "Edit" and enter your facility information. Check "save new sender in address book" so that you can use the same information in the future.
  3. Under "To", please select contact name "Jan Owens". The Texas DSHS Laboratory address will auto populate for you.
  4. Enter information under package and shipment details.
  5. Please make sure to double check the "Special Service" section. If you are shipping chilled with cold packs, please make sure "dry ice" is not checked in the form. Dry ice should not be used as a refrigerant.
  6. The FedEx system should auto populate the lab address. If it does not, please use:

Texas Department of State Health Services
Laboratory Services Section
1100 W. 49th Street
Austin, TX 78756-3199

Please call the AR laboratory at 512-776-7342 or email TexasARLN@dshs.texas.gov if you have questions about shipping Candida spp. specimens to the Laboratory.

Shipping Candida spp. Isolates

Candida spp. isolates should be clonal (selected from a single colony) and be submitted on separate SDA slants or other appropriate media.

  • Ship at ambient temperatures.

If you have CHROMagarTM Candida agar plates available, you may use it to isolate and ship to the lab.

Isolates for C. auris testing are classified as infectious substances. To minimize the likelihood of exposing mail handlers to the infectious substance, isolates for C. auris testing are required to be transported to the laboratory according to Category B Biological Substance, UN3373 shipping requirements.

Additional information on shipping infectious substances to the DSHS Austin Laboratory may be found at the laboratory’s general specimen shipping and mailing guidance pages.

Using the AR Laboratory FedEx Account to Ship Candida Isolates

Use the Texas AR Lab FedEx account to ship Candida specimens.  Please email TexasARLN@dshs.texas.gov for instructions for logging into the FedEx account.

NOTE: Packages containing biohazards should NEVER be dropped off at a FedEx Express® Drop Box!

When logging in to the FedEx site. please follow these steps:

  1. Ignore the "My Shipment" profile if this is your first time to use this account.
  2. Under "From", click "Edit" and enter your facility information. Check "save new sender in address book" so that you can use the same information in the future.
  3. Under "To", please select contact name "Jan Owens". The Texas DSHS Laboratory address will auto populate for you.
  4. Enter information under package and shipment details.
  5. Please make sure to double check the "Special Service" section. If you are shipping chilled with cold packs, please make sure "dry ice" is not checked in the form. Dry ice should not be used as a refrigerant.
  6. The FedEx system should auto populate the lab address. If it does not, please use:
     

Texas Department of State Health Services
Laboratory Services Section
1100 W. 49th Street
Austin, TX 78756-3199 
 

Please call the Texas AR Laboratory at 512-776-7342 if you have only plated medium for isolate submission, or if you have any questions about shipping Candida specimens to the lab.

Shipping N. gonorrhoeae (GC) Swabs for Antibiotic Susceptibility Testing

Swabs for GC antimicrobial susceptibility testing (AST) are classified as infectious substances. To minimize the likelihood of exposing mail handlers and carriers to the infectious substance, N. gonorrhoeae swabs are required to be transported to the laboratory according to Category B Biological Substance, UN3373 shipping requirements.

Additional information on shipping infectious substances to the DSHS Austin Laboratory may be found at the laboratory’s general specimen shipping and mailing guidance pages.

Ship GC AST specimens at ambient temperatures as soon as possible after collection. Specimens must be received at the Laboratory within 24 hours of collection.

Before shipping your specimens, make sure you have

  1. labeled the specimen with the patient’s name, date of birth, and the date of collection.
  2. completed the correct specimen submission form for the organism.
  3. attached a copy of previous lab results.
  4. affixed all required shipping labels to the outer mailer.

Shipping GC AST Swabs

Texas AR Laboratory began accepting GC AST swabs in January 2023. The Laboratory will provide swabs, mailing boxes, and UN3373 labels to submitters. Call (512) 776 - 7582 to request GC swab collection kits.

  • GC AST swabs may be shipped at ambient temperatures and must be shipped the day of collection. Specimens must be received at the Laboratory within 24 hours of collection.  

EQUIPMENT AND MATERIALS NEEDED 

1. Shipping Materials

Primary Receptacle

  • Specimens are collected using the nylon flocked Amies swab transport systems provided by DSHS.
    • A self-sealing tape, such as Parafilm, may be used to ensure swab containment after swab is used.

​

Nylon flocked swab Aimes collection kits for GC specimen collection. Collection and transport kits will be provided by the Lab. Image Source: DSHS (2022).   

Secondary Receptacle

  • Secondary receptacles must be watertight and leak-proof.
  • Generally, sealed plastic bags are acceptable as a secondary receptacle.
  • To minimize cross-contamination, place individual collection tubes in a single biohazard bag or sealable plastic bag. Ensure the bag contains enough absorbent material to soak up a potential leak of collection tube contents.
    • Multiple bagged collection tubes may be placed in the same sealable outer bag.
  • Do not overfill the bag with tubes; the outer bag must be sealed completely.
  • Absorbent material (e.g. absorbent pads, paper towels, or cotton balls) should be placed in the bag with the tubes in case of leakage.

Sturdy Outer Packaging

  • Once swabs are secured in a sealed plastic bag, place the bag into a box.
  • FedEx shipping requires the outer packaging box for Category B Biological Substances , UN3373 be made of corrugated fiberboard or wood.
  • Foam boxes, paper bags, and envelopes are not acceptable as an outer package for FedEx shipping of these specimen types.

The box should be an appropriate size to encase the bag of swabs; not too big and not too small.

Shipping N. gonorrhoeae Isolates

Isolates should be pure and submitted on a chocolate agar slant or other appropriate media.  

  • Ship at ambient temperatures.

Neisseria gonorrhoeae isolates are classified as infectious substances. To minimize the likelihood of exposing mail handlers to the infectious substance, N. gonorrhoeae isolates shipped to the laboratory according to Category B Biological Substance, UN3373 shipping requirements.

 

Using the AR Laboratory FEDEX Account to Ship N. gonorrhoeae Susceptibility Test Specimens

Note: GC AST swabs must be shipped the day of collection. Specimens must be received at the Laboratory within 24 hours of collection.

Use the Texas AR Laboratory FedEx account for shipping GC AST specimens to the Lab. Please contact the TexasARLN@dshs.texas.gov for instructions for logging into the FedEx account. 

NOTE: Packages containing biohazards should NEVER be dropped off at a FedEx Express® Drop Box!

When logging in to the FedEx site, please follow these steps:

1. Ignore the "My Shipment" profile if this is your first time to use this account.
2. Under "From", click "Edit" and enter your facility information. Check "save new sender in address book" so that you can use the same information in the future. 
3. Under "To", please select contact name "Tamara Baldwin".
The Texas DSHS Laboratory address will auto populate for you. 
4. Enter information under package and shipment details. 
5. Please make sure to double check under "special service". If you are not sending anything on dry ice, please make sure "dry ice" is not checked. 

The FedEx system should auto populate the lab address. If it does not, please use:

Texas Department of State Health Services 
Laboratory Services Section 
1100 W. 49th Street 
Austin, TX 787S6-3199 

Please call the AR laboratory at 512-776-7342 or email if you have any questions about shipping Neisseria gonorrhoeae clinical specimens.
 

 

Laboratory Services

Laboratory Services

Texas Antimicrobial Resistance (AR) Laboratory Network