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ESSENTIALS OF SPECIMEN
MANAGEMENT IN DIAGNOSTIC
MICROBIOLOGY
Dr.T.V.Rao MD
AIM OF MICROBIOLOGIC
EVALUATIONS
The goal of microbiologic
evaluation is to provide
accurate, clinically
pertinent results...
SCIENTIFIC SPECIMEN COLLECTION
FOR VALID INTERPRETATION
Valid interpretation of the results of culture can
be achieved onl...
BIOSAFETY A CONCERN IN
SPECIMEN COLLECTION
Wear gloves, gowns,
masks, and/or
goggles, when
appropriate, when
collecting sp...
SPECIMEN MANAGEMENT A
NEW CONCEPT
The impact of proper specimen management on
patient care is enormous. It is the key to a...
COLLECT THE SPECIMENS AT
OPTIMAL TIMES
Collect the
specimen at
optimal times (for
example, early
morning sputum
for AFB cu...
COLLECT SUFFICIENT
QUANTITY
Collect a sufficient quantity
of material. Use
appropriate collection
devices: sterile, leak-p...
DECONTAMINATE THE AREA
OF SPECIMEN COLLECTION
If appropriate,
decontaminate the skin
surface. Use 70-95%
alcohol (ALC) and...
MINIMISE THE TRANSPORT
TIME
Minimize transport
time. Maintain an
appropriate
environment between
collection of
specimens a...
CLINICIAN INTERACTION IMPROVES
THE LABORATORY PERFORMANCE
Today it is essential
the clinicians should
change the attitude
...
TRY TO COLLECT THE SPECIMENS
BEFORE ANTIBIOTIC THERAPY
Most Important criteria
of sample collection
continues to be a
spec...
COLLECTING SPECIMENS
FROM CRITICAL SITES
Microbiology
laboratories need
precise concepts to
collect the specimens
and use ...
APPROPRIATE LABELLING A
MUST
Specimens must be labelled
accurately and completely so
that interpretation of results
will b...
FOLLOW THE LABORATORY
MANUALS
The microbiology
laboratory policy manual
should be available at all
times for all medical s...
POOR QUALITY SPECIMENS
TO BE REJECTED
Specimens of poor
quality must be rejected.
Microbiologists should
act correctly and...
DO NOT PROCESS
COMMENSALS
These specimens processed
and many junior staff start
reporting commensals and
oral flora as pat...
DO NOT CULTURE NORMAL
MICROBIOTA
Many body sites have
normal microbiota that can
easily contaminate the
specimen. Therefor...
SWABS ARE NOT OPTIMAL
SPECIMENS FOR PROCESSING
Never forget the swab is
never optimal, the laboratory
requires a true clin...
HAVE TECHNICAL POLICY
The laboratory should
be allowed to set
technical policy; this is
not the purview of the
medical sta...
APPROPRIATE MICROBIOLOGY
SKILLS REDUCE SUPERBUGS
Microbiology laboratory
results that are reported
should be accurate,
sig...
APPROPRIATE MICROBIOLOGY
SKILLS REDUCE SUPERBUGS
I wish you refer the Peer
reviewed Diagnostic
Microbiology text books or
...
The Programme is Created and
Designed by Dr.T.V.Rao MD for Health
Care Professionals in Developing World
Email
doctortvrao...
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Essentials of specimen management in diagnostic microbiology

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Essentials of specimen management in diagnostic microbiology

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Transcript of "Essentials of specimen management in diagnostic microbiology "

  1. 1. ESSENTIALS OF SPECIMEN MANAGEMENT IN DIAGNOSTIC MICROBIOLOGY Dr.T.V.Rao MD
  2. 2. AIM OF MICROBIOLOGIC EVALUATIONS The goal of microbiologic evaluation is to provide accurate, clinically pertinent results in a timely manner. The quality of the specimens submitted to the microbiology laboratory is critical for optimal specimen evaluation
  3. 3. SCIENTIFIC SPECIMEN COLLECTION FOR VALID INTERPRETATION Valid interpretation of the results of culture can be achieved only if the specimen obtained is appropriate for processing. As a result, care must be taken to collect only those specimens that may yield pathogens, rather than colonizing flora or contaminants. Specific rules for the collection of material vary, depending upon the source of the specimen, but several general principles apply
  4. 4. BIOSAFETY A CONCERN IN SPECIMEN COLLECTION Wear gloves, gowns, masks, and/or goggles, when appropriate, when collecting specimens from sterile sites. Use strict aseptic technique.
  5. 5. SPECIMEN MANAGEMENT A NEW CONCEPT The impact of proper specimen management on patient care is enormous. It is the key to accurate laboratory diagnosis and confirmation, it directly affects patient care and patient outcomes, it influences therapeutic decisions, it impacts hospital infection control, and it impacts patient length of stay, hospital costs, and laboratory costs, and influences laboratory efficiency. Today it is essential the clinicians should change the attitude towards the Laboratory and to be more empowered with interaction with laboratory specialists.
  6. 6. COLLECT THE SPECIMENS AT OPTIMAL TIMES Collect the specimen at optimal times (for example, early morning sputum for AFB culture).
  7. 7. COLLECT SUFFICIENT QUANTITY Collect a sufficient quantity of material. Use appropriate collection devices: sterile, leak-proof specimen containers. Use appropriate transport media (anaerobe transport vials, Culturette for bacterial culture, Cary- Blair for stool culture,
  8. 8. DECONTAMINATE THE AREA OF SPECIMEN COLLECTION If appropriate, decontaminate the skin surface. Use 70-95% alcohol (ALC) and 2% chlorhexidine or 1-2% tincture of iodine (TIO) to prepare the site. Allow a contact time of two minutes to maximize the antiseptic effect.
  9. 9. MINIMISE THE TRANSPORT TIME Minimize transport time. Maintain an appropriate environment between collection of specimens and delivery to the laboratory.
  10. 10. CLINICIAN INTERACTION IMPROVES THE LABORATORY PERFORMANCE Today it is essential the clinicians should change the attitude towards the Laboratory and to be more empowered with interaction with laboratory specialists.
  11. 11. TRY TO COLLECT THE SPECIMENS BEFORE ANTIBIOTIC THERAPY Most Important criteria of sample collection continues to be a specimen should be collected prior to administration of antibiotics. Once antibiotics have been started, the flora changes, leading to potentially misleading culture results
  12. 12. COLLECTING SPECIMENS FROM CRITICAL SITES Microbiology laboratories need precise concepts to collect the specimens and use of special skills and selective media a must for effective methods in Diagnosis
  13. 13. APPROPRIATE LABELLING A MUST Specimens must be labelled accurately and completely so that interpretation of results will be reliable Labels such as “eye” and “wound specimens” are not helpful to the interpretation of results without more specific site and clinical information (e.g., surgical site infection after laparotomy).
  14. 14. FOLLOW THE LABORATORY MANUALS The microbiology laboratory policy manual should be available at all times for all medical staff to review or consult and it would be particularly helpful to encourage the nursing staff to review the specimen collection and management portion of the manual
  15. 15. POOR QUALITY SPECIMENS TO BE REJECTED Specimens of poor quality must be rejected. Microbiologists should act correctly and with responsibly when they call physicians to clarify and resolve problems with specimen submissions.
  16. 16. DO NOT PROCESS COMMENSALS These specimens processed and many junior staff start reporting commensals and oral flora as pathogens, equally ignorant clinician, Physicians should not demand that the laboratory report “everything that grows,” thus providing irrelevant information that could result in inaccurate diagnosis and inappropriate therapy.
  17. 17. DO NOT CULTURE NORMAL MICROBIOTA Many body sites have normal microbiota that can easily contaminate the specimen. Therefore, specimens from sites such as lower respiratory tract (sputum), nasal sinuses, superficial wounds, fistulae, and others require care in collection.
  18. 18. SWABS ARE NOT OPTIMAL SPECIMENS FOR PROCESSING Never forget the swab is never optimal, the laboratory requires a true clinical specimen, not a swab of a specimen. Actual tissue, aspirates, and fluids are always specimens of choice, especially from surgery. A swab is not the specimen of choice for many specimens because swabs pick up extraneous microbes, hold extremely small volumes of the specimen (0.05 mL),
  19. 19. HAVE TECHNICAL POLICY The laboratory should be allowed to set technical policy; this is not the purview of the medical staff. Good communication and mutual respect will lead to collaborative policies.
  20. 20. APPROPRIATE MICROBIOLOGY SKILLS REDUCE SUPERBUGS Microbiology laboratory results that are reported should be accurate, significant, and clinically relevant, do not report S. pneumonia from throat swabs, Susceptibility testing should be performed on clinically significant isolates, not on all microorganisms recovered in culture.
  21. 21. APPROPRIATE MICROBIOLOGY SKILLS REDUCE SUPERBUGS I wish you refer the Peer reviewed Diagnostic Microbiology text books or else you are communicating the commensal and contaminants as pathogens and with misuse of antibiotic as it a concern in the Era of raise of SUPER BUGS.
  22. 22. The Programme is Created and Designed by Dr.T.V.Rao MD for Health Care Professionals in Developing World Email doctortvrao@gmail.com
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