Microbiology MICROBIOLOGY USER MANUAL Microbiology Microbiology Service User Manual Document number: MIC-QP-008 Warning: This is a controlled document Page 1 of 107 Author: Angela Stear unless in authorised location Date of Issue: April 2021 Approved by: Naomi Rogers Revision: 15.0 Microbiology MICROBIOLOGY USER MANUAL INDEX 1 INTRODUCTION AND SCOPE ................................................................................. 6 2 GENERAL INFORMATION ON THE USE OF THE MICROBIOLOGY LABORATORY ................................................................................................ 6 LOCATING AND CONTACTING THE MICROBIOLOGY LABORATORY ...................................... 7 LABORATORY OPENING HOURS ...................................................................................... 8 MEDICAL ADVICE ........................................................................................................... 8 SENIOR MEMBERS OF THE MICROBIOLOGY SERVICE ....................................................... 8 INFECTION PREVENTION AND CONTROL NURSING TEAM .................................................. 9 3 COMMENTS, COMPLIMENTS & COMPLAINTS .................................................... 10 4 QUALITY ASSURANCE .......................................................................................... 11 5 DATA CONFIDENTIALITY ...................................................................................... 13 6 ROUTINE SAMPLES............................................................................................... 13 7 URGENT SAMPLES ............................................................................................... 13 8 SPECIMEN REJECTION ......................................................................................... 14 9 ORDERING CONSUMABLES (E.G. SPECIMEN CONTAINERS) ........................... 14 10 LABELLING SPECIMENS AND REQUEST FORMS .............................................. 15 SPECIMEN LABELLING ................................................................................................ 15 REQUEST FORM LABELLING ....................................................................................... 15 11 COLLECTION AND TRANSPORT OF SPECIMENS TO THE LABORATORY FROM GP SURGERIES / PRIVATE HOSPITALS / NON-HOSPITAL BASED CLINICS ....................................................................................................................... 16 12 TRANSPORTING SPECIMENS FROM EKHUFT WARDS AND HOSPITAL BASED CLINICS ......................................................................................................... 17 TRANSPORT OF HIGH RISK SAMPLE E.G VIRAL HAEMORRHAGIC FEVER (VHF) ............... 17 TRANSPORT OF ALL OTHER SPECIMENS ...................................................................... 18 13 REQUESTING ADDITIONAL INVESTIGATIONS .................................................... 19 14 ON-CALL INVESTIGATIONS .................................................................................. 19 TESTS AVAILABLE OUT OF HOURS ............................................................................... 20 ON-CALL SERVICE AT WILLIAM HARVEY HOSPITAL ...................................................... 20 MICROBIOLOGY ON-CALL SERVICE AT K&C AND QEQM .............................................. 20 MICROBIOLOGY ON-CALL SPECIMEN PROCEDURES – FOR REQUESTING CLINICIANS ....................................................................................................................... 20 MICROBIOLOGY ON-CALL PROCEDURES – FOR PATHOLOGY STAFF ...................... 21 CONTACTING THE CONSULTANT MICROBIOLOGIST ...................................................... 22 15 SUBMITTING SAMPLES TO THE LABORATORY ................................................. 23 Document number: MIC-QP-008 Warning: This is a controlled document Page 2 of 107 Author: Angela Stear unless in authorised location Date of Issue: April 2021 Approved by: Naomi Rogers Revision: 15.0 Microbiology MICROBIOLOGY USER MANUAL SPECIMEN REQUISITION............................................................................................. 23 PREPARATION TO COLLECTING SPECIMENS ................................................................. 24 16 OPTIMISING THE VALIDITY OF RESULTS ........................................................... 25 17 COLLECTION OF SAMPLES – ROUTINE BACTERIOLOGY ................................ 28 BLOOD CULTURE SPECIMENS: .................................................................................... 28 CEREBRAL SPINAL FLUID ........................................................................................... 30 FAECES .................................................................................................................... 32 PARASITES ............................................................................................................... 35 TISSUE AND FLUID SAMPLES ...................................................................................... 37 URINE SPECIMENS .................................................................................................... 39 WOUND SWABS AND PUS........................................................................................... 42 THROAT SWABS ........................................................................................................ 43 NOSE SWABS ............................................................................................................ 43 PERNASAL SWAB (PERTUSSIS CULTURE) .................................................................. 44 EYE SWABS ............................................................................................................ 44 CORNEAL SCRAPES ................................................................................................. 44 EAR SWABS ............................................................................................................ 45 GENITAL SWABS ...................................................................................................... 45 RECTAL SWABS ....................................................................................................... 46 PNEUMONIA ............................................................................................................ 47 MRSA SCREEN ...................................................................................................... 51 MYCOLOGY SAMPLES .............................................................................................. 52 18 COLLECTION OF SAMPLE - VIROLOGY / SEROLOGY ....................................... 53 BLOOD SAMPLES FOR SEROLOGY/VIROLOGY. .............................................................. 53 NPA (NASOPHARYNGEAL ASPIRATES) FOR RSV AND PCR .......................................... 54 THROAT SWABS IN VIRAL TRANSPORT MEDIA (VTM) FOR PCR ..................................... 54 GENITAL SWABS (AND OTHERS) FOR HERPES SIMPLEX IN VTM. ................................... 55 OTHER SWABS IN VTM (EYE SWABS, SKIN SWABS, VESICLE SWABS/FLUID ETC) ............. 55 CSF 55 URINE FOR PCR (CMV) ............................................................................................ 55 FAECES SAMPLES FOR VIROLOGY .............................................................................. 55 SALIVARY SAMPLES FOR MUMPS TESTING .................................................................. 56 SAMPLES FOR CHLAMYDIA, GONORRHOEA AND HSV PCR TESTING. .......................... 56 QUANTIFERON/ T SPOT SAMPLES FOR DIAGNOSIS OF LATENT TB ............................. 57 BAL/LOWER RESPIRATORY SAMPLES FOR PNEUMOCYSTIS IMMUNOFLUORESCENCE. ... 59 HIV VIRAL LOAD MONITORING (SPECIALIST TEST) ..................................................... 59 Document number: MIC-QP-008 Warning: This is a controlled document Page 3 of 107 Author: Angela Stear unless in authorised location Date of Issue: April 2021 Approved by: Naomi Rogers Revision: 15.0 Microbiology MICROBIOLOGY USER MANUAL HCV, HBV AND CMV VIRAL LOAD MONITORING ........................................................ 60 HEPATITIS .............................................................................................................. 60 ANTENATAL SCREENING SPECIMENS ........................................................................ 60 18.17 SUMMARY TABLE OF SAMPLE COLLECTION FOR IN-HOUSE TESTS: ............................... 61 19 STORAGE OF COLLECTED SPECIMENS PRIOR TO TRANSFERRING TO THE LABORATORY .............................................................................................. 64 20 REFERRING SAMPLES TO OTHER LABORATORIES ......................................... 65 21 RESULTS ................................................................................................................ 69 22 TELEPHONED RESULTS ....................................................................................... 69 23 REFERENCE LABORATORY RESULTS ............................................................... 69 24 REPORTS ............................................................................................................... 69 25 INTERPRETATION OF RESULTS .......................................................................... 70 26 CLINICAL TESTS AVAILABLE AND TURNAROUND TIMES ................................ 71 27 REFERENCES ........................................................................................................ 78 28 APPENDICES ........................................................................................................