MBBS, FCPS Senior Instructor Department of Pathology/Microbiology DIAGNOSTIC CYCLE The Patient P P Test Selection o r Report e s Interpretation t A Collection The n A Laboratory n a Cycle Report l a Transport Transmission y l Bartlett ‘80 t y I Report t c Accession Creation I c Analysis 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