40 Questions
What should be reported in microbiology testing?
All isolates from normally sterile sites and robust growth
Handling of biological specimens during the COVID-19 pandemic does not require stringent safety protocols.
False
What kind of specimens are considered high-risk during the COVID-19 pandemic?
Specimens from the respiratory tract, such as bronchoalveolar lavage, sputum, and nasopharyngeal swabs.
Universal PPE includes coats, gloves, eye protection, and _______________________ to protect against splashes.
face protection (face shields or bench shields)
Match the following high-risk specimens with their corresponding category:
Bronchoalveolar lavage = Respiratory tract Blood = Low-risk specimen Nasopharyngeal swabs = Respiratory tract CSF = Low-risk specimen
Any procedure that can generate aerosols is considered low-risk during the COVID-19 pandemic.
False
What is the purpose of biosafety cabinets/chemical fume hoods in handling high-risk specimens?
To contain aerosols and droplets.
What should be done with high-risk specimens during the COVID-19 pandemic?
Handle them in biosafety cabinets/chemical fume hoods
What is one of the roles of a clinical microbiologist?
Liaising with the treating physician
The pre-analysis phase involves identifying microorganisms and susceptibility testing.
False
What is the purpose of collecting specimens from multiple sites or at multiple times?
To increase the chances of identifying the pathogen
Proper collection of specimen is crucial to the confirmation of the ______________________.
pathogen
Match the following stages of the diagnostic cycle with their descriptions:
Pre-analysis phase = Collecting, transporting, labeling, and setting up specimens Analysis phase = Identifying microorganisms and performing susceptibility testing Post-analysis phase = Reporting results and consulting with clinicians
Why is it important to use a suitable collection device and container?
To preserve the integrity of the specimen
Clinical microbiologists are responsible for quality assurance and quality control.
True
What factor can affect the quantity of microorganisms in a specimen?
Severity of infection
Which of the following specimens should be handled in a biosafety cabinet or chemical fume hood during the COVID-19 pandemic?
Answers c and d are both correct
SARS-CoV-2 RNA can be detected in stool and is considered infectious.
False
What is the purpose of using viral inactivation buffers in point of care testing for COVID-19?
To inactivate the virus and reduce the risk of transmission
Ideally, point of care testing for COVID-19 should be done in a _______________________ to reduce the risk of transmission.
biosafety cabinet
Match the following specimens with their corresponding category during the COVID-19 pandemic:
Blood, CSF, and pleural fluid = Low-risk specimens Pleural fluids, oropharyngeal swabs, and saliva = High-risk respiratory specimens Stool = Non-infectious specimens
What is the primary purpose of using biosafety cabinets/chemical fume hoods in handling high-risk specimens during the COVID-19 pandemic?
To reduce the risk of transmission
Proper handling and safety protocols are not crucial when dealing with biological specimens during the COVID-19 pandemic.
False
What is the benefit of following proper handling and safety protocols when dealing with biological specimens during the COVID-19 pandemic?
To significantly reduce the risk of SARS-CoV-2 transmission
What is one of the responsibilities of a clinical microbiologist?
Designing and developing new tools
The analysis phase of the diagnostic cycle involves reporting of test results and consultation with clinicians.
False
What are the factors that can affect the quantity of microorganisms in a specimen?
Infection site, time of incubation period, and severity of infection
Proper collection of a specimen is crucial to the confirmation of the ______________________.
pathogen
Match the following stages of the diagnostic cycle with their descriptions:
Pre-analysis phase = Collection, transporting, labelling, and setting up before running tests Analysis phase = Identification of the microorganism and susceptibility testing Post-analysis phase = Reporting of test results and consultation with clinicians
Clinical microbiologists are responsible for devising laboratory testing for optimum management.
True
What is the importance of sample transport in microbiology?
All of the above
A sample received in formalin fixative is acceptable for microbiology testing.
False
What is the purpose of including interpretative statements in microbiology reports?
To provide additional information to healthcare professionals to aid in patient diagnosis and treatment.
Stuart's, Amies, and Cary-Blair transport media are used to preserve microorganisms during transportation, depending on what you want to do with the sample ______________________.
downstream
What is a criterion for specimen rejection in microbiology?
All of the above
Growth of mycobacteria is a reason to issue results quickly in microbiology testing.
False
What is the purpose of using a biosafety cabinet in microbiology?
To prevent inhalation of respiratory pathogens and to handle certain types of stool samples.
Match the following conditions with the correct action in microbiology testing:
Overgrown or dried-out culture plates = Reject the sample No label on the sample = Reject the sample Insufficient sample for multiple requests = Discard the sample and notify the healthcare professional
Results in microbiology testing should be reported in a ______________________ form to provide a clear indication of the presence of microorganisms.
semiquantitative
Reporting of normal flora from contaminated sites is not necessary in microbiology testing.
False
Study Notes
Point of Care Testing
- SARS-CoV-2 RNA can be detected in stool, but it is not considered infectious
- Point of care testing involves collecting and manipulating nasal or nasopharyngeal swabs
- Ideal testing environment: biosafety cabinet
- Practical alternatives: using viral inactivation buffers, direct dosing devices that avoid sample manipulation
Case Study: Phlebotomy Top Gun Presentation
- Which specimens should be handled in a biosafety cabinet or chemical fume hood during the COVID-19 pandemic?
- Correct answer: pleural fluids, oropharyngeal swabs, and saliva, and buccal swabs, nasopharyngeal swabs, and tracheal aspirates
Handling Biological Specimens During the COVID-19 Pandemic
- Proper handling and safety protocols are crucial to protect healthcare workers from SARS-CoV-2 transmission
- Guidelines: use appropriate PPE, containment strategies, and handling techniques to minimize exposure risk
Reporting Microbiology Results
- Report normal flora from contaminated sites (e.g., "normal skin flora")
- Report results in a semiquantitative form (robust growth, moderate growth, minimal growth)
- Report all isolates from normally sterile sites
- Provide a source of reference for further information
- Reports must be distinctly presented
Case Study: Handling of Specimens During the COVID-19 Pandemic
- High-risk specimens: those from the respiratory tract (e.g., bronchoalveolar lavage, sputum, nasopharyngeal swabs, oropharyngeal swabs, nasal swabs, nasal tissue, oral tissue, lung tissue, tracheal aspirates, pleural fluids, saliva, spit, salivary glands, buccal swabs)
- High-risk activities: procedures that generate aerosols (e.g., uncapping or aliquoting specimens)
- Safety measures: universal PPE, biosafety cabinets/chemical fume hoods
- Safe handling of specific specimens: low-risk specimens (e.g., blood, CSF, urine, fixed respiratory tissue) do not require special handling
Roles of Clinical Microbiologists
- Consult with healthcare professionals
- Devise laboratory testing for optimum management
- Diagnose infectious diseases
- Liaise with treating physicians
- Design and develop new tools
- Quality assurance (QA) and quality control (QC)
Responsibilities of Clinical Microbiologists
- Provide guidelines for proper collection, transport, and processing of specimens
- Identify microorganisms
- Conduct susceptibility testing
- Report test results
- Consult with clinicians
Diagnostic Cycle
- Pre-analysis phase: collecting, transporting, labeling, and setting up before running tests
- Analysis phase: identifying microorganisms and conducting susceptibility testing
- Post-analysis phase: reporting, consultation, and quality control
Specimen Collection
- Proper collection of specimens is crucial for confirming pathogens
- Factors affecting specimen collection: infection site, time (incubation period), quantity (severity of infection), collection device, and container
Roles of Clinical Microbiologists
- Consult with healthcare professionals to diagnose infectious diseases
- Devise laboratory testing for optimal management
- Design and develop new tools for diagnosis and treatment
- Ensure quality assurance and quality control
Responsibilities of Clinical Microbiologists
- Provide guidelines for proper specimen collection and transport
- Identify microorganisms and perform susceptibility testing
- Report test results to clinicians and provide consultation
- Ensure proper collection and handling of specimens
Diagnostic Cycle
- Pre-analysis phase: collecting, transporting, and labeling specimens
- Analysis phase: identifying microorganisms and performing susceptibility testing
- Post-analysis phase: reporting results, consulting with clinicians, and providing interpretative statements
Specimen Collection
- Proper collection of specimens is crucial for confirming pathogens
- Consider factors such as infection site, time, quantity, and collection device
- Use suitable transport media to preserve specimens
Sample Information
- Minimum information required on sample collection containers: name, date, date of birth, and sterile containers
Sample Transport
- Maintain samples in their original state with minimal deterioration
- Minimize hazards to specimen handlers
- Use suitable transport media (e.g., Stuart's, Amies, Cary-Blair) depending on downstream requirements
- Transport samples within 2 hours, except for stool samples
Specimen Acceptability and Rejection Criteria
- Reject specimens with no label, prolonged transport time, or improper containers
- Reject unsuitable, duplicated, or contaminated specimens
- Reject specimens received in formalin fixative or with insufficient sample for multiple requests
Post-analytical Phase
- Report results as soon as useful information becomes available
- Include interpretative statements, notification of improper specimen collection or handling, and clear explanations
- Report relevant susceptibility results, negative results, and normal flora
- Provide normal values with numerical data and semiquantitative results
- Report all isolates from normally sterile sites and provide a source of reference for further information
This quiz covers COVID-19 testing methods, including point of care testing and phlebotomy techniques. It also touches on the importance of biosafety precautions.
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