Medical Microbiology

Contents

General
Microbiology Staff
Infection Control Team
Contact Information for Clinical Advice & Range of Services
Services
Quality
Laboratory Opening Times (Including Out of Hours)
Test Requests, Specimen Labelling and Reports
Time Limits for Requesting Additional Examinations

Specimen Collection Guide

General

The department of Microbiology provides a hospital based service for the laboratory diagnosis and clinical management of microbial diseases for patients in the hospital and the community. Infection control advice is provided by the Infection Prevention and Control Team which includes Infection Control nurses and Consultant Medical Microbiologists.

Microbiology Staff

Consultants & Senior StaffPosition HeldContact Detail – Ext. and (Full No.)
Dr Gail SpeirsConsultant Medical Microbiologist2798 (01271 322798)
Dr David RichardsConsultant Medical Microbiologist and Director of Infection Prevention & Control2320 (01271 322320)
Dr Tom LewisConsultant Medical Microbiologist, Pathology Director and Lead for Antimicrobal Stewardship)2798 (01271 322798)
Annette WestLaboratory Manager3278 (01271 370278)
Charlotte WilliamsSenior Biomedical Scientist2797 (01271 322797)
John SoukalSenior Biomedical Scientist2347 (01271 322347)
Simon TurnbullSenior Biomedical Scientist2347 (01271 322347)

This is in addition to a team of State registered Biomedical Scientists and Medical Laboratory Assistants.

Infection Prevention & Control Team

Infection Control advice is provided by the Infection Prevention and Control Team of  Nurses and the Clinical Medical Microbiologists and led by Consultant Medical Microbiologist Dr David Richards. The Infection Prevention and Control Team can be contacted on 322680 or bleep 011 between 9am and 17.00 Mon-Fri. Out of hours advice is via the on call Consultant Medical Microbiologist through the hospital switchboard.

The Infection Control Manual is available via the intranet on BOB via www.northdevonhealth.nhs.uk/infection-control

Contact Information for Clinical Advice & Range of Services

Clinicians who are in doubt about the range of services offered should consult the Consultant Medical Microbiologist on bleep 193 or out of hours through the hospital switchboard. There is also a non-urgent, interpretive and clinical advice e-mail service via ndht.Pathologynddh@nhsnet. This e-mail account is checked daily and a response within 24 hours Monday to Friday. (This generic Pathology e-mail account can be used for advice on all Pathology queries).

Services

The Microbiology Department provides a full range of tests for the diagnosis of bacterial, viral, fungal and parasitic infection, an Andrology Service for post vasectomy and infertility semen, antenatal screening for infectious diseases in pregnancy and Serology Diagnostic Service which utilises various reference laboratories around the UK. National reference laboratories are also used for identification and confirmation of complex organisms and PCR diagnostic work. These reference laboratories are assessed for quality by checking their accreditation status on the UKAS website. This was last undertaken in September 2018.

LaboratoryCPA statusUKAS/CPA registration number
Sandwell & West Birmingham Hospitals NHS TrustAccreditedUKAS 7979
CJD research and surveillance unit ,Western GeneralHospital, EdinburghNot Accredited See assurance letter – Click Here
Clinical Microbiology Leeds, Leeds General InfirmaryAccreditedUKAS 8924
Clinical Microbiology Liverpool, Liverpool University HospitalAccreditedUKAS 9595
Clinical Microbiology, PHE CambridgeAccreditedUKAS 8177
County Hospital Hereford, Microbiology and ImmunologyAccreditedUKAS 8628
Derriford Hospital, MicrobiololgyAccreditedUKAS 8050
Heartlands Hospital, BirminghamAccreditedUKAS 8217
PHE BristolAccreditedUKAS 8043
PHE London School of Hygiene Tropical Medicine – Diagnostic ParasitologyAccreditedUKAS 9148
PHE Central ManchesterAccreditedUKAS 8195
PHE Colindale Bacteriology Reference Dept.AccreditedUKAS 1595
PHE Virus Reference DeptAccreditedCPA 2904
Public Health Wales NHS TrustAccreditedUKAS 1591
Rare and Imported Pathogens Laboratory, HPA Porton DownAccreditedUKAS 8552
Royal Cornwall Hospital, MicrobiologyAccreditedUKAS 9053
Royal Devon and Exeter, Chemical PathologyAccreditedCPA 0057
Royal Devon and Exeter, MicrobiologyAccreditedCPA 0056
Royal Preston Hospital, MicrobiologyAccreditedUKAS 8545
UCLH NHS Trust (Parasitiology), London Hospital for Tropical diseasesAccreditedCPA 2204

 

Quality
The Microbiology service aims to provide a quality service in which all efforts are made to provide a clinically based, timely and cost effective diagnostic service with the highest in-built quality standards.

The technical work in the laboratory is undertaken by a team of State registered Biomedical scientists and Medical Laboratory Assistants with reference to national guidelines and Standard Operating Procedures. Consultant Medical Microbiologists advise on the choice and applicability of diagnostic tests performed in the laboratory and provide interpretative advice and guidance for treatment.

The laboratory participates  in a rigorous inspection process by the accreditation body Clinical Pathology Accreditation (CPA), part of the United Kingdom Accreditation Service (UKAS) and currently holds a certificate of accreditation. Health and Safety is regulated by the Health and Safety Executive (HSE). There is a robust Quality Management Programme in place with a Quality Committee which meets regularly.

There are also regular meetings of senior staff and Consultant Microbiologists to review methods, performance in external and internal quality control schemes, discuss new diagnostic techniques, and ways of improving the service.

Laboratory Opening Times (Including Out of Hours)

Monday to FridaySaturdays and SundaysBank holidays
Core hours 09.00-17.30 Ensure samples reach laboratory by 17.00. For urgent tests (including CSFs and surgical material) the laboratory must be telephoned in advance on ext 5767 (specimen reception staff will then arrange transport) and 2347 (the Microbiology staff who also need to be informed).On call service 17.30 -09.00 available for out of hours emergency work .It is the responsibility of the requesting doctor to contact the duty Biomedical scientist via the switchboard to have any urgent specimens processed; failing this, the specimens may be processed the next day and the results could be unreliable.Restricted service  between 08:30 -and 12.30 and on call from 12.30 until the following day Restricted service  between 08:30 -and 12.30 and on call from 12.30 until the following day 
Exceptions Semen  samples – click HERE for information on when the laboratory will accept semen specimens for infertility and post vasectomy testing.Additionally There is a Biomedical scientist available from 20.00 to 22.00 hours to process any un-notified urgent samples, blood cultures and urine.Additionally There is a Biomedical scientist available from 20.00 to 22.00 hours to process any un-notified urgent samples, blood cultures and urine.Additionally There is a Biomedical scientist available from 20.00 to 22.00 hours to process any un-notified urgent samples, blood cultures and urine.
NB: the on call service must not be used as a results service as all validated Microbiology results are available on the Pathology Computer System
Please restrict all on call requests to genuinely urgent samples or discuss with the on-call Consultant Microbiologist

 

Test Requests, Labelling and Reports

Request forms
Request forms are colour coded as follows:-

Blue-lined form – (NDDH form)General microbiology, urine analysis and virology/serology
Blue & red lined – (NDDH form)Antenatal screening for infectious diseases in pregnancy

 

Labelling 

One adequately completed request form should accompany each sample on the whole; exceptions include MRSA and SCBU screens and theatre orthopaedic specimens.

Clinical governance requires unequivocal identification. As a minimum requirement, the laboratory requires the patient’s name, National Health Service Number (preferred) or hospital case note number, date of birth, ward, consultant or GP surgery, the specimen type, clinical history, and tests required. Inappropriately labelled specimens may not be analysed.

Additional information on antibiotic therapy, foreign travel should be provided if possible. Specimens should be placed in appropriate containers and it is especially important that those containing pus, fluids, blood or semen are closed tightly as specimens which leak in transit will be discarded because of the hazard to staff or the adverse effect on results.

For further information on labelling, refer to the Pathology Specimen Acceptance Policy on BOB.

Advice from Microbiologists and Infection Control Team

Clinicians having specific concerns about patients and infection are encouraged to contact the Consultant Medical Microbiologist on bleep 193 for advice on appropriate investigations and management; early consultation about patients may result in more rapid analysis of specimens, hasten the availability of results and their interpretation.

Those in doubt about appropriate infection control procedures are encouraged to contact a member of the prevention  and infection control team especially as some patients who are colonized or infected with certain infectious agents require special precautions when taking specimens or for their transport. The Infection Control manual can be viewed on www.northdevonhealth.nhs.uk/infection-control.

Specimen Types

Most specimen container types are available in all wards or clinical areas, although some are only available by contacting Pathology Stores on Ext 2342.

Please could you ensure that all your stocks are maintained at a level to meet your requirements for out of hours.

The Pathology Stores (01271 322342 or ext 2342) will provide specimen containers from 08:00 to 1600 Mon-Fri.

For further information on specimen collection or appropriate specimen containers, please see Microbiology Specimen Collection guide in this handbook

 

Time Limits for Requesting Additional Examinations

Additional examinations can be added to the following specimen types within the following times:-

Specimen typeTime frame for adding extra tests or sensitivities
UrineUp to 48 hours after receipt in laboratory, specimens are retained for 1 week
Swabs and Pus samples for routine culture and sensitivityUp to 48 hours after receipt in laboratory, specimens are retained for 1 week
SputaUp to 24 hours after receipt in laboratory, specimens are retained for 1 week
Faeces for routine culture. C Diff toxin,  Parasitology and Helicobacter pylori Up to 1 week after receipt in laboratory
Sterile fluids including CSFUp to 1 week after receipt in laboratory
Serology tests (in house)Up to 2 years after receipt of antenatal booking bloods and a maximum of 2 weeks for all other serology specimens.
Serology tested by external reference laboratoryDiscuss with Duty Microbiologist who will contact the reference laboratory. Reference lab keeps all antenatal booking bloods for a minimum of 2 years.
Chlamydia and N Gonorrhoea by NAATSSamples kept for 1 week, add on tests not required
Sensitivities on positive blood culture isolates1 year
Semen samplesRetained for 1 week , add on tests not possible on this sample type
MRSA swabs and broths and Mycology samplesSpecimens are stored for 1 week but add on tests not required
Rejected samplesAll rejected samples are stored for 1 week

The Microbiology Specimen Collection page gives advice on the collection of specific common specimens but is not an exhaustive list. Please contact the laboratory if in doubt about any specimen collection or transport issues.

NOTE: If printed, information on this page is only valid on day of printing.

Last updated: September 24, 2018