Role Of Clinical Microbiology In The Delivery Of Health Care

Specim en Handl ing and Pr ocessi ng Dr. Kauser Jabeen MBBS, FCPS Senior Instructor Department of Pathology/Microbiology

DIAGNOSTIC CYCLE

The Patient P r e

Test Selection

A n a l y t I c

Collection

Report Interpretation

Transport

The Laboratory Cycle

Report Transmission

Bartlett ‘80

Report Creation

Accession Analysis

P o s t A n a l y t I c

The chi ef functi on of cl ini cal mi crobiol ogy lab is to exami ne and cu lture speci men f or microorgani sms, to make accurate specie s identi fication of imp or tant isol ates an d to perform antibi oti c su scept ibi lity tests when in dicated

Patie nt | De termi ne di agnost ic di ffer en tial | Sele ct and col lect most appr op riate speci mens f or the inf ectious agents suspe cted |

Serol ogy

Di rect detect ion

Cul ture

DIR ECT DET ECTI ON Special stains Gram,acid-fast, negative Antigen detection Cryptococcal antigen Toxin detection Clostridium difficile toxin Molecular assays probes and PCR

SERO LOGY Presence of IgM Diagnostic titer Fourfold increase in titer

CUL TURE Identification by bio-chemical reactions Identification with specific anti-sera Identification using molecular based methods Anti-microbial susceptibility testing

Wh en ma ny po or q ualit y spec imens are sent, the labor atory produces many us el ess results!

Spe cimen selec tion , coll ection an d processing

Se le ctio n of g ood quality sp ecime n fo r test in g d epends on multip le facto rs Optimal time of collection Known characteristics of certain infectious processes or infectious agents Appropriate test must be directed accordingly

General Criteria for Specimen Collection and Transport (Most important)

Sa mple sh ould b e colle cted prior to antib iotic t herapy

Ea rly m orning sp ecimen Myc obacteriu m

Co rr ect t yp e o f specime ns Pu s/A spirated in st ead o f swa bs

Ad equate q uantit y of ste ril e body flu id CSF , p le ural flu id , blo od

Ap propria te n umber of sp ecim ens to incre ase th e yie ld

Pus aspirate

Sputum

Sputum

Sputum

Blood collection

Urine collection

Proper containers

Incorrect transportation

Proper labeling

Sa fe h andlin g or sa fety at wo rk

Safe handl ing or safety at work

Safe handl ing or safety at work

Personal protective equipment

Safety hood

Reject if

Processing

Staining

Staining

Staining

Staining

Urgent results CSF Blood AFB smear MP

Selection of media

Selection of media

Selection of media

Sterile condition

Streaking

Temperature and atmosphere

Direct sensitivity

Consu lta tion

In and Outs ide Campus Interpretation of results Investigation Input on management of patients with infectious problems Guide and monitor the course of anti-microbial therapy

Qu alit y Assu rance Quality control Internal and External Audit Certification or accreditation ISO 9002 JCIA

Thank you