The diagnostic microbiology lab

Question 1

Urinary tract infections

Answer 1

Half of women will suffer a UTI during their lifetime
If left untreated = kidney damage/failure/septicemia
E. Coli causes 80% of UTIs
Taking a mid stream sample of clean catch urine = no contamination, DIPSTICK - look for raised white blood cell count
Perform microscopy, grow organism

Question 2

Gonorrhea

Answer 2

Purulent discharge from involved site after 2-5 days of incubation
95% of males show symptoms
Females:
- 50% show symptoms of discharge and dysuria
- can lead to pelvic inflammation disease = increase probability of sterility if not treated
Ophthalmia neonatorum:
- purulent ocular infection acquried by neonate at birth
Diagnosis:
- gram stain, culture
Treatments:
Ceftriaxone 250mg IM single dose
Cefixime 400mg oral single dose
Spectinomycin 2g IM single dose
Alternatives if organism is known to be sensitive
Ciprofloxacin 500mg oral single dose

Question 3

What methods are there for identifying suspected pathogens?

Answer 3

Microscopy, culture, latex antigen kits, toxin testing, biochemical tests, sugar fermentation reactions, molecular

Question 4

What to look for on a specimen before it can be accepted?

Answer 4

Patient identification: name, DoB, Unit number, NHS number
Source essential - where is the result to go, who does the lab phone for significant results
Labs will not accept unlabeled samples, insufficient identification of patient, leaking specimens

Question 5

What are the 5 alert organisms?

Answer 5

MRSA 
VRE
C. difficile
ESBL and CPE enterobacteriaceae 
MDR M. tuberculosis