General Information

Is bronchial lavage/washings still acceptable for a KOH? Most of our organization has vaginal wet mounts as the only sample type for KOH. Thanks

Hi I hope someone can explain to me . I have seen two blood tests 1. Protein creatinine [urine] ratio and 2. Urinary Protein creatine ration. What is the difference?

Hello! I’m a long-time blood banker who has recently entered the world of microbiology. This forum has been such a great resource during my time in transfusion, so I’m hoping that the microbiology folks could answer a few questions related to WBC smears. I am interested in learning more about the workflow for this test and how these are prepared and read in different facilities. In your facility, are these typically done in microbiology or hematology? What stain are you using for WBC smears in your lab?

Does anyone use the BacT/Alert along with Meditech? If you do, please let me know because I have some interface and programming questions! Natalie

Has this outbreak in ground beef impacted anyone else's laboratory? https://abcnews.go.com/GMA/Food/58k-pounds-raw-ground-beef-recalled-multiple-states/story?id=103275626

Does anyone have any additional information regarding a change to how CDI is defined by NHSN? In Section 2 of the 2022 Update to SHEA/IDSA/APIC guidelines, a potential change is mentioned, which will include a combination of ANY positive test (not only last test of record) AND treatment within 2 days. When this article was published, the NHSN was still validating this updated definition, but I'm curious to know if anyone has any updates and also what impact this potential change may have on your C. diff testing algorithm?

We are looking to move our kits to our serology department from micro for flu, strep and RSV. When we were CAP accredited (years ago), we were cited under MIC.19840 for not processing the specimens under the biosafety hood. We are currently JC and have been unable to find a similar standard. Do any of you process these specimens in your main labs? My issue is that these are performed in doctor's offices and clinics daily without a hood...why are we any different?

We just had an API AFB survey where the specimen was put on the back of the slide... Not the labeled side. After the staining process, the specimen circle didn’t take on any color and nothing would come in focus. I stained the other side and sure enough, positive!!!! API’s response, is we should notice where the specimen is regardless of the labeling!

Does anyone have a procedure for a quantitative wound culture they would be willing to share?

You can see what fun we blood bankers have been having these past few years and get a few laughs while you are at it. Then you microbiologists can really go buggy in here.

Is there anyone out there using the Meridian Immunocard STAT EHEC? If so, how is it performing and do you like it? Thank you for your input, Sharon

Hi Micro people, I see that there is still not much action here on the Micro forum, compared to the awesome Blood bank forum..but I am going to try my luck anyway and put my question out there! I need to export some raw MIC data from the Vitek 2 compact, to a flash drive for use on a study that the lab is participating in. Yes I could phone the company etc and ask some colleagues but boy, everyone is sooo busy during our shift, so its way easier for me when I have the headspace at home. I correlate the data for a quarterly timeframe and use the AGAR (Australian Group on Antimicrobial Resistance) portal to lodge our findings. I have recently take…

Has anyone had much experience with this system? We are changing over from a BacTAlert3D because of inventory problems. My first impression is that the software with the VersaTrek is fairly simple without much flexibility.

Hello! For some reason our microbiology department has different prices for organism identification. If a patient has one organism the price is higher than the charge for the second organism. And the second organism charge is higher than the third. They all use the same CPT code. Multiple sensitivities are set up the same way. Is there any reason for this? No one here knows why we have different charges like this. I'd like to simplify charging by making it automatic. Currently because of the different charges they have to manually enter them as they are working up the specimens.

Hi all, My first post here, but I've lurked for quite awhile. Here's my question: Would you accept a blood culture on a 12 day old ER patient that was collected from a heelstick? The blood culture bottle came up positive in less than 24 hrs-GPC in clusters-surprise, surprise. I would have rejected it when it was collected, but the tech on duty at the time accepted it and put it in the bactec. After coming up positive, the supervisor decided that we could not reject and the doctor would have to decide if it was a contaminate or not. What would you have done or what is your policy/procedure? Thanks!

Hi all - How do you prepare your wet mount specimens? Have seen adding 1-2 drops saline to the swab (ancient policies and the Dr's UpToDate ref source)- reason being you don't want to dilute the sample? and 0.5 -1 ml of saline ( other hosp's in our organization) - reason being you don't want the cotton tip to dry out. I also think that if you add more liquid, you get more uniform distribution of your sample. Have asked our micro dept, but have heard nothing yet.

Our theatres send us water samples for legionella testing and they are transported in a cooler box with ice packs that have been stored at -80oC. Would this not kill any bacteria? Or is legionella testing done via PCR? I'm BB/haem trained so just curious as I get requests out of hours for freezer packs and I'm not entirely comfortable with the process.

Hi, everybody. I have generalist medical laboratory scientist training, but for over 2 years I have been specializing in Blood Bank. Although I like Blood Bank, I have often have an "itch" to switch over to Microbiology. Can you offer tips to "wow" a prospective interviewer so I can specialize in something new? My previous experience in Microbiology was as a student 4 years ago. Thanks!

Consider for the sake of discussion, E-tests, automated micro-dilution, Kirby-Bauer methods for antibiotic susceptibility testing. If there are no CLSI guidelines for reporting a particular drug/organism combination (therefore no in-vitro to in-vivo validation); If a physician requests the MIC value only or Kirby-Bauer measurement; Can this be reported? If yes, does anyone have a comment they post with the result? If yes, how do you justify which method you utilize to report and how do you justify the in-vitro/in-vivo correlation? Since there are no CLSI guidelines or data?

Hello I need help in TTI screening test for blood donors we observe variation in results between full automation machines although they processing in the same methodology for example Architect and Vitros machine some samples reactive for anti-HCV on Architect machine and negative by Vitros machine, and some samples are positive by Vitros machine and negative by Architect, so in this situation which machine considered as accurate to use for screening test for blood donors. Thank you

We use BacT/Alert and followed new CAP requirement to "have a system for monitoring blood cultures for adequate volume and feeding back the results to blood collectors". We performed random volume checks throughout 2014 using 5ml - 10ml as an acceptable volume for adults - knowing that 5ml is too little (should be 7ml I would think). Manufacturer only says "10ml is optimal" - no minimum or maximum. Do others feel the same? Even at 5ml only 75% met the criteria. (Of course most of the failures were nurse draws.) As a result of this I want to include this monitor as a 2015 QA monitor with more indept monitoring and followup to get this to improve. Others doing this check an…

Does anyone have policies, processes, procedures to share regarding how you deal with gram stain discrepencies between technologists and when you would perform a corrected report. Also if you have any references regarding how and why you use this criteria that would be helpful also. Thanks.

What are the ways in which urine culture orders are screened? For some time, we have been going by the concept that we can cancel C&S orders with a "screen negative" comment if the UA shows no evidence of a UTI. In practice, our protocol is way too complicated. We have so many exceptions that it generates far more work than we save by cancelling the few C&Ss based on the protocol. If a UA is not ordered at the same time, and recent UA results are not available, we order one ourselves. If the nitrite and esterase are negative, we have to look at the microscopic for WBCs or bacteria/yeast. We do not screen outpatient UAs, just those collected in our hospital. …

Hi, We have just published an interview with Dr Robert Jerris, the Director of Clinical Microbiology at the Children's Healthcare of Atlanta Pediatric Hospital. In the interview, Dr Jerris discusses the implementation of the Bruker MALDI Biotyper (which has recently received FDA clearance), and the impact that it has had on the laboratory, staff and the patients. Dr Jerris is extremely passionate about the advantages of using MALDI-TOF MS, and I would be interested to know your thoughts on the subject. http://bit.ly/1kO9Scl

Does anyone still utilzie this broth with routine cultures? If you have specific sources/sites that you use or don't use what are they? Has there been a recent paper published regarding the use of thio? We have had a increasing number of physicians requesting how the organism was growing in the broth, i.e., at the top, at the bottom, etc.... We have been trying to limit our use of Thio broth because of getting so much contaminating flora being picked up, especially from swab specimens.... Just would like to hear where everyone else is with this. mic