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The Role of Microbiology Laboratory Improving the laboratory diagnosis of Infectious Disease

Gunturu Revathi Aga Khan University Hospital Nairobi KPA Pre C ongress Symposium Infectious Diseases 9 th April 2019 White sands, Mombasa. The Role of Microbiology Laboratory Improving the laboratory diagnosis of Infectious Disease.

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The Role of Microbiology Laboratory Improving the laboratory diagnosis of Infectious Disease

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  1. Gunturu Revathi Aga Khan University Hospital Nairobi KPA Pre Congress Symposium Infectious Diseases 9th April 2019 White sands, Mombasa The Role of Microbiology LaboratoryImproving the laboratory diagnosis of Infectious Disease

  2. Antimicrobial usage in humans, animals and agriculture, and resulting dispersion of antimicrobial residues into aquatic and terrestrial environments (Berkner et al., 2014)

  3. Complex problem

  4. Some preventable infections are more preventable than others

  5. The quality of health services is founded on a good education and training and continued maintenance of such competencies

  6. Role of Microbiology Lab Diagnostic lab work Advice to clinicians - treatment of infected patients Infection control Surveillance of Infectious diseases Close personal contact with clinicians in daily treatment of patients ensures rational AM use

  7. ASP: Antimicrobial Stewardship Program; DSP: Diagnostic Stewardship Program; ISP: Infection Prevention Stewardship Program.

  8. Scope of infection control Offices Shops Factories Hotels Eateries Farms Agricultural Poultry Diary farms Community Hospital Special settings Schools Colleges Day care centers Hostels Play grounds Churches Temples

  9. Factory of Superbugs

  10. Human microbiome research has shown that the use of antibiotics can disrupt the normal array of microbes that live in and on our bodies. Suspected etiology for - Childhood Obesity Autoimmune conditions Chronic inflammatory conditions

  11. HOSPITAL MICROBIOME A new hypothesis says that hospital-acquired infections are being driven not only by the existence of harmful microbes but also by the absence of helpful species in the environment due to disinfectant use

  12. I AM CONCERNED ABOUT THE HIGH LAVELS OF BLOOD WE FOUND IN YOUR BLOOD TEST

  13. Optimal laboratory test utilization is important for - Providing high quality clinical care and Efficiently using limited health care resources . • Microbiologists - the earliest advocates for the appropriate use of laboratory studies • There is an urgent need for laboratory leaders to partner with clinical colleagues to implement effective laboratory testing stewardship protocols.

  14. Recent widespread adoption of electronic medical records (EMRs) with an ability to support computerized provider order entry (CPOE) and CDSTs has provided effective new avenues for implementation of sustainable automated test utilization programs in developed countries.

  15. COST SAVING MEASURESUnnecessary and wasteful practices • Routine • Microbiological Swabbing of environment • Disinfectants for environmental cleaning e.g. floors & walls • Fumigation of isolation room with formaldehyde • Unnecessary • Use of overshoes and dust attracting matt • Personal Protective Equipment in the Intensive Care, & Neonatal Unit • Excessive/unnecessary use of • IM/IV injections • Insertion of indwelling devices e.g. IV lines, urinary catheters, nasogastric tube • Antibiotics both for prophylaxis and treatment Damani NN. Journal of Hospital infection 2007; 65(S1): 151-154.

  16. The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician/advanced practice provider and the microbiologists who provide enormous value to the healthcare team.

  17. Unlike other areas of the diagnostic laboratory, clinical microbiology is a science of interpretive judgment that is becoming more and more complex,

  18. HEAVY MIXED GROWTH OF THREE TYPES OF COLONIES

  19. At an elementary level, the physician needs answers to 3 very basic questions from the laboratory: Is my patient’s illness caused by a microbe? If so, what is it? What is the susceptibility profile of the organism so therapy can be targeted?

  20. To meet those needs, the laboratory requires a specimen that has been appropriately selected, collected, and transported to the laboratory for analysis

  21. Caught in the middle, between the physician and laboratory requirements, are the medical personnel who actually select and collect the specimen and who may not know or understand what the physician or the laboratory needs to do their work

  22. Enhancing the quality of the specimen is everyone’s job, so communication between the physicians, nurses, and laboratory staff should be encouraged and open with no punitive motive or consequences

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