Previously Asked Questions:
Previously asked questions are arranged by category, with the most recently answered questions appearing first. Click on the ? to view the answer to a question.
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Antimicrobial Testing - general
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On a few E.coli isolates, we received an interpreation of sensitive or intermediate for gentamycin and resistant for tobramycin. Should we change the interpretation for gentamycin to resistant to match the tobramycin result?
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Is there a relation between MLS(B/c)and HLR-aminoglucosides resistency in Enterococcus spp?I have observed statistical relation between these two types of resistence.Please write me on iiosifov@yahoo.com
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Bacteriology - gram postive cocci
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What is the significance of isolating MRCons from Umbical Artery Catheter & Umblical Venous Catheter of neonates.Baby is Clinically stable do we have to report it.We isolate Lot of MRCoNS from ET TIP,Trachestomy tips any guidelines on reporting.Thank you.
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Compliance
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WE DID A SKIN STREP TEST WITH A DX OF 691.0, WHAT WOULD BE THE CPT CODE? THANKS, KERRY
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Culture, blood
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Do you know if there is any reason why LMX/Lidocaine creme could not be used on a pediatric patient if blood cultures are being drawn. Would cleaning the site immediately prior to drawing the blood culture negate the effect of the lidocaine?
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Culture, other
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Our CSF culture protocol includes aerobic culture, gram stain, and Cryptococcal antigen. Is there documentation for not performing repeat Cryptococcal antigens on multiple specimens? What is an acceptable time interval between repeat testing? Thanks!
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Culture, respiratory
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This question is in regard to Cystic fibrosis cultures. We are a small lab and have a few patients with cystic fibosis that have respiratory cultures done on a routine basis. We currently process them the same as the other respiartory cultures. At this point we have not isolated any Pseudo in the cultures. From what I read these type of cultures should have some specialized media and possibly held longer than a routine culture? Would it be appropriate for us to screen at our facility on our routine media or would we be missing an important pathogen. Any protocols or references would be appreciated.
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Culture, stool
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Is it clinically relevant to test for C diff toxin in patients who are currently receiving either Vancomycin or Metronidazole?
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WHEN THERE IS NO GROWTH ON MEDIA PLATES,IS IT OK TO REPORT NO GROWTH ON STOOL CULTURE INSTEAD OF REPORTING NO SALMONELLA, SHIGELLA, E.COLI O157:H7 AND CAMPYLOBACTER ISOLATED?
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Culture, urine
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cystoscopic urine nephrostomy urines,how should we treat these cultures both in regard to plating and reporting.
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Miscellaneous
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Does HIV induce systemic lupus erytematosis? or, Does systemic lupus erytematosis cause false positive HIV results?
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Mycobacteriology
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mycobacterium other than tuberculosis was reported by pcr in endometrial cureettage, is it significantor contaminant/ which are the significant mott in endometrium ?
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mycobacteria
is it ok to heat fix afb stains at 80 degrees celcius for 15 mins?
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does qc need to be perform on middlebrook 7h11(nonexempt) by the user lab? also which control organisms should be run?
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Mycology
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We are currently using a modification of the hair test for dermatophytes. The hair is unsterile and plate media is SAB with chloramphenicol and getamicin (Mycology agar PML)to suppress the bacteria on the hair . I don't find this method very scientific even though it has been vlidated with appropriate organisms In your opinion is this method acceptable?
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We are interested in the ChromAgar Candida to give our doctors a presumptive Id on yeast for treatment. Since this a singl, presumptive ID, do we need to have a survey for this? Any help would be appreciated.
thanks
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Is there an antimicrobial agent that I can add to my fungal culture plates (PDA or SDA) that will prevent bacterial growth without inhibiting fungal growth?
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We received an identification of Saccharopolyspora species from an aortic valve. Are there any cases reporting this organism as a pathogen at this site?
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Parasitology
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We want to switch from PVA to Protofix for ova and parasite collection. What validation is required? Do we need to collect samples from patients in duplicate? If so, how many positives/negatives? Is there another way to validate without involving patients?
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Quality Control
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Is user QC required for the tubes used to set up AFB in the Bactec MGIT 960 or is the manufacturer QC sufficient?
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Virology - general
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Is it recommendet to use swabs with AMIES transport medium for collecting influenza samples? Thank you.
iris_hatibi@hotmail.com
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Other
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Our microbiology department make our agar plates in house. To preserve the quality of the plates they package them in plastic bags and seal them to prevent drying out. They also put packets of desiccants in the bag. This seem to be a bit of a paradox. Could someone enlighten me because it seems thst the desiccants should not be in there.
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Hello: Is there a procedure or protocol to determine if the spread of VRE in a particular area or unit is the same organism or just randomly isolated separate organisms? Where or how can these isolates by typed to determine a possible source? Thank you.
Carol Wegman MT(ASCP)SM
Microbiology Technical Specialist
St.Joseph Medical Canter
Reading PA 19605
phone 610-208-8845
fax 610-208-8846
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IN THE NEW CLSI STANDARDS THERE ARE INTERPRETIVE CRITERIA FOR DAPTOMYCIN ON STAPH BUT NOTHING IS SPECIFIED FOR ENTEROCOCCUS-- CAN DAPTOMYCIN BE TESTED ON BOTH ENTEROCOCCUS FAECIUM ( VANCOMYCIN RESISTANT) AND OR ENTEROCOCCUS FAECALIS ( VANCOMYCIN SENSITIVE)
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Gram Neg. Rod's Multiple Drug resistance, which patterns should be reported for isolation in a hospital? And for Strep. pneumonieae wich is considered MDR pattern to report? Thank you
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QC Susceptibility Testing on a New Antibiotic. We routinely use MicroScan panels for our susceptibility testing. I am being asked by one of our physicians to include a new "study" antibiotic on selected respiratory isolates. This new antibiotic is not on any Microscan panel and will appear on the patient's medical record. The study protocol suggests using E-test for this new antibiotic. What would be the appropriate QC protocol for such a situation? I was thinking of choosing the one (of five) QC organism that is closeset in identification to the patient isolate and running one of the five QC organisms each day of use. I suppose if I had two patient isolates, a Staph and a Pneumo to test on a given day, I would have to run both the Staph and Pneumo QC organisms on that day because of the different MH media requirements. Does this plan sound right?
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Are there any guidelines for what antibiotics should be reported on a Shigella from an extraintestinal source?
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Are there any published zone sizes for Shigella sonnei isolates to azithromycin? Azithromycin has been indicted for the treatment of Shigella sonnei, but I cannot find testing requirements.
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why are pure cultures used for antimicrobial susceptibility testing?
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Can interpertive guidelines for staphylococcus aureus be used for staphylocccus lugdenensis if an automated system is used to determine susceotiblities, i.e., key-id staphylococcus aureus for staphylococcus aureus?
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SHOULD NALIDIXIC ACID BE RUN ON URINE CULTURE KIRBY BAUER PANELS FOR E. COLI?
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I need to find the breakpoint MIC's for Colistin/Pseudo aeruginosa.
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