Normally Sterile Sites: Invasive Bacterial Diseases

Definition of normally sterile sites (and exceptions) for submission of clinical isolates to the Minnesota Department of Health Public Health Laboratory.

A normally sterile site is defined as:

  • blood
  • cerebrospinal fluid (CSF)
  • pleural fluid
    • includes:
      • chest fluid
      • thoracentesis fluid
  • peritoneal fluid
    • includes:
      • abdominal fluid
      • ascites
  • pericardial fluid
  • bone
    • includes:
      • bone marrow
  • joint fluid
    • includes:
      • synovial fluid
      • fluid, needle aspirate, or culture of any specific joint:
        • knee
        • ankle
        • elbow
        • hip
        • wrist
  • internal body sites
    • specimen obtained from surgery or aspirate from one of the following:
      • lymph node
      • brain
      • heart
      • liver
      • spleen
      • vitreous fluid
      • kidney
      • pancreas
      • ovary
      • vascular tissue

Exceptions:

  • Group A Streptococcus if the source is:
    • Muscle
      • tissue or biopsy that is surgically obtained
      • any site (even non-sterile sites) in a case of toxic shock syndrome (TSS)
        or necrotizing fasciitis (NF).
  • Group B Streptococcus if fetal death occurs:
    • placenta or amniotic fluid

Updated Wednesday, April 18, 2012 at 10:03AM