Microbiology
Introduction
The
Microbiology department at Dorset County Hospital Foundation Trust
(DCHFT) offers Bacteriology, Virology, Serology, Parasitology and
Mycology testing as well as advice to DCHFT, local community hospitals,
General Practitioners and Environmental Health Officers. It also
provides an Infection Control advice, as well as being an acceptance
point for environmental samples to be sent to Porton food, water and
environmental services. There are staff available that have been trained
in the specialist area of the deliberate release of biological agents.
The
laboratory provides epidemiological data for the The Public Health England (PHE) Centre of Infectious Disease Surveillance and Control at Colindale, North London
and investigates outbreaks/incidents of infectious disease in support of
the Consultant in health Protection.
Test Repertoire
For test repertoire and information on specific microbiology tests including turn-around-times and urgent request procedures - click here
Laboratory opening times and on-call service
Most routine specimens are accepted during the following hours:
Monday to Friday 9am to 5.15pm
Saturday 9am to 12 noon
Sunday and Bank Holidays on site as required
- Outside normal hours of service (on-call)
Please
Note: The Microbiology on-call staff do not work the same shift
patterns as Blood Sciences and MUST be contacted for urgent tests
required outside of routine hours.
There
is a 24-hour on-call service. The on-call Biomedical Scientist (BMS)
can be contacted via the hospital switchboard. Specimens will be
processed outside normal laboratory hours if requested and agreed
criteria are satisfied.
Appropriate specimens for urgent examination on-call include:
- cerebrospinal fluid (CSF)
- operative specimens such as biopsies or pus including drainage of empyema
- urine microscopy in children where it may influence the decision for acute abdominal surgery
- cultures in pyrexial patients with neutropenia or in labour
Consultant Advice
Always check policies and refer to senior staff before contacting the Consultant Microbiologist for advice
For
advice on diagnosis and the interpretation of microbiology results or
antimicrobial use, contact the duty Consultant Microbiologist.
- During normal working hours (as above) contact Duty Consultant on Ext 4343. If the consultant is not immediately available, a message will be taken by lab staff and replied to as soon as possible. If a more urgent response is required, the consultant can be paged via switchboard.
- Outside of normal hours contact duty Consultant via the hospital switchboard. Out of Hour calls should be made by doctors at registrar level or above. However, calls will be accepted from other grades for urgent advice on patients if team seniors are not available in a timely manner.
Please have the following information available when calling for advice, as consultants may be covering from home without access to electronic system.
- Previous microbiology results
- Current antibiotics and dose
- Previous antibiotics in the past month
- Details of antibiotic allergies
- Current and previous inflammatory markers
- Renal and liver function
There are cross-cover arrangements with Salisbury District Hospital over weekends.
Infection Control
Infection Control Information and Resources – Please click here (Internal users only)
For Infection Control telephone enquiries: 01305 253279
Results
Always
check the ICE laboratory information system (LIMS) for results before
telephoning the laboratory. If results are not available on the computer
an update may be available from the laboratory on Ext 4338.
Reports
are available electronically every working day. Most bacteriology
culture results are reported after 2-5 days, depending on the
investigation. Urine microscopy results are available on the day of
receipt Monday to Saturday lunchtime. Serology and virology results and
reporting depends on the frequency of testing and the urgency of the
request.
Telephone results
Results of
urgent requests will be available on the computer as soon as possible.
Urgent results that cannot be entered onto the computer for whatever
reason will be telephoned if they will aid immediate patient management.
This includes all positive blood cultures and CSF results.
Staff and telephone numbers
General laboratory/Results telephone: 01305 254343
Supply of specimen containers
Most sample containers are obtained via the stores supply system.
The following are obtained direct from the laboratory by phoning 4338
- Blood
culture bottles - store at room temperature in the dark. Keep bottles
of each set together and return any unused bottles. Tell laboratory
staff if you require ordinary sets or those sets for patients on
antibiotics.
- Chlamydia collection kit – store at room temperature.
- Per nasal swab/plate kits for whooping cough - store at 4oC.
- Virus transport media for NPAs (nasopharyngeal aspirate) – store at room temperature.
- TB urine kits
All other supplies are obtained via the normal hospital supplies system.
Request forms
A
hand-written, printed or ICE request form must accompany all specimens
sent to the laboratory. It should clearly state the following
information: Comprehensive Clinical
Information is essential - Please click here for further information on specimen and request form acceptance criteria
Health & Safety
See information from Health and Safety Executive (HSE) and Advisory Committee on Dangerous Pathogens (ACDP).
HSE http://www.hse.gov.uk/biosafety/infection.htm
ACDP http://webarchive.nationalarchives.gov.uk/20130107105354/http://dh.gov.uk/health/about-us/public-bodies-2/advisory-bodies/acdp/
General information
The
best results are obtained when an appropriate, well taken specimen, in
the proper container, is delivered to the laboratory promptly and
relevant clinical information is provided on the request form.
For specific instructions on methods of sample collection, specimen containers, sample volumes and requirements for transport and storage click here (Collection of Microbiological Specimens Policy).
General guidelines on microbiology specimen collection are:
- Do not send specimens in non-sterile containers
- Where possible specimens should be obtained before antimicrobial agents have been administered
- An adequate quantity of material should be obtained for complete examination. Always send pus ( in a universal container) rather than a swab of the pus
- The
specimen taken should be representative of the disease process. For
example, material swabbed from the opening of a sinus tract is more
likely to yield commensal organisms on the skin than would material
obtained by curettage or biopsy of the base of the tract
- Care
must be taken to avoid contamination of the specimen by micro-organisms
normally found on the skin and mucus membranes. Sterile equipment and
aseptic technique must be used for collecting specimens, particularly
for those from normally sterile sites
- Material must be
transported promptly to the laboratory. Fastidious organisms may not
survive prolonged storage or may be overgrown by less fastidious
organisms before culture can be undertaken.
Please contact the laboratory if there is any doubt about the best specimen to take or concerning the availability of a test
Collection of Blood Cultures
The document 'POLICY FOR TAKING BLOOD CULTURES' can be found on the Infection Prevention and Control intranet site. Please click here
It
contains full information on the rationale for blood culture sampling,
indications for sampling, when to take samples, procedure for taking
blood cultures and the equipment required.
