Quality control and Susceptibility Flashcards
what is quality assurance?
- monitor ongoing total tests and effectiveness
- correct problems to ensure accurate results
- assess competency of staff (pre, post, analytical)
what is quality control
monitor quality of each method to ensure accuracy and reliability
what are examples of benchmarking
- reference point
- seeking best practices to imitate
- done willingly
- productivity and cost
what does CLSI stand for
clinical and laboratory standards institute
what does NCCLS stand for
national committee for clinical laboratory standards
what is the CLSI vision
leader in clinical and lab standards to improve quality of care
what is CLSI mission
develop best practice in lab in the wold
what is CLSI values
excellence, responsiveness, inclusiveness, fairness
what is ATCC and what do they do
american type culture collection
- global supply of standard strains of typical morphs and biochem characteristics
what are the routine schedule components of a QC program
mechanical
media
reagents
antisera
antimicrobial disksw
when should incubators and fridges be cleaned inside
every 3 months
when should freezers be defrosted
every 6 months
where are chemical indicators seen
monitoring temperature and pressure of autoclaves
when should biological spore strips be performed on autoclaves
every month
what are the chemical controls in anaerobe/CO2 conditions
methylene blue for CO2
resazurin for anaerobes
fyrite CO2 testing
what are biological controls in anaerobic and CO2 conditions
Clostridium haemol - strict anaerobe
Neisseria gonnorrh - needs CO2
Campy jejuni - microaerophilic
how many plates undergo sterility testing
2-5% of final product are test plates for sterility
<100 plates received = all plates tested for sterility
what is sterility testing
media is placed in temperatures for 24 hours when those temperatures are needed for testing
how is pH of plates tested
surface electrodes or macerate the media and test at RT
does the pH get affected by sterilization T/F
T
what is performance testing for plates
nutrient quality and reliability using heavy inoculum
what are macroscopic tests for media before use
clairty and color
moisture free
no signs of dryness
how should reagents be stored
closed brown or opaque containers
-20 to 20 degrees
how long is short term storage for antimicrobial disks
1 week
where are long term antimicrobial disks stored
in freezer
what is required for each antimicrobial kit and why
desiccant to prevent moisture
how does an internal proficiency testing work
supervisor introduces unknown specimens to regulate the workflow and check for errors
purpose of internal proficiency testing
check sensitivity of routine methods to detect pathogens and staff ability to isolate
how does external proficiency testing work
rare and unusual samples received from outside associations are run and then compared by supervisors
what is the purpose of external proficiency testing
determines lab ability to ID difficult organisms - accuracy
who is the source of stock cultures
American type culture collection (ATCC)
how is semi stock cultures prepared
- lyophilized vial is subbed to media.
- second subbing is inoculated to freezer vials.
- new vial of same organism removed to prevent repeated thawing and freezing (prevent mutations)
what should semi stock media should not contain and why
no sugars
organisms will use sugars while maintained and acids produced can kill organisms over time
examples of semi stock media
glycerol
skim milk
chopped meat - for anaerobes
tryptic soy sugar
cysteine tryptic agar withOUT carbs
what should organisms in freezer temp be
-70 to -80 C
or use liquid nitrogen and lyophilisation
what are working cultures
every month, fresh subculture from frozen stock is used on appropriate media
QC for ALA (porphyrin)
H parainfluenzae pos
H influenzae neg
QC for oxidase
pseudo and neisseria pos
e coli neg
QC for DNase
pos:
staph aureus
serratia
m cat
steno
neg:
other staph sp.
other enterobac
other moraxel
other NFB
QC for TSB at 42
pseudo aeru pos
pseudo fluor or putida neg
QC for ONPG
shigella sonnei pos
other shigella for neg
QC for Butyrate disk
m cat pos
Neisseria gonorrh neg
QC for BCSA
burk pos
steno neg
QC for BCYE
legionella pos
NFB neg
QC for PYR
Ent or strep pyo for pos
strep bovis or agal for neg
QC for spot indole
E coli pos
Proteus mirabilis neg
QC for HEK
Salmonella pos (blk)
E coli neg (ng or yellow)
QC for salmonella shigella (SS)
shigella sp pos (clear/wh)
ECOLI *** (ng)
QC for catalase
staph aur pos
Ent weak pos
Strep pyo neg
what guidelines are used in antimicrobials
pharmacodynamics guidelines
what antimicrobials belong to the Aminoglycosides class
Amkikacin
Gentamicin
Tobramycin
what antimicrobials belong to the Glycopepties class
Vancomycin
what antimicrobials belong to the Quinolines class
Naladixic Acid
what antimicrobials belong to the Macrolides class
Erythromycin
what antimicrobials belong to the Cephalosporin class
Cefuroxime
Cephalothin
what antimicrobials belong to the Fluoroquinalones
Ciprofloxacin
what antimicrobials belong to the Beta Lactams class
Meropenem
Amipicillin
what antimicrobials belong to the Sulfonamide
Co trimoxazole
what antimicrobials belong to the Lincosamides
Clindamycin
what antimicrobials belong to the Thienamycin
Imipenem
MOA of bacterial cell wall syntyhesis
inhibit synthesis of peptidoglycan wall
class of bacterial cell wall synthesis
glycopeptides
beta lactams
MOA of protein synthesis
Inhibit 30S or 50S ribosomal subunit
Class ofprotein synthesis
aminoglycosides
tetracycline
macrolides
lincosamide
stretogramins
MOA of DNA and RNA synthesis
inhibit DNA/RNA replication
class of DNA and RNA synthesis
quinolones
fluoroquinolones
MOA of metabolic pathways
inhibit folic acid production
class of metabolic pathways
sulforamides
MOA of cell membrane integrity
detergents of phospholipids in cell membrane to increase permeability (GNB affected)
class of cell membrane integrity
polymixins
colistins
SPICE group consists of?
Serratia
Providenicia
Indole pos Proteus
Citrobacter
Enterobacteraciaes
significance of SPICE group
quickly develops resistance to antibiotics
Mechanism, Detection, and Organism of MRSA
MecA-PBP2 altered
Chromagar / Cefoxitin
S. aureus
Mechanism, Detection, and Organism of VRE
VanA + VanB gene
Vancomycin E test
E. faecium
Mechanism, Detection of VISA/VRSA
VISA - thicken cell wall
VRSA - VanA from VRE
Vancomycin E test
Mechanism, Detection, and Organism of B Lactamase
Class A - basic penicillinase
Cefimase or nitrocefen
H. Influenze, neisseria, M Cat
Mechanism, Detection, and Organism of ESBL
Class A penicillinase
ESBL disk
E coli
Mechanism, Detection, and Organism of MBL
Class B - zinc required
MAST disc (no b-lactmase)
CPO organism
Mechanism, Detection of MCR
MCR + Enterobac from livestock
PCR
Mechanism, Detection, and Organism of inducible clindamycin resistance
erm gene
Erythro = I/R and clindamycin = S
S. aureus
