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Pathology Services User Manual - Central Manchester University

1. Specimen No special needs transport Minimum 7mm diameter blood spot Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 110 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner volume of sample Special Ensure blood spot has dried and submit with dessicant pouch enclosed precautions Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Spots too small not all spots filled with blood significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 111 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis B virus HBV core IgM Anti HBc IgM Virology General Information Backto Index Collection container 6mLclotted blood tube including preservatives Specimen Type
2. Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 97 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner placed in Amies transport medium with charcoal Urethral swabs Contamination with micro organisms from the vulva or the foreskin should be avoided Thin swabs are available for collection of specimens The patient should not have passed urine for at least one hour For males if a discharge is not apparent attempts should be made to milk exudate from the penis The swab is gently passed through the urethral meatus and rotated Place the swab in Amies transport medium with charcoal Intrauterine contraceptive devices IUCDs The entire device should be sent Rectal swabs Rectal swabs are taken via a proctoscope Throat swabs Throat swabs should be taken from the tonsillar area and or posterior pharynx avoiding the tongue and uvula Fluids and pus These are taken from the fallopian tubes tubo ovarian and Bartholin s abscesses etc during surgery Specimen Specimens should be transported and processed as soon as possible transport Minimum Fluids and pus preferably a minimum volume of ImL volume of sample Special Endocervical swabs for gonorrhoea investigation should not be precautions refrigerated
3. Clinical Information Clinical decision Not applicable points Factors known to Spots too small not all spots filled with blood significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 115 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis B virus HBV surface antibody Anti HBs Virology General Information Back to Index Collection container 6mLclotted blood tube including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen transport Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Minimum volume of 2 mL sample Special precautions All samples are suitable for overnight refrigeration only they must not be stored over a weekend Laboratory Information Measurement units mIU mL Turn round time for 3 days Turn round time to 4 days Provisional result Final result calendar calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue on
4. Measurement units Cell count x10 L Biological reference Leucocytes WBC units Neonates 0 30 cells x 109 L 1 4yr old 0 20 cells x 10 L 5yr puberty 0 10 cells x 10 L AdultsO 5 cells x 10 L When possible the WBC count will be differentiated into lymphocytes and polymorphs Erythrocytes RBC Newborn 0 675 cells x 10 L Adults O 10 cells x10 L Protein Performed by Biochemistry Neonates lt 6d 0 7 g L Others 0 2 0 4g L lt 1 of serum protein concentration Glucose Performed by Biochemistry 260 of simultaneously determined plasma concentration CSF serum ratio 20 6 Turnaround time 30 mins to 1 hour for microscopy 24 hrs 72 hrs for culture Clinical Information Clinical decision points Not applicable Factors known to Cells disintegrate and a delay may produce a cell count that does significantly affect the not reflect the clinical situation of the patient results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 70 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Culture Bacteriology General Information Back to Index Collection Collect specimens in appropriate CE marked leak proof containers and container transport specimens in sealed pla
5. Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results EDTA even in trace amounts inhibits the growth of some Mycobacterium species Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 164 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Nose Swab Bacteriology Nasal colonisation with Staphylococcus aureus increases the risk of staphylococcal infections at other sites of the body such as postoperative wounds and dialysis access sites Single organism nasal screens for Staphylococcus aureus may be requested as part of a PVL outbreak as part of a IPC investigation General Information Back to Index Collection Collect specimens in appropriate CE marked leak proof containers and container transport specimens in sealed plastic bags including Collect swabs into Amies transport medium with charcoal and preservatives transport in sealed plastic bags Specimen Type Nose Swab Collection Collect specimens before antimicrobial therapy where possible Plain sterile cotton wool swab Sample the anterior nares by gently rotating the swab over the mucosal surface Unless otherwise stated swabs for bacterial and fungal culture should t
6. Authorised by Dr AJL Turner Streptococcus pneumoniae IgG antibody determination by flow analysis bead assay for 12 pneumococcal serotypes Vaccine Evaluation Unit General Information Back to Index Collection container including preservatives Clotted blood sample tube no preservative Specimen Type Clotted blood sample tube no preservative Specimen Transport to the laboratory without delay transport Minimum volume Clotted Blood serum paired sera Minimum volume 0 1mL of sample Special All samples are suitable for overnight refrigeration only they must not precautions be stored over a weekend Laboratory Information Measurement ug mL units Biological Not applicable reference units Turnaround time 28 Working Days Clinical Information Clinical decision points gt 0 35 ug mL putative correlate of protection Factors known to significantly affect the results None known Limitations Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 183 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Syphilis Confirmation including Immunoblot Virology General Information Back to Index Collection 6mL blood tub
7. Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round time 30 60 mins for Turn round time to 48 72hrs for Provisional microscopy Final result calendar result calendar 24 hrs for culture days days Clinical Information Clinical decision Not applicable points Factors known to HVS swabs for gonorrhoea investigation should not be refrigerated as significantly this significantly reduces the recovery rate affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 98 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Haemophilus influenze PCR Molecular Microbiology General Information Back to Index Collection container CE marked leak proof container including preservatives Specimen Type EDTA whole blood serum CSF Collection Compliance with current postal and transportation regulations is essential Clinical samples should be collected into a sterile leak proof container in a sealed plastic bag Appropriate hazard labelling according to local policy should be applied Specimen transport Ambient or refrigerated Minimum volume of Minimum volume 500ul sample Special precaution
8. Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 215 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner PHE Bristol Bristol PHE AHVLA Myrtle Road Ovine Chlamydia antibodies Weybridge Laboratory Kingsdown PCR Services CPA 0042 Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue Pertussis antibodies PHE Colindale London NW9 5HT CPA 2904 Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue Polio antibodies PHE Colindale London NW9 5HT CPA 2904 PHE Bristol Myrtle Road Kingsdown Q Fever antibodies PCR Bristol PHE RIPL CPA 0042 AHVLA Weybridge Central Veterinary Laboratory UKAS 0941 Rabies antibodies PCR Laboratory Services Weybridge IS017025 PHE Microbiology Services Porton Down Salisbury Wiltshire SP4 OJG Rickettsia serology PCR RIPL Porton Down CPA 1612 Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue Rubella PCR PHE Colindale London NW9 5HT CPA 2904 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 216 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Salmonella serotyp
9. Specimen Type EDTA blood CSF BAL Specimen transport Ambient or refrigerated Compliance with current postal and transportation regulations is essential Clinical samples should be collected into a sterile leak proof container in a sealed plastic bag Appropriate hazard labelling according to local policy should be applied Specimens should be transported and processed as soon as possible If processing is delayed refrigeration is preferable to storage at room temperature Minimum volume of sample Minimum volume 500ul Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Threshold Cycle CT Biological reference units Not applicable Turn round time for Provisional result calendar days Turn round time to Final result calendar days 4 days 5 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result i
10. Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 202 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Varicella zoster virus PCR Molecular Microbiology Chickenpox Shingles Encephalitis meningitis rash lesion General Information Back to Index Specimen CE marked leak proof container container Specimen Type EDTA blood CSF swab Specimen Ambient or refrigerated transport Compliance with current postal and transportation regulations is essential Clinical samples should be collected into a sterile leak proof container in a sealed plastic bag Appropriate hazard labelling according to local policy should be applied Specimens should be transported and processed as soon as possible Minimum volume Minimum volume 500ul of sample Special If processing is delayed refrigeration is preferable to storage at room precautions temperature Laboratory Information Measurement Threshold Cycle CT units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicabl
11. Specimen Ambient or refrigerated transport Minimum 3 0 mL volume of sample Special Haemolysed specimens can be inhibitory where this is unavoidable precautions such as with post mortem samples the laboratory should be contacted 0161 276 8843 Plasma should be stored at 4 C and dispatched as soon as possible An additional 3mL fresh whole blood in EDTA should be sent if the initial HCV PCR is positive Laboratory Information Measurement Results presented as genotype units Turnaround time The results of all tests will be available within 5 working days after receipt of the specimen in the laboratory and may be available sooner by prior arrangement Clinical Information Clinical decision Not applicable points Factors known to False negative results may occur for a variety of reasons for example significantly inappropriate timing of sample collection inappropriate sample affect the results presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 103 of 22
12. 6mL clotted blood tube Venous Blood 6mL blood tube Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 2mL Collection Specimen transport Type and volume of sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Turn round time for Provisional result calendar days 3 days Turn round time to Final result calendar days 4 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results Haemolysis Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Copy no FREE TO PRINT Edition no 6 Page 101 of 221 Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner HBV Genotyping and Resistance Markers Molecular Microbiology General Information Back to Index Collection container including preservatives CE marked leak proof container Specimen Type EDTA blood Collection Specimen Ambient or refrigerated transport Minimum volume 3 mL of sample Special If processing is delayed refrigeration is preferable to storage
13. Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street Hospital for Tropical London Amoebiasis Diseases London WCIE 6JB CPA 2354 Mycology Reference Centre Manchester Antifungal drug assays MRCM Wythenshawe Wythenshawe Hospital CPA 0635 PHE Microbiology Services Porton Down Salisbury Arbovirus RIPL Porton Down Wiltshire SP4 OJG CPA 1612 Staphylococcus Reference Unit Anti staphylolysin PHE Colindale SRU CPA 2904 Carlisle North Cumbria Healthcare NHS Avian antibodies Carlisle Foundation Trust CPA 0484 Bacteriology Reference Department RVPBRU 61 Colindale Avenue Bartonella serology PHE Colindale London NW9 5HT CPA 2904 Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street Hospital for Tropical London Babesia serology Diseases WC1E 6JB CPA 2354 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Laboratory Bacterial identification typing amp sensitivity testing Borrelia recurrentis serology C botulinum antibody Brucella antibodies Burkholderia pseudomallei serology Chikungunya Coccidiomycosis Printed 24 7 2015 3 54 AM Copy no FREE TO PRINT Edition no 6 Page 207 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner PHE Microbio
14. epididymitis epididymis and prostatitis prostate gland Infection may spread to surrounding tissues eg perinephric abscess or to the bloodstream The microscopical presence of White Blood Cells WBC is quantified and correlated to bacterial growth to diagnose a urinary tract infection The presence of Red Blood Cells RBC and epithelial cells is also reported General Information Back to Index Collection container Collect specimens in appropriate CE marked leak proof containers including and transport specimens in sealed plastic bags preservatives Specimen Type Urine Clean catch urine CCU Mid stream urine MSU Supra pubic aspirate SPA Bladder urine amp Catheter urine Collection MSU and clean catch urines are the most commonly collected specimens and are recommended for routine use Suprapubic aspirate SPA is seen as the gold standard but is usually reserved for clarification of equivocal results from voided urine in infants and small children Before SPA is attempted it is preferable to use ultrasound guidance to determine the presence of urine in the bladder Specimen transport Delays and storage at room temperature allow organisms to multiply which generates results that do not reflect the true clinical situation Where delays in processing are unavoidable refrigeration at 4 C is essential Minimum volume of A minimum volume of 0 5mL sample Printed 24 7 2015 3 54 AM Vali
15. location for report delivery not given It may not be possible to issue a report or to interpret results Appropriate comments will be made on the report where this can be issued Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 31 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Good practice demands the provision of more than the minimum of information The use of NHS number is becoming more prevalent and will be considered as an essential identifying criterion in future policy The DLM is currently reviewing ways in which this can be implemented Anonymous Uniquely Identified Specimens and Requests In certain circumstances patient identification details are intentionally hidden or substituted with particular ID numbers eg Sexual Health Clinical trials donor specimens in such instances a properly coded identifier must be used in place of the patient lastname amp firstname Clinical amp Epidemiological Information To ensure samples can be safely and appropriately tested in the laboratory information including details of foreign travel symptoms and known or suspected contact with other patients known to have communicable disease is important For example samples likely to contain high risk pathogens as described by the Advisory Committee for Dangerou
16. Measurement units Threshold Cycle CT Turn round time for 4 days Turn round time to 7 days Provisional result Final result calendar calendar days days Clinical Information Clinical decision Not applicable points Factors known to All samples are suitable for overnight refrigeration only they must significantly affect not be stored over a weekend the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 198 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Urines Bacteriology Urinary tract infection UTI results from the presence and multiplication of microorganisms in one or more structures of the urinary tract with associated tissue invasion This can give rise to a wide variety of clinical syndromes These include acute and chronic pyelonephritis kidney and renal pelvis cystitis bladder urethritis urethra
17. Rubella IgG Virology Rubella IgM Virology Rubella Avidity Virology referral S Sapovirus PCR enteric Molecular Microbiology Sepsis Sialadenitis Skin Superficial Non surgical Wounds Bacteriology Sputum Bacteriology Staphylococcal serology AST Virology referral Sterile Fluids Bacteriology Streptococcal serology including anti DNaseB Virology Streptococcus pneumoniae serology Vaccine Evaluation Unit Syphilis antibody Virology Syphilis confirmationincludingimmunoblot Syphilis IgM Virology T TB examination microsco Bacteriolo Tetanus antibodies Vaccine Evaluation Unit Throat Swab Bacteriology Tips Bacteriology Tissue Bacteriology Toxoplasma PCR Molecular Microbiology Toxoplasma serology IgG Virolo Toxoplasma serology IgM Virolo Toxoplasma serology Avidity Virology Treponema pallidum syphilis PCR Molecular Microbiology Treponema pallidum confirmation Virology Treponema pallidum screen Virology Trichomonas vaginalis Virology U Ulcers Printed 24 7 2015 3 54 AM Valid on day of issue only Urinary Tract Infection Urine cell count Bacteriology Urine Culture Bacteriology V Varicella Zoster IgG Virology Varicella Zoster IgM Virology Varicella Zoster virus PCR Molecular Microbiology Vincent s angina Viral Haemorragic Fever VHF W Whooping Cough Wounds Skin
18. Special precautions Please send to the laboratory without delay Laboratory Information Measurement units Not applicable Biological reference Not applicable units Turn round time for 48 hrs Turn round time to 48 72 hrs Provisional result Final result calendar calendar days days Clinical Information Clinical decision Not applicable points Factors known to All samples are suitable for overnight refrigeration only they must significantly affect not be stored over a weekend Sputum may be refrigerated for up to the results 2 3 h without an appreciable loss of pathogens Any delay beyond this time may allow overgrowth of Gram negative bacilli and Haemophilus species and S pneumoniae may be rendered non viable Printed 24 7 2015 3 54 AM Valid on day of issue only Copy no FREE TO PRINT Edition no 6 Page 177 of 221 Author Microbiology Management Team Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Authorised by Dr AJL Turner Back to Index Respiratory virus PCR Molecular Microbiology Respiratory screen including 1 Influenza A inc H1N1 avian types contact lab 2 Influenza B 3 Parainfluenza viruses 1 2 3 4 Respiratory syncytial virus 5 Metapneumovirus 6 Adenovirus 7 Rhinovirus General Information Back to Index Specimen Type
19. Superficial Non surgical Bacteriology Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 39 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Abscesses and Deep Seated Wound Infections Bacteriology Abscesses are accumulations of pus in the tissues and any organism isolated from them may be of significance They occur in many parts of the body as superficial infections or as deep seated infections associated with any internal organ General Information Back to Index Collection Use aseptic technique Collect specimens in appropriate CE marked leak container proof containers and transport specimens in sealed plastic bags including Avoid accidental injury when pus is aspirated Collect swabs into Amies preservatives transport medium with charcoal and transport in sealed plastic bags Collection Collect specimens before antimicrobial therapy where possible Samples of pus are preferred to swabs However pus swabs are often received when using swabs the deepest part of the wound should be sampled avoiding the superficial microflora Unless otherwise stated swabs for bacterial and fungal culture should then be placed in Amies transport medium with charcoal Collect specimens other than swabs into appropriate CE marked leak pro
20. endocervical swab penile swab urethral swab genital ulcer swab semen screening swabs for N gonorrhoeae aspirates from bartholin s gland fallopian tube tubo ovarian abscess pouch of Douglas fluid intra uterine contraceptive device IUCD products of conception High Vaginal swabs HVS are not suitable for the isolation of N gonorrhoeae Endocervical swabs should be submitted Aspirates Genital Swab Urethral Swab Collection Use aseptic technique Collect specimens in appropriate CE marked leak proof containers and transport in sealed plastic bags Collect swabs into appropriate transport medium and transport in sealed plastic bags Genital tract swabs Cervical and high vaginal swabs should be taken with the aid of a speculum It is important to avoid vulval contamination of the swab For Trichomonas the posterior fornix including any obvious candidal plaques should be swabbed If pelvic infection including gonorrhoea is suspected the cervical os should be swabbed Separate samples should be collected into appropriate transport media for detection of viruses or C trachomatis High vaginal swabs After the introduction of the speculum the swab should be rolled firmly over the surface of the vaginal vault The swab should then be placed in Amies transport medium with charcoal Cervical swabs After introduction of the speculum to the vagina the swab should be rotated inside the endocervix The swab should then be
21. for example known to inappropriate timing of sample collection inappropriate sample presence significantly of virus below the detectable limit of the assay New and emerging variants affect the may also occur which may not be detected by this assay Towards the limit results of detection of an assay sampling variation will result in lower reproducibility Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 171 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Pneumococcal urinary antigen detection General Information Back to Index Collection 10mL urine container including preservatives Specimen Type Urine Collection 10mL urine Specimen No special needs transport Minimum 10mL urine volume of sample Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round time 24 hrs Turn round time to 48 hrs for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to None known significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Med
22. refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Type and minimum volume Not applicable of sample Special precautions None Laboratory Information Measurement units Threshold Cycle CT Biological reference units Not applicable Turnaround time Rapid CPE Screens Designated wards agreed with IPC amp Trafford Transfers 2 4 hours from receipt into Microbiology Reception The laboratory MUST be telephoned prior to the patient s being sampled Samples should be received in the laboratory before 6pm Mon Fri and before 4pm Weekends Bank Holidays Routine CPE Screen Designated wards agreed with IPC 24 48hrs Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 55 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results Faecal material must be visible on the cotton tip of the swab failure to provide faecal material may produce a false negative screening result Some faecal products may prove inhibitory to the PCR process samples will be reported as inhibitory and a repeat will be requested Printed 24 7 20
23. sent to the Birmingham PHE Laboratory Both specimens from the health care worker are tested in parallel in the same test run in both laboratories and the final result is the mean of all results on both samples Test runs are done in batches and for this reason turnaround is at least 30 days from receipt of the second specimen in the laboratory Clinical Information Clinical decision Not applicable points Factors known to None known significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Hepatitis C antibody HCV screen and confirmation Dried Blood Spot Virology This service is designed for those patients on whom it is difficult to obtain venous blood especially for intra venous drug users Contact the laboratory for supply of postal packs containing all necessary items for using this service Paediatric infant packs are available on request General Information Back to Index Collection Envelope with dessicant container including preservatives Specimen Dried blood spot card Type Sample Collection eere 2 Ensure the patients hands are clean If the hands are cold ask the patient to rub them together It is important the puncture site is warm 8 Spot blood onto each of the 3 Identify and clean the eee he card To en Pic one of he ater 3 frgers ald the pacare she Som Avoid ger pad and nail bed x a Clean site wit
24. to the laboratory for microscopy and culture General Information Back to Index Collection container including Collect specimens in appropriate CE marked leak proof containers preservatives and transport specimens in sealed plastic bags Specimen Type Cerebrospinal Fluid Collection Use aseptic technique Collect specimens into appropriate CE marked leak proof containers and place in sealed plastic bag Specimen transport Specimens should be transported and processed as soon as possible Minimum volume of For routine cell count amp culture ideally a minimum volume of 1 sample mL For Mycobacteria sp culture Tb at least 6mL where possible such investigations cannot be performed outside of normal hours CSF is normally collected sequentially into three or more separate containers which should be numbered consecutively Special precautions Always contact the laboratory when sending a CSF sample Send sample 3 or the last sample if more than 3 taken to Microbiology Outside of normal hours contact the on call Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 69 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Biomedical Scientist through the main switchboard Laboratory Information
25. 5 0 SPECIMEN ACCEPTANCE POLICY ccccccscscscccccccccecccsscccscscscecscscccececses 29 6 0 REPERTOIRE OF TESTS PacZ free ssesssscaconssstncvessesneussssnssesssonsvcenosnsvonssenacesseseases 32 7 0 REFERRAL LABORATORIES cccccccccscccecccccscssscccvccccccecscccssccececesccsscccece 205 8 0 FEEDBACK ON OUR PATHOLOGY SERVICES AND COMPLAINTS PROCEDURE 219 9 0 PATIENT CONSENT DISCLOSURE cccscsceccccccccccsccvscccccecscececesesescscess 219 10 0 RESEARCH amp DEVELOPIMENT cccscsccecscscccsccccsseccccscuccccesececsscccecssecess 221 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 3 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 1 0 INTRODUCTION The Manchester Medical Microbiology Partnership MMMP is a collaboration between Central Manchester University Hospitals NHS Foundation Trust CMFT and Public Health England PHE In May 2013 Trafford Microbiology Services successfully transferred to the MMMP The objective of this partnership is to provide Central and South Manchester with a unified Microbiology Service embracing all aspects of medical and public health microbiology The MMMP is made up of the following Departments and Units e Microbiology Department CMFT e Microbiology Department Wythensha
26. CAPD is used as an alternative to haemodialysis for the management of patients with end stage renal failure General Information Back to Index Collection container including preservatives Withdraw fluid aseptically from the injection port of the plastic dialysate bag with a sterile needle and syringe and transfer to a CE marked leak proof containers and place in sealed plastic bag Specimen Type In a sealed plastic bag with a request form Cell count Sterile leakproof container in a sealed plastic bag containing 20mL of fluid for microscopy Culture Inoculated BacT ALERT FA bottle green top Collection Use aseptic technique Collect specimens in appropriate CE marked leak proof containers and transport specimens in sealed plastic bags Large volumes or whole dialysate bags may require special transportation according to local protocols They should be transported in rigid leakproof outer containers Specimen transport Specimens should be transported and processed as soon as possible Minimum volume of sample Minimum volume of10mL If blood culture bottles are used they should be inoculated aseptically with 5 10 mL of dialysate Special precautions Collect specimens before antimicrobial therapy where possible Laboratory Information Measurement units Cell count x 10 per litre Turnaround time 48 hrs 7 days for culture 30 60 mins for cell count
27. Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 20 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 4 2 LABELLING OF SAMPLE CONTAINERS Please see the Blood Tube Guide PDF 210KB for the selection of appropriate container for test alternatively please see the specimen containers in the REPERTOIRE OF TESTS A Z The MMMP will make every effort to ensure requests are processed in a safe and timely manner but it is essential that request forms and samples are labelled appropriately and legibly in compliance with the specimen acceptance policy See Specimen Acceptance Policy It is also important to clearly identify the investigations required with relevant supporting information If you have any doubts regarding this policy please ring the relevant department for further information Specimens will not be accepted for analysis if e There is no unique identification of the patient i e they do not meet the minimum data set for identification e There is an incorrect sample type or tube e Incorrect transportation conditions e Sample is received in a hazardous condition e g leaking or sharps attached e Sample or request form is unlabelled or incorrectly labeled with less than the minimum data sets for patient identification e Mismatch of details between the form and sample s e The information provided is illegible 4 3 HOW TO C
28. Cysts and Parasites Bacteriology P Paronychia Parotitis Parvovirus B19 IgG Virology Parvovirus B19 IgM Virology Parvovirus B19 viral load Molecular Microbiology Peritoneal fluids culture and microscopy Bacteriolo Pernasal swab for pertussis Bacteriology Pharyngitis Pneumococcal PCR Molecular Microbiology Pneumococcal serotype specific IgG Vaccine Evaluation Unit Pneumococcal urinary antigen detection Virology Pneumocystis jirovecii PCR Molecular Microbiology Polyoma viruses BK Molecular Microbiology Polyoma viruses JC Molecular Microbiology Polysaccharide antigen detection Meningococcal Reference Unit Posaconazole Level Mycology Pregnancy tests urine Bacteriology Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 37 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Progressive multifocal leucoencephalopathy Prosthetic valve endocarditis PVE Pus Bacteriology Pyuria Q Q FeverElA IgG and IgM Virology Q Fever Serology and PCR Referral R Respiratory specimens Bacteriology Respiratory Screen Molecular Microbiology Respiratory virus PCR Molecular Microbiology Rhinovirus Rotavirus PCR enteric Molecular Microbiology RSV Respiratory Syncytial Virus
29. Doctor Dr Ed Kaczmarski 0161 276 5746 Lead Consultant Microbiologist for Christie Hospital Consultant Microbiologist Paediatrics Consultant Microbiologist Dr Kirsty Dodgson 0161 276 5746 Consultant Clinical Scientist Deputy Infection Control Doctor Dr Barzo Faris 0161 746 2469 Consultant Microbiologist Mrs Geraldine Featherstone 0161 276 5686 Microbiology Secretary Specialist Registrars Office 0161 276 6333 66333 Mr Bernard Wood 0161 276 4420 PHE Regional Head of Laboratory Operations Head BMS MMMP Mirs Rachel Jones 0161 276 5747 Laboratory Manager Mr Malcolm Armstrong 0161 276 8822 68822 uments eee oe Mrs Katherine Mather 0161 276 4909 64909 Senuyisbostoytonger ee ana sale ce i cc Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 10 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 4 1 2 MICROBIOLOGY DEPARTMENT UNIVERSITY HOSPITAL SOUTH MANCHESTER The Microbiology User Manual for the Wythenshawe site is contained within the UHSM Pathology Handbook This is accessed via the UHSM intranet and also by internet at http www uhsm nhs uk pathology Pages home aspx The total workload is approximately 315 000 specimens per annum Contact details Name OO o eeN O Dr Ibrahim Hassan 0161 291
30. HIV Ag Ab Virology Dried Blood Spot Syphilis antibody Virology Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 34 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Dysuria E Ear Bacteriology Ebola EBV Epstein Barr virus viral load Molecular Microbiology EBV VCA IgG screening Virology EBV VCA IgM screening Virology EBV EBNA Virology Ecthyma gangrenosum Ehrlichia IF Virology referral Enteric Virus Panel Molecular Microbiology Enterovirus and parechovirus Molecular Microbiology Eye Bacteriology Eye Virology ie Molecular F Faeces Clostridium difficile Bacteriology Faeces culture microscopy Bacteriology Faeces culture Clostridium difficile screen Bacteriology Fluids Bacteriology Folliculitis G Galactomannan Aspergillus antigen Virology referral Gastric Biopsy for H pylori Bacteriolo Genital specimens Bacteriology Glucan Mycology Gonococcal TMA confirmation Virology H Haematuria Haemophilus influenzae PCR Molecular Microbiology Haemophilus influenzae type b antibody Vaccine Evaluation Unit Helicobacter pylori stool antigen Bacteriology Helicobacter pylori in Gastric Biopsies Bacteriology Hepatitis A IgG Virology
31. Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 195 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Toxoplasma IgG Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen No special needs transport Minimum volume 2 mL of sample Special All samples are suitable for overnight refrigeration only they must not precautions be stored over a weekend Laboratory Information Measurement IU mL units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 196 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Toxoplasm
32. IS IMPORTANT replace cap and tighten shaft of swab must not obstruct cap do not perforate foil cover on cap o Urines remove cap of collection tube transfer urine using disposable pipette provided fill to the window on the side of the collection tube replace cap and tighten Specimen transport Transport at ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Type and volume of 2mL Urine sample Special precautions Patient consent must be obtained for both Chlamdyia and Gonococcal testing Single tests cannot be accepted for either Chlamydia or Gonorrhoea If consent for both cannot be obtained please contact the laboratory for information on alternative laboratories that provide a single analyte service Laboratory Information Measurement units Relative Light Units RLU Biological reference Not applicable units Turn round time for 3 days Turn round 4 days Provisional result time to Final calendar days result calendar All reactive tests are confirmed days For urgent tests please contact the laboratory Clinical Information Clinical decision Not applicable points Factors known to Samples must be kept at ambient temperature significantly affect the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presen
33. Microbiology Management Team Authorised by Dr AJL Turner Neisseria meningitidis PorA sequencing from cultures General Information Back to Index Collection Not applicable container including preservatives Specimen Referral of Viable pure cultures on slopes and transport swabs Type Collection Not applicable including preservative Specimen Only submit viable isolate samples in approved packaging UN3373 which transport are suitable for Royal Mail post airfreight or commercial couriers such as HAYS DX Agar slopes where possible pure viable cultures inoculated on chocolate heated blood agar blood agar or Dorset egg slopes after establishing growth by overnight incubation at 37 C On occasion it may be necessary to submit an unincubated culture This can save time but requires a heavy inoculum to ensure survival in transport Please indicate on the request form if the material slope has not been incubated Short term storage of sloped cultures is optimal at 30 C if there are delays before submission Minimum Not applicable volume of sample Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turnaround 3 working days upon urgent request time Clinical Information Clinical Not applicable decision points Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Mi
34. Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 76 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Cytomegalovirus viral load Molecular Microbiology General Information Back to Index Collection container CE marked leak proof container or including EDTA blood tube preservatives Specimen Type Urine EDTA blood Specimen transport Ambient or refrigerated Minimum volume of Minimum volume 500ul sample Special precautions None known Laboratory Information Measurement units Copies mL Biological reference Not applicable units Turn round time for 3 days Turn round time to 4 days Provisional result Final result calendar calendar days days Turnaround time The results of all tests will be available within 3 working days after receipt of the specimen in the laboratory and usually within 24 hours Clinical Information Clinical decision points Not applicable Factors known to False negative results may occur for a variety of reasons for significantly affect the example inappropriate timing of sample collection inappropriate results sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay
35. PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 156 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Neisseria meningitidis Serogrouping and outer membrane typing General Information Back to Index Collection Not applicable container including preservatives Specimen Type Referral of viable pure cultures on slopes and transport swabs Collection Not applicable including preservative Specimen Only submit viable isolate samples in approved packaging UN3373 transport which are suitable for Royal Mail post airfreight or commercial couriers such as HAYS DX Agar slopes where possible pure viable cultures inoculated on chocolate heated blood agar blood agar or Dorset egg slopes after establishing growth by overnight incubation at 37 C On occasion it may be necessary to submit an unincubated culture This can save time but requires a heavy inoculum to ensure survival in transport Please indicate on the request form if the material slope has not been incubated Short term storage of sloped cultures is optimal at 30 C if there are delays before submission Minimum Not applicable volume of sample Special Non viable cultures cultures which are no longer viable may still be precautions considered for characterisation by molecular based methods after consultation with the MRU A heavy inoculum of the inert material
36. Preparing the Gram Stain Clear wipe the infected area by removing as much cellular material as possible using a syringe needle and spread this evenly over the scribed area of the glass slide 2 Innoculating the Culture plates amp Blood Blobs Scrape the infected area using a fresh needle and inoculate the surface of the agar with a large C streak Figure 1 if the syringe needle is dug deep into the agar this will delay signs of bacterial growth Figure 1 ne Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 65 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Innoculate each agar blob using a fresh needle each time Slide amp Choc agar amp blobs MUST all be appropriately labelled Acanthameoba plates should be labelled on the lid of the plate as labelling the agar side obstructs the visualisation of the plate down the microscope Specimen Specimens should be transported and processed as soon as possible transport Minimum Corneal scrapings should be of sufficient quantity to make a visible deposit volume of on a microscope slide and to inoculate culture plates sample If insufficient specimen to make an impression smear and inoculate plates cultures should be the priority Special Collect specimens
37. Printed 24 7 2015 3 54 AM Valid on day of issue only sampling variation will result in lower reproducibility Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 78 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner CMV Cytomegalovirus antiviral Resistance markers CMV viral load positive bloods Complete CMV antiviral resistance genotypic screening including UL97 Nucleotide sequencing of the CMV phosphotransferase gene for the identification of mutations encoding resistance to ganciclovir UL54 Nucleotide sequencing of the DNA polymerase gene for the identification of mutations encoding resistance to ganciclovir foscarnet and cidofovir General Information Back to Index Collection container CE marked leak proof container including EDTA blood tube preservatives Specimen Type EDTA blood Specimen transport Ambient or refrigerated For PCR for confirmation of active CMV infection and monitoring of antiviral therapy please send 4mL of EDTA blood This should be stored at 4 C and dispatched as soon as possible after being drawn If longer storage is unavoidable serum or plasma may be stored frozen but should not be repeatedly frozen and thawed In special circumstances 0 5mL of serum or
38. an active research programme and encourages collaborations locally nationally and internationally Ongoing projects include novel platforms for multiplexing assays immunoassays for Human Papilloma Virus Nationally the VEU is a key player in the National Vaccine Evaluation Consortium and UK Paediatric Vaccine Group whilst internationally advises WHO on serological assays for meningococci together with strong links to most vaccine manufacturers who use the Unit as a reference centre The VEU is also committed to training of staff from laboratories both nationally and internationally particularly those from developing countries Laboratory opening hours The VEU is open Monday to Friday 8 00am 5 00pm Clinical Advice A full clinical advice service is maintained For advice during normal working hours Tel 0161 276 6793 or 0161 276 5697 or 0161 276 6791 Results Printed 24 7 2015 3 54 AM Valid on day of issue only For general results enquiries Tel 0161 276 88540r 0161 276 8788 Out of hours Service There is no out of hours service for the Vaccine Evaluation Unit For further information about the Sero epidemiology Unit SEU please contact ezra linley phe gov uk Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 18 of 221 Document no MMMP QU MAN1 Author Microbiology Management T
39. at precautions ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Not applicable Turnaround time The results of all tests will be available within 5 working days after receipt of the specimen in the laboratory and may be available sooner by prior arrangement Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 102 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner HCV Genotyping Molecular Microbiology HCV genotyping would only be performed on an HCV viral load positive sample General Information Back to Index Collection CE marked leak proof container container including preservatives Specimen Type EDTA blood
40. committed to good professional practice and conduct maintain confidentiality of information and records of service users staff and patients commit to comply with relevant environmental legislation and guidelines The Partnership will comply with CPA UK Ltd and ISO 15189 2012 and is committed to e staff recruitment training development and retention at all levels to provide a full and effective service to its users e the proper procurement and maintenance of such equipment and other resources as are needed for the provision of the service e the collection transport and handling of all specimens in such a way as to ensure the safe and correct performance of laboratory examinations and the safety of our staff and the general public e the use of examination procedures that are fit for use and will ensure the highest achievable quality of all tests performed within the resources available e reporting results of examinations in ways which are timely confidential accurate and clinically useful e the assessment of user satisfaction by the use of regular clinical liaison meetings satisfaction surveys and face to face meetings with external users e ensure ongoing evaluation and improvement by the process of internal audit external quality assessment and by the identification of non conformities with procedures and standards e take into consideration the needs and requirements of patients by liaison and surveys of patient groups whereve
41. controlling communicable diseases MMMP is committed to providing a high quality clinical analytical and advisory service It provides Clinical Diagnostic Microbiology and Virology services including Molecular Diagnostics Specialist services on site include the PHE Meningococcal Reference Unit and the PHE Vaccine Evaluation Unit MMMP aims to take into account the needs and requirements of its users and other stakeholders and to operate in a safe manner for staff visitors and patients In order to ensure these aims are met the MMMP will operate a quality management system designed to integrate the function of the organisation and its processes procedures resources and safety set measurable quality objectives and plans in order to implement this quality policy in line with the objectives of Central Manchester University Hospitals NHS Foundation Trust CMFT and the Public Health England PHE consult with users on a regular basis to ensure their needs and requirements are met ensure that all personnel are familiar with this policy and the quality manual review the quality policy for suitability and effectiveness at the annual management review e commit to the health safety and welfare of its entire staff Visitors to the department will be treated with respect and due consideration will be given to their safety while on site e commit to promoting a culture of continuing quality improvement uphold professional values and be
42. decision Not applicable points Factors known to Spots too small not all spots filled with blood significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Dried blood Spot Hepatitis C RNA Screening Virology This service is designed for those patients on whom it is difficult to obtain venous blood especially for intra venous drug users Contact the laboratory for supply of postal packs containing all necessary items for using this service Paediatric infant packs are available on request General Information Back to Index Collection Envelope with dessicant container including preservatives Specimen Dried blood spot card Type Collection Sample Collection 1 Disposable gloves should be worn for the whole Procedure to protect you and to protect the sample from degradation 2 Ensure the patients hands are clean If the hands are cold ask the patient to rub them together It is important the puncture site is warm 3 Identify and clean the cture 4 Break the Seal by Twisting 5 Hold the lancet with two fingers and place at the puncture site 6 Gently apply pressure until the lancet is activated A click sound will be heard when this has happened 7 Safely discard the lancet in a sharps container Avoid repetitive making it can damage the area NOTE FILL each circle with N S blood Fail
43. may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 42 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Aspergillus PCR Molecular Microbiology General Information Back to Index Collection container CE marked leak proof containeror 5mL EDTA blood collection tube including preservatives Specimen Type EDTA Blood Sputum BAL CSF Specimen transport Ambient or refrigerated Transport at ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Type and volume of Disseminated infection with Aspergillus spp sample Aspergillus PCR 5mL of EDTA blood This test cannot be performed on serum or plasma mL Pulmonary infection with Aspergillus spp A minimum of 1mL of a bronchoalveolar lavage in a sterile screw capped plastic container should arrive at the laboratory within 1 working day The sample should not be frozen but should be stored at 4 C before dispatch and kept cool during transport to the laboratory Non invasive samples such as sputum and EDTA blood may be used if BAL is unobtainable Fungal infections
44. of haematobium terminal samples of urine may be obtained Worms seen in stool Worm Please send actual worm seen in a universal container If any other types of samples require testing or other parasite investigations required please contact the Microbiology department on 0161 276 6717 If amoebic dysentery is suspected and clinical advice needed please Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 167 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner tel 0161 276 6333 On occasions we may need to refer samples to a reference laboratory for specialised testing procedures and further samples may be necessary ATi Andrew Dodgson Consultant Microbiologist Infection Control Doctor and Clinical Lead for Microbiology Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 168 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Human Parvovirus B19 IgG Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous B
45. ona slope may be submitted with an appropriate request form Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turnaround Serogroup telephoned to sending laboratory within 24 72hrs time The final printed report is submitted within 1 2 weeks Printed 24 7 2015 3 54 AM Valid on day of issue only Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results Contaminated culture will delay the results Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 158 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Neisseria meningitidis Minimum inhibitory concentration General Information Back to Index Collection Not applicable container including preservatives Specimen Type Referral of Viable pure cultures on slopes and transport swabs Collection Not applicable including preservative Specimen Only submit viable isolate samples in approved packaging UN3373 transport which are suitable for Royal Mail post airfreight or commercial couriers such as HAYS DX Agar slopes where possible pure viable cultures inoculated on chocolate hea
46. other work and so this would be outside the scope of the licence If additional work on samples from the deceased is thought necessary by the medical microbiologist or virologist they must obtain written confirmation of consent from the sending departments All relevant material is stored securely and under conditions which maintain the integrity of the sample if possible and confidentiality is maintained in compliance with Caldicott principles as are all samples received into the Partnership Following processing relevant material is only retained for the period of time specified by the retention policy It may also be retained if it is likely to be of value for research Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 221 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner under research ethics committee approval Residual relevant material once outside of the retention policies must be discarded sensitively If the sender of relevant material requests tests not performed by the MMMP or a PHE Reference Laboratory the sending clinician or pathologist may request the return of the material 9 4 Medico legal specimens Any specimens submitted for medico legal purposes should have documentation accompanying these specimens to provide an unbroken
47. placed in Amies transport medium with charcoal Samples of pus exudate if present are preferred to swabs Specimen Type Collection Sample a representative part of the lesion Swabbing dry crusted areas is unlikely to yield the causative pathogen If specimens are taken from ulcers the debris on the ulcer should be removed and the ulcer should be cleaned with saline Specimen If processing is delayed refrigeration is preferable to storage at ambient transport temperature Delays of over 48hr are undesirable Minimum Not applicable volume of sample Special If only a minute amount of pus or exudate is available it is preferable to send precautions a pus exudate swab in transport medium to minimise the risk of desiccation during transport Laboratory Information Measureme Not Applicable nt units Biological Not Applicable reference units Turn round 24 hrs Turn round time to 48 72 hrs Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 204 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner time for Final result calendar Provisional days result calendar days Clinical Information Clinical Not applicable decision points Factors Collect specimens befo
48. precautions The specimen is unsatisfactory if any residual soap detergent or disinfectant remains in the pan Laboratory Information Measurement units Not applicable Biological reference units Not applicable Turn round time for 24 hrs Turn round time to 48 72hrs Provisional result Final result calendar calendar days days Clinical Information Printed 24 7 2015 3 54 AM Valid on day of issue only Clinical decision points Not applicable Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 94 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Fluids from Normally Sterile Sites The detection of organisms in fluids that are normally sterile indicates significant infection which can be life threatening Soecimens may be taken primarily for culture or this may be incidental to the prime reason for obtaining the specimen Blood cultures may be positive with the same infecting organism and occasionally may be positive when culture of the fluid fails to reveal the organism Fluids will be sterile in the absence of infection as will sympathetic effusions and those of immunological or traumatic origin and those due to metabolic disease or heart failure Signs of
49. than 48 hours after commencement of antibiotic therapy are unlikely to give useful results CSF may remain positive for longer periods Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 146 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Mouth Swab Bacteriology General Information Back to Index Collection container Collect specimens in appropriate CE marked leak proof containers including and transport specimens in sealed plastic bags preservatives Collect swabs into Amies transport medium with charcoal and transport in sealed plastic bags Specimen Type Mouth Swab b p Collection Collect specimens before antimicrobial therapy where possible To assure that the preconditions of the sampling for oral infections are comparable it is advised that patients should not 1 Eat or drink within 2 hours 2 Brush their teeth within 2 hours 3 Use any mouth rinse of disinfectant within 2 hours prior to sampling If possible samples should be taken in the morning under fasting conditions Unless otherwise indicated collect each swab for bacterial and or fungal culture and place in appropriate transport medium Collect specimens other than swabs into appropriate CE marked leak proof containers and p
50. the outer 3 fir the puncture site down Clean site with alcohol wipe then dry strong repetitive pressure making t can damage the area NOTE FILL each circle with Sf blood Failure to do so may ar reduce the sensitivity of the NYO screening tests 5 Hold the lancet with two 9 Leave the card to dry for a minimum of 30 minutes fingers and place at the puncture site 10 Place card along with one bag of desiccant in the plastic carrier attached to the request from 11 Ensure the required details have been entered on both the request fom and the dried blood spot card Place the re quest card in the envelope pro vided and send back to the Specimen No special needs Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 123 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner transport Minimum 7mm Dried blood spot card volume of sample Special Ensure blood spot has dried and submit with dessicant pouch enclosed precautions Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round time 5 days Turn round time to 7 days for Provisional Final result calendar result calendar days days Clinical Information Clinical
51. the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 75 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Cytomegalovirus CMV IgM Specific CMV IgM assay is useful in distinguishing individuals who have acquired the infectionrecently from those who have not Further information may be gained from IgG avidity testing where IgM is General Information Back to Index Collection container 6mLclotted blood tube including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen transport No special needs Minimum volume of 2 mL sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Not applicable Biological reference Not applicable units Turn round time for 3 days Turn round time to 4 days Provisional result Final result calendar days calendar days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical
52. 1 Author Microbiology Management Team Authorised by Dr AJL Turner Helicobacter pylori Bacteriology Infection with H pylori is associated with peptic ulceration There is evidence that it may play an important role in non ulcer dyspepsia General Information Back to Index Collection container including preservatives Collect specimens in appropriate CE marked leak proof containers Specimen Type Faeces Collection Specimen may be passed into a clean dry disposable bedpan or similar container and transferred into an appropriate CE marked leak proof containers and place in sealed plastic bags Specimen transport If processing is delayed refrigeration is preferable to storage at ambient temperature Minimum volume of sample A liquid specimen of 1 2 mL is sufficient 1 gram of solid specimen Special precautions The specimen is unsatisfactory if any residual soap detergent or disinfectant remains in the pan Laboratory Information Measurement units Not applicable Biological reference units Not applicable Turn round time for Provisional result calendar days 48 hrs Turn round time to 48 72 hrs Final result calendar days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results None known Printed 24 7 2015 3 54 AM Back to Index Val
53. 1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis D delta antibody Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum 2mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement Not applicable units Turnaround time 7 days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 127 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Herpes simplex virus types 1 and 2 PCR Molecular Microbiology General Information Back to Index Collection container including preservatives CE marked leak proof container Specimen Type EDTA blood CSF lesion swab eye swab Collection Samples for PCR testing should be colle
54. 14 Page 36 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Microbiology Meningococcal Serology Bacteriology Metapneumovirus Molecular subtyping of isolates Meningococcal Reference Unit Mouth swab MRSA screen Bacteriology Mumps IgG Virology Mumps IgM Virology Mycobacteria microscopy culture Bacteriology Mycobacterium PCR Bacteriology Mycology culture Bacteriology Mycology microscopy Bacteriology Mycoplasma PCR Molecular Microbiology Referral Mycoplasma pneumoniae particle agglutination Virology N Neisseria meningitidis Functional antibody to serogroups A C W and Y by internationally standardised serum bactericidal antibody assays Vaccine Evaluation Unit Functional antibody to Neisseria meningitidis serogroup B by Serum Bactericidal Antibody Assay SBA Vaccine Evaluation Unit Neisseria meningitidis isolate characterisation Meningococcal Reference Unit Neisseria meningitidis Serogrouping and outer membrane typing Meningococcal Reference Unit Neisseria meningitidis Minimum inhibitory concentration Meningococcal Reference Unit Neisseria meningitidis PorA sequencing from cultures Meningococcal Reference Unit Neisseria meningitidis serology Vaccine Evaluation Unit Neonatal Sepsis Norovirus PCR Molecular Microbiology Nose Swab Bacteriology O Otitis externa Otitis media Ova
55. 15 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 56 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Carbapenemase Producing Enterobacteriaceae CPE Screen Bacteriology Wythenshawe In response to the increasing numbers of CPE producing clinical isolates of Enterobacteriaceaethe Infection Control Consultant and Microbiology department have produced a protocol for CPE screening and detection The isolation of a clinical CPE isolate prompts the Infection Control Team to screen all possible patient contacts to reduce the transmission of resistance enzymes within the Trust General Information Back to Index Collection container Charcoal Swab PLEASE NOTE THESE ARE NOT SUITABLE FOR including preservatives THE MRI CPE SCREENING METHOD gy P Specimen Type Screening of faeces rectal swabs Specimen transport If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Type and minimum volume Not applicable of sample Special precautions None Laboratory Information Measurement units MIC mg L Biological reference units Not applicable Turnaround time Negative screen 24 hrs Postive results 72 hrs Clinical Information Clin
56. 2014 Page 191 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Tissue and Biopsies Bacteriology A biopsy may be defined as a portion of tissue removed from the living body for further examination Ideally these specimens should be discussed with the laboratory prior to sampling to ensure that transport and processing are timely and appropriate tests are performed General Information Back to Index Collection container including preservatives Tissue or biopsy material in a microbiologically CE marked leak proof container without formalin Specimen Type Tissue Biopsy Ulcer Biopsy Collection Collect specimens before antimicrobial therapy where possible Specimen transport Specimens should be transported and processed as soon as possible Minimum volume of sample Large enough to carry out all microscopy preparations and cultures Special precautions If specimen is small place it in sterile water to prevent desiccation Laboratory Information Measurement units Not applicable Biological reference units Not applicable Turn round time for Provisional result calendar days Turn round time to 48 72 hrs Final result calendar days Gram stain 30mins 2hours within receipt into the Microbiology laboratory on request Culture 24 hrs Clinical Information Printed 2
57. 2014 Page 211 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner WCIE 6JB B d glucan MRCM Wythenshawe HHV6 7 antibodies PCR PHE Colindale HHV8 PCR PHE Colindale HBV viral load Health Care Workers Gartnavel Glasgow Hepatitis C genotyping PHE Colindale Printed 24 7 2015 3 54 AM Mycology Reference Centre Manchester Wythenshawe Hospital Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue London NW9 5HT Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue London NW9 5HT PHE Microbiology Services Porton Down Salisbury Wiltshire SP4 0JG West of Scotland Specialist Virology Centre Main Specimen Reception Level 4 New Lister Building Glasgow Royal Infirmary 10 16 Alexandra Parade Glasgow G31 2ER Scotland Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue London NW9 5HT CPA 0635 CPA 2904 CPA 2904 CPA 1612 CPA 0406 CPA 2904 Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 212 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner ae CPATORAS accreditation Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue London NW9 5HT Hepatiti
58. 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Mr Alan Lord 0161 276 8843 68843 Deputy Laboratory Manager Mr John Marsh 0161 276 8843 68843 Deputy Laboratory Manager 0161 276 8787 5744 68787 5744 Hospital Switchboard 0161 276 1234 ne 4 1 5 PHE MENINGOCOCCAL REFERENCE UNIT The Meningococcal Reference Unit User Manual and a copy of the request form are available from the PHE Website using the following link MRU User Manual The total workload is approximately 16 000 specimens per annum External Internal Numbers Numbers Head of Unit Deputy Head of Unit Dr Steve Gray 0161 276 6757 66757 Lead BMS 0161 276 5744 65744 Hospital Switchboard 0161 276 1234 61234 Laboratory opening hours The laboratory is open Monday to Friday 8 30am 5 30pm Answerphone message redirection for Saturday am and urgent clinical enquiries Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 16 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 4 1 6 VACCINE EVALUATION UNIT The Vaccine Evaluation Unit VEU specialises in serological determination of immune responses to Neisseria meningitidis and Streptococcus pneumoniae either following vaccination or disease It has internation
59. 4 7 2015 3 54 AM Valid on day of issue only Clinical decision points Not applicable Factors known to Specimens received in formol saline are not suitable for culture significantly affect the If processing is delayed refrigeration is preferable to storage at results ambient temperature Delays of over 48 hr are undesirable Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 193 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Toxoplasma PCR Molecular Microbiology General Information Back to Index Collection container CE marked leak proof container including preservatives Specimen Type EDTA blood amniotic fluid Specimen transport Ambient or refrigerated Minimum volume of 500ul sample Special precautions Please send to the laboratory without delay Laboratory Information Measurement units Threshold Cycle CT Biological reference Not applicable units Turn round time for 7 days Turn round time to 10 days Provisional result Final result calendar calendar days days Clinical Information Clinical decision Not applicable points Factors known to All samples are suitable for overnight refrigeration only they must signif
60. 4756 Head of Department Consultant Microbiologist Dr Barbara Isalska 0161 291 2892 Consultant Microbiologist Infection Control Doctor Dr Mairi Cullen Consultant Microbiologist Dr Stephanie Thomas 0161 291 4792 Consultant Microbiologist Dr Sawsan Awad 0161 291 2884 Consultant Microbiologist Specialist Registrar 0161 291 4784 4863 Mr David Weston Laboratory Manager Mrs Angela Downes 0161 291 4758 A a a 0161 291 4862 4754 Secretary Office SS Laboratory Enquiries 0161 291 4819 Hospital Switchboard 0161 998 7070 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 11 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 4 1 3 MOLECULAR MICROBIOLOGY Introduction The MMMP offers a wide range of molecular diagnostic assays for viral bacterial fungal and parasite infections We are continuing to develop a microbiology molecular diagnostic service that will provide a wide range of clinically relevant diagnostic assays exploiting the real time PCR platforms available within the MMMP The molecular diagnostic services are developed by senior clinical scientists and routine assays undertaken by biomedical scientific staff Within this unit there is an active programme in developing new molecular approaches to diagnosis and char
61. 5 3 54 AM Valid on day of issue only d Guidance on storage of faecal specimens https nww cdrn nhs uk http www hpa org uk Topics InfectiousDiseases InfectionsAZ ClostridiumDifficile Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 63 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Contact lens Bacteriology General Information Back to Index Collection Contact lens case or Sterile container with saline container including preservatives Specimen Type Contacts lens Specimen If processing is delayed refrigeration is preferable to storage at transport ambient temperature Delays of over 48hr are undesirable Minimum volume Not applicable of sample Laboratory Information Turnaround time 24 72 hrs for culture Acanthameoba investigations 7 days Fungal Culture 5 days Clinical Information Factors known to The sample should be sent to the laboratory without delay significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 64 of 221 Document no MMMP QU MAN1 Author Microbiolog
62. 5 days Turn round time to 7 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 74 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Cytomegalovirus CMV IgG General Information Back to Index Collection container 6mLclotted blood tube including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen transport No special needs Minimum volume of 2 mL sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units AU mL Biological reference Not applicable units Turn round time for 3 days Turn round time to 4 days Provisional result Final result calendar days calendar days For urgent tests please contact the laboratory for 4 hour turnaround Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect
63. 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 80 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Diphtheria IgG Antibody Determination Vaccine Evaluation Unit Diphtheria IgG antibody determination by flow analysis assay bead assay General Information Back to Index Collection Clotted blood sample tube no preservative container including preservatives Specimen Clotted Blood serum paired sera Type Specimen Specimens should be transported and processed as soon as possible transport Type and Clotted Blood serum Minimum volume 0 1mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement IU mL units Biological Not applicable reference units Turnaround 28 Working Days time Clinical Information Clinical IgG of 2 0 1IU mL considered protective decision points Factors none known known to significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Pa
64. CAL ADVICE AND RESULTS LINE ccssccssccssccescesceees 7 4 1 1 MICROBIOLOGY DEPARTMENT MANCHESTER ROYAL INFIRMARY 7 4 1 2 MICROBIOLOGY DEPARTMENT UNIVERSITY HOSPITAL SOUTH MANCHESTER 10 4 1 3 MOLECULAR MICROBIOLOGY cccsccscssccsccsscsecsccecceccssceccssceceescesescsesees 11 4 1 4 VIROLOGY DEPARTMENT cesccsccsccsccsssssccccssccenssccccecesssececcteceecseseecsecens 12 4 1 5 PHE MENINGOCOCCAL REFERENCE UNIT sccscssscssssscsscsccesssscessecescsecees 15 4 1 6 VACCINE EVALUATION UNIT ssccsccsccssssccsccsccsccscccececessssccecsecessseseessesens 16 4 1 7 MYCOLOGY REFERENCE CENTRE MANCHESTER cccccsccsscsscsscescsscsscescecees 19 4 2 LABELLING OF SAMPLE CONTAINERS sccsscsccsscsccssccccssccscssccccsscecesssesesscecees 20 4 3 HOW TO COMPLETE REQUEST FORDM sccsscsccsscssesscsccesccccssccccssceccsssesesssecees 20 4 4 TRANSPORT SERVICES INCLUDING ANY SPECIAL HANDLING NEEDS E G HG3 PATHOGENS E E O O AE 27 4 4 1 TRANSPORTATION OF ROUTINE SAMPLES TO THE LABORATORY 000088 27 4 4 2 URGENT SAMBPLEG cccccscnsccns E h s nsesssssosessssossnsosssssosessssossssesss 27 4 4 3 SAMPLES SUBMITTED OUT OF HOURS ON CALL 0ssccccsssseecccnsseeceeees 27 4 4 4 OUTBREAK SAMPLE csccscssccscssscsccsccsscccccecscccecsseccceceescecescsesesesesesssecens 27 4 4 5 PACKAGING OF HIGH RISK SAMPLEG ssccscssscssssscsccsccssceccscsscesssecesssecees 29
65. CM provides a specialist medical mycology service for the North West of England and further afield Antifungal and mycological advice can be offered on the diagnosis of disease clinical management and care of patients The MRCM laboratory is open from 08 30 to 17 00 hours Monday to Friday Emergency medical advice can be obtained by contacting Professor D Denning Dr P Newton Dr R Richardson or the appropriate duty Consultant Microbiologist via the switchboard on 0161 998 7070 Contact Details Name SSS Phone Number s 0161 291 2124 laboratory Professor Malcolm Richardson 0161 291 5914 Office Director of MRCM and Consultant 0161 291 5839 Secretary Clinical Mycologist 07545994936 Mobile Dr Caroline Moore 0161 291 5839 office Principal Clinical Scientist 0161 291 2124 laboratory Fox 0161 2915806 General Enquiries Results 0161 291 2124 Further information is available on the Mycology Reference Centre Manchester MRCM website at http www mycologymanchester org All samples should be sent to the Microbiology Department Wythenshawe Hospital who will ensure appropriate transportation to the Mycology Laboratory Additional Tests Additional tests can be requested by telephoning or writing to the laboratory although it must be recognised that the archive sample available will have a limited volume Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership
66. Copy no FREE TO PRINT Edition no 6 Page 1 of 221 Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner SIII IEIET Public Health Central Manchester England University Hospitals NHS Foundation Trust Manchester Medical Microbiology Partnership User Guide A Z of tests Please use the hyperlinks control and click on the links to navigate the user guide Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 2 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 1 0 INTRODUCTION sisscviscdcccccdvds scntce coctccscesitcecedecccedsdua dette cecdesevseadvetedictessddeadetees 3 Roles and TUMCTIONS fesscssiccceiccccsdessccaccsdesssceesdveacecsaceeseedssasscesavenssceseocsesdbsceceessvessecbacesceces 3 2 0 LOCATION OF MMMP AND CONTACT DETAILS cccccecccecccesescscscscsceces 4 3 0 QUALITY ASSURANCE istiiiccis cccccedeaceadcess condtdicititcdis cecdedeedescestacwectiesceiecececesens 5 3 1 QUALITY POLICY wtesscsccsccoccvsscssesccccescvassdcestuscsscoscbaceadscivacsssesssccsisecsesteucsecesseacsacts 6 4 0 INFORMATION FOR HEALTHCARE PROFESSIONALG ccccccccscssscscscscsceces 7 4 1 OPENING HOURS CLINI
67. Dr AJL Turner 8 0 FEEDBACK ON OUR PATHOLOGY SERVICES AND COMPLAINTS PROCEDURE Any complaints should be directed to the Clinical or Laboratory Managers please make any reservations you may have about the quality of any aspect of the service known to us as soon as possible we take your complaints very seriously Any suggestions from users on how this user guide could be improved would be welcome for inclusion in future edtions Please forward suggestions to Ben Kirkman Quality Manager ben kirkman cmft nhs uk or ben kirkman phe gov uk or to the following address Ben Kirkman Quality Manager Manchester Medical Microbiology Partnership PO Box 209 Clinical Sciences Building Manchester Royal Infirmary Oxford Road Manchester M13 9WZ Please also let us know about new services you would wish to see developed 9 0 PATIENT CONSENT DISCLOSURE 9 1 While several hundred laboratory tests are performed on site for some rare or complex tests patient specimens may be sent to specialist laboratories elsewhere which have the necessary expertise In some cases there will be only one specialist laboratory in the whole country which performs a particular test meaning using referral laboratories is essential There is a detailed policy in place to govern how we choose these referral laboratories They are selected for their expertise and their quality standards We regularly check their accreditation status which gives us assurance that t
68. EE TO PRINT Edition no 6 Page 121 of 221 Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis C viral load Molecular Microbiology General Information Back to Index Collection container including preservatives EDTA Blood tube Specimen Type EDTA Blood Plasma Collection Freshly drawn whole blood in EDTA Specimen transport Clinical samples should be collected into a sterile leak proof container in a sealed plastic bag Appropriate hazard labelling according to local policy should be applied Specimens should be transported and processed as soon as possible complying with postal and transport regulations If processing is delayed refrigeration is preferable to storage at room temperature Minimum volume of sample 3 0 mL Special precautions Haemolysed specimens can be inhibitory where this is unavoidable such as with post mortem samples the laboratory should be contacted 0161 276 8843 Plasma should be stored at 4 C and dispatched as soon as possible An additional 3mL fresh whole blood in EDTA should be sent if the initial HCV PCR is positive Laboratory Information Measurement units IU mL Dynamic range The dynamic range for this assay is 12 10 copies mL Turnaround time The results of all te
69. H RISK SAMPLES High risk groups can include patients suffering or thought to be suffering from e HIV infection e Hepatitis B e Hepatitis C e E coli 0157 e Mycobacterium tuberculosis TB e Salmonella typhi Typhoid fever e Coccidioides immitis e All other Category 3 and 4 organisms Advisory Committee on Dangerous Pathogens e V drug use e patients who have had recent foreign travel with unexplained high pyrexia NB Specimens MUST be labelled with Danger of Infection stickers on the specimen bag and form The form must be folded to ensure confidentiality The specimen must be sealed in the plastic transport bag The specimen must then be placed in a secondary biohazard plastic bag and sealed To protect all health care workers requests for investigations on high risk samples should be the minimum required for diagnosis and good management Great care must be taken in obtaining specimens and equipment such as needles and blades must be immediately Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 29 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner disposed of safely in approved sharps boxes Should a spillage of blood fluids or tissue occur this should be made safe and disposed of no matter what the risk to the patient
70. HIV Integrase Resistance Virology HIV P24 antigen and neutralization Virology HIV Resistance Molecular Microbiology HIV screen Virology HIV screen 4 generation HIV1 and 2 antibody and p24 antigen Virology HIV screen same day Virology HIV Tropism prediction Molecular Microbiology HIV Viral load Molecular Microbiology HIV Ag Ab Dried Blood Spot Virology HIV Resistance Markers Molecular Microbiology HTLV 1 and 2 antibody Virology Human Herpes virus 6 amp 7 Molecular Microbiology Human Papillomavirus PCR Molecular Microbiology l Impetigo Infective endocarditis Influenza A Influenza B Intravascular cannulae Bacteriology Invasive infection with Aspergillus Molecular Microbiology Invasive infection with Candida Molecular Microbiology J JC virus Molecular Microbiology Joint Fluids Bacteriology K L Legionella urinary antigen detection Virology Leptospira Virology referral Lyme Disease Referral at present but this service will be offered later this year M Measles IgG Virology Measles IgM Virology Measles virus PCR Molecular Microbiology Meningitis Meningococcal DNA detection by PCR multiplex with Pneumococcal DNA PCR Molecular Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 20
71. Hepatitis A IgM Virology Hepatitis B confirmation Virology Hepatitis B core antibodies Virology Hepatitis B corelgM Virology Hepatitis B core antibody Dried Blood Spot virology Hepatitis B e antigen Virology Hepatitis B e antibody Virology Hepatitis Bgenotypic antiviral resistance and genotyping Molecular Microbiology Hepatitis B surface antibody Virology Hepatitis B surface antigen Virology Hepatitis B surface antigen Dried Blood Spot Virology Hepatitis B viral load Molecular Virology Hepatitis B virus Genotyping and Resistance Markers Molecular Microbiology Hepatitis C confirmation Virology Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 35 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis C screen Virology Hepatitis C viral load Molecular Microbiology Hepatitis C virus Genotyping Molecular Microbiology Hepatitis C Dried Blood Spot Virology Hepatitis D delta antibody Virology Hepatitis E IgG Virology referral Hepatitis E IgM Virology referral Herpes simplex 1 2 antibody type specific IgM and total antibody Virolo Herpes simplex virus types 1 and 2 PCR Molecular Microbiology Histoplasma Virology referral HIV confirmation Virology
72. M Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 173 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Pregnancy Test Bacteriology The preferred sample is a blood sample for biochemistry however if blood cannot be collected a urine specimen may be sent to Microbiology hCG is a glycoprotein hormone produced by the blastocyst The appearance of hCG soon after conception and its subsequent rise in concentration during early gestational growth makes it a good marker for the early detection of pregnancy General Information Back to Index Collection A urine sample collected at any time of the day is suitable but a first container morning sample is recommended including preservatives Specimen Type Urine Collection Samples must be collected in a clean and dry container including preservative Specimen Samples may bestored at 2 8 C for up to 72hrs transport Minimum The assay requires approximately 200 l for a single test volume of sample Special Analysis should cannot be performed on visibly blood stained samples or precautions dilute samples low specific gravity Laboratory Information Measurement IU L units Biological Not applicable reference units Turnaround Please contact the laboratory for ur
73. NT Department ALL Edition no 6 Date of issue 19 December 2014 Page 58 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Chlamydia trachomatis Neisseria gonorrhoea Trichomonas vaginalis NAATs Molecular Microbiology General Information Back to Index Collection container Aptima Collection System including preservatives Specimen Type Swab urine Collection Specimens should be collected and handled following the recommended guidelines on the collection packs Yellow Urine Collection White Female endocervical and urethral Male urethral White shafted swab is cleaning swab Blue or Pink shafted swab is for sample collection Orange Vaginal Swab Collection Please note o Endo cervical Urethral swabs only use the white shaft swab for cleaning the cervix and then discard Use blue shaft swab for taking the sample and then send to laboratory in Aptima tube o Urethral swabs urine should not urinate for one hour prior to sampling Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 59 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner o All swabs Remove cap of collection tube place swab in collection tube break off swab at the mark THIS
74. OMPLETE REQUEST FORM 4 3 1 Electronic Requesting ICE requests Where this is available please use whenever possible as it enables more rapid receipt and processing within the laboratories It is important to ensure that the correct ICE barcoded number is attached to the correct specimen and correct request form before placing inside the specimen bag Please ensure that you order the correct test and select the correct specimen type as failure to do this may lead to incorrect testing The ICE requesting system will show those tests most commonly requested for Microbiology Services should the test you require not be visible please contact the laboratory to check that the test is available This information is the same as that is required on handwritten request forms and should include clinical details and symptoms as well as information on antibiotic use foreign travel outbreaks date of onset etc Where ICE requesting is not available the following request forms should be used Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 21 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 4 3 2 Virology Request forms You are strongly requested to use these new forms in preference to any other including previous versions of Virology request forms plea
75. Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street London WCIE 6JB CPA 2354 Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue London NW9 5HT CPA 2904 PHE Microbiology Services Porton Down Salisbury Wiltshire SP4 0JG CPA 1612 Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 214 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner CPA UKAS accreditation Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street Hospital for Tropical London Malaria antibodies PCR Diseases WCI1E 6JB CPA 2354 AMRHAI PHE Colindale Bacteriology 61 Colindale Avenue LONDON PHE Centre for NW9 SHT MRSA typing Infections Tel 020 8200 4400 ext 6511 CPA 1834 Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue Mumps PCR PHE Colindale London NW9 5HT CPA 2904 PHE Newcastle Mycobacterium Reference Unit Level 2 Freeman Hospital Mycobacterium identification High Heaton Newcastle and sensitivity Newcastle PHE NE7 7DN CPA 0200 Department for Bioanalysis amp Horizon Technologies PHE Colindale 61 Colindale Avenue LONDON Nocardia PHE Colindale NW9 SHT CPA 2792 Printed 24 7 2015 3 54 AM Valid on day of issue only
76. Special None known precautions Laboratory Information Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 153 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Measurement Not applicable units Turnaround Culture up to 3 weeks time Microscopy 24 48 hrs Clinical Information Clinical decision points Clinical advice on Mycology results is available by contacting the laboratory Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Copy no FREE TO PRINT Edition no 6 Page 154 of 221 Author Microbiology Management Team Date of issue 19 December 2014 Document no MMMP QU MAN1 Authorised by Dr AJL Turner Neisseria meningitidis Functional antibody to serogroups A C W and Y by internationally standardised serum bactericidal antibody assays General Information Back to Index Collection container including preservatives Clotted Blood serum paired sera no preservatives Specimen transport Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Minimum volume of sample Minimum volume 0 2mL per serogroup Specimen type C
77. T The Virology department provides a comprehensive screening and diagnostic service including specialised testing for most of the North West of England Some of the reference facilities are offered nationally The total workload is in excess of 150 000 samples 300 000 tests per annum Laboratory opening hours The laboratory is open Monday to Friday 8 30am 5 00pm Saturday 8 30am 12 30pm A restricted urgent testing service is available see 10 7 below outside normal working hours by contacting the on call Biomedical Scientist BMS via the Hospital Switchboard 0161 276 1234 Clinical Advice A full clinical advice service is maintained 24 hours a day For advice during normal working hours Tel 0161 276 8853 For Clinical advice out of hours Tel 0161 276 1234 and ask for the duty Consultant Virologist Results Result and other enquiries can be made to the microbiology call centre Result enquiries Tel 0161 276 8788 8854 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 13 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Results will only be telephoned when requested or if there is a clinically significant result Notification of Delayed Results Where results will be delayed beyond expected turn round times due to circumst
78. Telephone the laboratory in advance for urgent microscopy Clinical Information Factors known to significantly affect the results If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 52 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Candida PCR Molecular Microbiology General Information Back to Index Collection container EDTA blood collection tube including preservatives Specimen Type EDTA Blood Sputum CSF BAL swabs Specimen transport Ambient or refrigerated Transport at ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Type and minimum 5mL of EDTA blood volume of sample A minimum of 1mL of a bronchoalveolar lavage in a sterile screw capped plastic container should arrive at the laboratory within 1 working day The sample should not be frozen but should be stored at 4 C before dispatch and kept cool during transport to the laboratory Non invasive samples such as sputum and EDTA blood may be used if BAL is unobtainable A minimum of 0 5mL of whole CSF Do not centrifuge Use a small capa
79. Venous Blood Collection 6mL blood tube Specimen transport No special needs Minimum volume of 2mL sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units S CO Biological reference Not applicable units Turn round time for 3 days Turn round time to 4 days Provisional result Final result calendar calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 112 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis B virus HBV core antibodies Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum 2mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient preca
80. Viral Load Ward Department Surgery Heath Centre o La o o oO oO Mumps Immunity 19G NEW HIV Immunity Screen Rubeta immuntty 19G Syphilis Screen Syphilis Contrmation Toxoplasma Serology VZV Immunity 19G Omer Serology specify FILL BOXES LIKE THIS X Syphilis PCR Trichomonas vaginalis TMA VZV PCR Other specify HIV Antiviral Resistance Protease RT _ integrase Clinical Features LMP famm LAOTI Serological Screening for Infections 7 mis cioffed Dood C Hepatitis B surface Antigen Screen HIV Screen Rubella Immunity Syphilis Screen Additional Serological Tests Required 7 mis clotted diood C cmv Recent intection oO C cmv immunty Li C Hepatitis C Screen o C Parvovirus 613 Recent intecton C Li CO Parvovirus 519 immunity VIROLOGY amp SEROLOGY REQUEST ANTENATAL SEROLOGY x lt FILL BOXES LIKE THIS FILL BOXES LIKE THIS C Rupeta Recent infection Toxoplasma Serology Variceta Zoster virus Recent infection Vanceta Zoster virus immunity Other specify I contact of rash Date of contact amay Contact Detalis eg contact of chickenpox shingles parvovirus Printed 24 7 2015 3 54 AM Valid on day of issue only VIROLOGY amp SEROLOGY REQUEST DRIED BLOOD SPOT TESTING FIVE FULL SPOTS of whole blood FILL BOXES LIKE THIS X C 1 Hepatis C Soreen RNA wal be pertormed ant HCV r
81. Viral haemorrhagic fever ACDP algorithm and guidance on management of patients available on hyperlink below http www hpa org uk Topics InfectiousDiseases InfectionsAZ ViralHaemorrhagicFever Gu idelines 5 0 SPECIMEN ACCEPTANCE POLICY This policy ensures adequate identification criteria for Pathology specimens and request forms in order for them to be accepted by the laboratory for analysis It is the requesters responsibility to ensure that all details are correct clearly written and that the specimen details match those on the form and patient wrist band if applicable Inadequately or inaccurately labelled specimens or forms will not be accepted unless they are considered to be unrepeatable A classification of unrepeatable will be on an individual basis and in these cases the requester may be required to come to the laboratory to amend their request information and to document that they have done SO Any labelling discrepancy will be included on the pathology report Inadequate or inaccurate labelling results in delays before pathology results are available and hence affects patient care Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 30 of 221 Author Microbiology Management Team Specimens MUST be labelled with a minimum of 3 unique i
82. a IgM Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen No special needs transport Minimum volume 2 mL of sample Special All samples are suitable for overnight refrigeration only they must not precautions be stored over a weekend Laboratory Information Measurement IU mL units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 197 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Treponema pallidum syphilis PCR Molecular Microbiology General Information Back to Index Collection container CE marked leak proof container including preservatives Specimen Type Swab Specimen transport Ambient or refrigerated Minimum volume of Not applicable sample Special precautions Send to the laboratory without delay Laboratory Information
83. able points Factors known to False negative results may occur for a variety of reasons for significantly affect example inappropriate timing of sample collection inappropriate the results sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 138 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Human T Lymphotropic virus HTLV 1 and 2 Virology Tropical spastic paraperesis General Information Collection container including preservatives Specimen Type Back to Index 6mLclotted blood tube Venous Blood Collection 2mL blood tube Specimen transport Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Minimum volume of 3mL sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Turn round time for Provisional result calendar days 3
84. acking instruction 650 Minimum volume 2 mL of sample Special If processing is delayed refrigeration is preferable to storage at precautions ambient temperature Delays of over 48hr are undesirable Laboratory Information Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 176 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Respiratory Samples for Culture Bacteriology General Information Back to Index Collection container including preservatives Specimen Type Bronchial aspirate transthoracic aspirate bronchoalveolar lavage transtracheal aspirate bronchial brushings protected catheter specimens bronchial washings endotracheal tube specimens sputum expectorated Collection All specimens should be fresh and taken before antimicrobial treatment is started Specimen transport If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Minimum volume of 1 mL sample
85. acterisation of pathogens Consultant microbiology staff have a leading role in establishing the clinical utility of the service The total workload is approximately 300 000 specimens 600 000 tests per annum Laboratory opening hours The laboratory is open Monday to Friday 8 30am 5 00pm Saturday 8 30am 12 30pm Sunday October to March 09 00 to 1 00pm Clinical Advice A full clinical advice service is maintained 24 hours a day For advice during normal working hours Tel 0161 276 8853 5686 For Clinical advice out of hours Tel 0161 276 1234 and ask for the duty Consultant Virologist For technical advice during normal working hours Tel 0161 276 8833 For testing out of hours There is no routine out of hours service for molecular diagnostics Results Result enquiries can be made through the microbiology call centre Tel 0161 276 8788 8854 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 12 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Results will only be telephoned when requested or if there is a clinically significant result For Contact Details see here 4 1 4 VIROLOGY DEPARTMENT Introduction The Clinical Virology Department of the MMMP is situated on the third floor of the Clinical Sciences Centre at CMF
86. actors known to significantly affect the results Haemolysis Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 87 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Epstein Barr Virus EBV IgM screening General Information Back to Index Collection 6mL clotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum 2mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement U mL units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issu
87. ak proof container Specimen Type EDTA Blood Collection Freshly drawn whole blood in EDTA Specimen Blood to arrive at the laboratory within 6 hours of being drawn transport Minimum 3 0 mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Turn round time for Provisional result calendar days Turn round time to Final result calendar days 7 days 10 days Urgent results available by prior arrangement Clinical Information Treatment information In order to provide a more complete service it would be helpful for us to know the treatment history of the patient results of previous tests and if possible CD4 counts A specific request form for tropism will be supplied on request Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only HIV 1 and 2 antibody and p24 antigen screen Dried Blood Spot Virology This service is designed for those patients on whom it is difficult to obtain venous blood especially for intra venous drug users Contact the laboratory for supply of postal packs containing all necessary items for using this service Paediatric infant packs are available on request General Information Back to Index Collection Envelope with dessicant container inc
88. al Information Clinical decision Not applicable points Factors known to Sensitivity of the microscopy may be reduced if the biopsy is submerged significantly in the saline because mucus globules form and production of a affect the results satisfactory smear becomes difficult Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Copy no FREE TO PRINT Edition no 6 Page 105 of 221 Author Microbiology Management Team Date of issue 19 December 2014 Document no MMMP QU MAN1 Authorised by Dr AJL Turner Hepatitis A virus HAV IgG Virology General Information Back to Index Collection container including preservatives 6mLclotted blood tube Specimen Type Venous Blood Collection 6mL blood tube Specimen transport Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Minimum volume of sample 2mL Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Turn round time for Provisional result calendar days Turn round time to 4 days Final result calendar days 3 days Clinical Information Clinical decision points Not applicable Factors known to significantly af
89. al recognition for all of the assays that encompass serum bactericidal antibody assays and ELISA for all serogroups of N meningitidis as well as offering determination of IgG concentrations for pneumococcal serotype specific Haemophilus influenzae type b tetanus and diphtheria The VEU underpinned the implementation of the meningococcal serogroup C conjugate vaccine in the U K with performance of meningococcal serological assays and redefining the correlates of protection Currently the VEU is involved in a similar project that has led to the implementationof a serogroup A vaccine in Sub Saharan Africa The VEU is currently collaborating on studies with the Saudi Arabian Ministry of Health to inform on future immunisation policies It offers a range of validated assays for meningococcal serogroup B and is involved in many vaccine trials both here and overseas The pneumococcal serology assays are now widely used by clinicians as well as for vaccine trials and were incorporated into the vaccine surveillance of the impact of the pneumococcal conjugate vaccination programme for children in England Wales and Northern Ireland The VEU also now houses the Seroepidemiology Unit SEU VEU has been involved in serosurveys for pneumococcal antibodies meningococcal serogroups A C Y and W as well as serogroup B serology and human papilloma IgG VEU also evaluate new kits for the SEU The total workload is approximately 200 000 assays per annum The VEU has
90. ances beyond our control a duty consultant will notify clinicians of such delays if it is believed that the delay will adversely affect a patient s management Out of hours Service The Virology out of hours service is an emergency service A limited number of investigations are offered out of normal laboratory hours i e 17 00 08 30 weekdays 12 30 to 08 30 Saturdays and 08 30 to 08 30 Sundays and Bank Holidays where urgent results are required The duty BMS can be contacted through MRI switchboard 0161 276 1234 The following assays are available as appropriate Hepatitis B surface antigen Hepatitis C antibody HIV antigen antibody HTLV antibody CMV IgG antibody Hepatitis B core antibody total Toxoplasma antibody Varicella zoster IgG Treponemal antibody Legionella urinary antigen Pneumococcal urinary antigen Requests for additional tests Additional tests can be requested by telephone or letter on samples received by the laboratory up to 2 years after the receipt of the sample although it must be recognised that the archive sample available will have a limited volume and the antibody profile may be different to their current sample Issue of immunoglobulin Ig Specific immunoglobulin for prophylaxis of hepatitis B and Varicella zoster and normal immunoglobulin for prophylaxis of hepatitis A and measles are available Specific immunoglubulin and vaccine are available for rabies as part of the national rabies immun
91. and container Nose and or throat swab virus transport medium BAL Sputum sterile container NPA Sterile container Specimen transport Ambient or refrigerated Minimum volume of sample Minimum volume 500ul Special precautions For avian flu please contact the laboratory with full travel history Laboratory Information Measurement units Threshold cycle CT Biological reference units Not applicable Turn round time for Provisional result calendar days 2 days Turn round time to Final result calendar days 3 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results All samples are suitable for overnight refrigeration only they must not be stored over a weekend False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 178 of 221 Document no MMMP QU MAN1 Author Mic
92. assay is 200 10 mL Hepatitis B infected health care workers Qualitative PCR e Two samples of a minimum of 10mL of blood in EDTA should be taken from the health care worker a week apart and should be sent separately and as soon as possible after sampling to the laboratory The laboratory request form should be photocopied locally and both copies sent with the request Minimum volume of 3 0 mL sample Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 117 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Special precautions All samples are suitable for overnight refrigeration only they must not be stored over a weekend Laboratory Information Measurement units IU mL Dynamic range The dynamic range for this assay is 10 10 copies mL Turn round time for 3 days Turn round time to 4 days Provisional result Final result calendar calendar days days The results of in house tests will be available within 5 working days after receipt of the specimen in the laboratory and may be available sooner by prior agreement Specimens sent from hepatitis B infected health care workers are sent to the Regional Virus Laboratory Gartnavel General Hospital Glasgow where they are divided and an aliquot
93. ays days Clinical Information Clinical decision points Not applicable Factors known to Spots too small not all spots filled with blood significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 120 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis C antibody HCV screen and confirmation Virology General Information Backto Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Specimen Ambient temperature via porter courier Royal Mail or DX compliant with transport IATA packing instruction 650 Minimum 2 mLVenous Blood volume of sample Special All samples are suitable for overnight refrigeration only they must not be precautions stored over a weekend Laboratory Information Measurement Not applicable units Turnaround Rountine 2 3 days time Please contact the laboratory if urgent for 4 hour turnaround screen only Clinical Information Clinical Not applicable decision points Factors known Haemolysis to significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Copy no FR
94. before antimicrobial therapy where possible precautions Laboratory Information Turnaround 24 72 hrs for culture time 30 60 mins for microscopy if telephoned in advance Clinical Information Factors known Where media and smears are inoculated at the patient s side they must to significantly be transported immediately to the laboratory for processing affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 66 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Corneal Scrape Virology General Information Back to Index Collection CE marked leak proof containerwith or without virus transport media container including preservatives Specimen Type Corneal Scrape for Microbial Viral PCR Specimen Specimens should be transported and processed as soon as possible transport Minimum Not Applicable volume of sample Special Care with small sample size precautions Laboratory Information Turnaround 24 48 hrs time Clinical Information Factors known None Known to significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiol
95. cable units Biological Not applicable reference units Turnaround time 3 days Same day testing offered contact the laboratory for 4 hour turnaround screen and confirmation for same day request only Clinical Information Clinical decision points Not applicable Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 136 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner HIV viral load Molecular Microbiology General Information Back to Index Collection container including preservatives CE marked leak proof container Specimen Type EDTA Blood CSF Collection Freshly drawn whole blood in EDTA Specimen transport Ambient or refrigerated Minimum volume of sample 3 0 mL Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Copies mL Dynamic range The dynamic range for this assay is 40 10 copies mL Biological reference units Not applicable Turn round time for Provisional result calendar days Tu
96. ce in sealed plastic bags Any available pus should be sampled as well as the lesion of interest Swabs for bacterial and fungal culture should be placed in Amies transport medium with charcoal Specimen Type Pus Eye Swab Small syringes 0 25ml containing pus will be accepted but the needle MUST be removed before submission Specimen transport e g at room temperature or within 4 hrs If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Minimum volume of sample Not applicable Laboratory Information Measurement units Not applicable Biological reference units Not applicable Turn round time for Provisional result calendar days 24 hrs Turn round time to 48 72hrs Final result calendar days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results Collect specimens before antimicrobial therapy where possible and preferably before application of local anaesthetic Printed 24 7 2015 3 54 AM Valid on day of issue only Limitations Superficial swabs although not ideal may be all that is available Deep seated samples if available should be sought Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Departme
97. ce of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 60 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Clostridium difficile Bacteriology C difficile is a Gram positive spore forming strictly anaerobic rod so named because of the difficulty in original culture and characterisation Toxigenic strains produce large protein toxins A and B both being major virulence factors Most disease associated with C difficile is intestinal though C difficile may be isolated from blood or tissues General Information Back to Index Collection container Collect specimens in appropriate CE marked leak proof containers including and transport specimens in sealed plastic bags g preservatives a Iy 5 Specimen Type Faeces Collection Specimen may be passed into a clean dry disposable bedpan or similar container and transferred into a CE marked leak proof container The specimen is unsatisfactory if any residual soap detergent or disinfectant remains in the pan Specimen tra
98. chain of evidence 10 0 RESEARCH amp DEVELOPMENT Research and development are key parts of the activity of MMMP and contribute to the scientific basis of the advice and services that the Partnership provides both for clinical and public health microbiology Current R amp D activity spans Vaccine evaluation for clinical trials performed under MHRA GCLP e g meningococcal pneumococcal Serosurveys eg measles mumps rubella varicella pneumococcal Technology e g techniques for rapid diagnosis and molecular epidemiology Evaluation of new platforms eg MesoScale Discovery Quickplex Public health microbiology e g collaborative projects on meningococcal infections and gastrointestinal infections Printed 24 7 2015 3 54 AM Valid on day of issue only
99. city screw capped container Special precautions Samples should be stored at 4 C and dispatched as soon as possible after being drawn If longer storage is unavoidable serum or plasma may be stored frozen but should not be repeatedly frozen and thawed In special circumstances 0 5mL of serum or plasma can be tested but for such small volumes avoid using a large container use a small capacity container with a screw cap such as an Eppendorff tube Laboratory Information Measurement units Threshold Cycle CT Biological reference Not applicable units Turn round time to 6 days Final result calendar days if urgent please contact the laboratory Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 53 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Clinical Information Clinical decision Not applicable points Factors known to All samples are suitable for overnight refrigeration only they must significantly affect not be stored over a weekend the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which ma
100. crobiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 161 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Mycobacteria Culture and Sensitivity Bacteriology General Information Back to Index Collection Use aseptic technique container Collect specimens in appropriate CE marked leak proof containers and including transport in sealed plastic bags preservatives Specimen Sputum gastric washing sterile site body fluids CSF pleural fluids etc Type urine skin or tissue biopsies bone marrow bronchoalveolar washings blood post mortem specimens bone Collection If sample volume is insufficient for both culture is usually preferred to microscopy due to greater sensitivity Specimen Specimens should be transported and processed as soon as possible transport Specimens should be transported and received in the laboratory within one working day of collection and processed as soon as possible Requirements of individual testing laboratories should be referred to If processing is delayed refrigeration is preferable to storage at ambient temperature Blood and Bone Marrow Request the MB BacT blood culture bottles from the laboratory on 291 4424 and request a porter to collect These bottles MUST NOT be sent via the pod system Sputum specimens Sputum specimens should be relatively fresh
101. ct you and to protect the sample from a sharps container 2 Ensure the patients hands are clean If the hands are cold ask the patient to rub them together It is important the puncture site is warm 8 Spot blood onto each of the 5 circles on the card To en puncture si sure enough blood flow pepekna the puncture site down Clean site with alcohol wipe then dry a a NOTE FILL each circle with blood Failure to do so may reduce the sensitivity of the screening tests 4 Break the Seal by Twisting 5 Hold the lancet with two 9 Leave the card to dry for a minimum of 30 minutes fingers and place at the puncture site 10 Place card along with one bag of desiccant in the plastic carrier attached to the request from 11 Ensure the required details 6 Gently apply pressure until have been entered on both the the lancet is activated request form and the dried A click sound will blood spot card Place the re be heard when this has quest card in the envelope happened vided and send back to the laboratory Specimen No special needs transport Minimum 7mm Dried blood spot card volume of sample Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 185 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner S
102. cted according to local protocols Ideally a separate sample for PCR processing should be obtained Specimen transport Ambient or refrigerated Minimum volume of sample Minimum volume 500ul Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Threshold Cycle CT Biological reference units Not applicable Turn round time for Provisional result calendar days Turn round time to Final result calendar days 3 days 4 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 128 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Tu
103. d cycle CT units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to None known significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Edition no 6 Page 86 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Epstein Barr Virus EBV IgG screening General Information Collection container including preservatives Specimen Type Back to Index 6mLclotted blood tube Venous Blood 6mL blood tube Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Collection Specimen transport Minimum volume of 2 mL sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units U mL Turn round time for Provisional result calendar days 3 days Turn round time to Final result calendar days 4 days Clinical Information Clinical decision points Not applicable F
104. d on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 199 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner For Mycobacteria culture collect 3 consecutive early morning urine samples in 200mL containers Special precautions Specimens should be transported and processed within 4 hr Laboratory Information Measurement units X10 L WBC RBC Urine culture is quanitified cfu Biological reference Not applicable units Turnaround time 30 60 mins for cell count if laboratory contacted prior to sending 24 72 hrs for culture Clinical Information Clinical decision Not applicable points Factors known to Collect specimens before antimicrobial therapy where possible significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 200 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Varicella zoster IgG Virology General Information Back to Index Collection 6mL clotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL b
105. days Turn round time to Final result calendar days 4 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results Haemolysis Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 139 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner JC virus PCR Molecular Microbiology General Information Back to Index Collection container including preservatives CE marked leak proof container Specimen Type EDTA blood urine CSF Specimen transport Compliance with current postal and transportation regulations is essential Clinical samples should be collected into a sterile leak proof container in a sealed plastic bag Appropriate hazard labelling according to local policy should be applied Specimens should be transported and processed as soon as possible If processing is delayed refrigeration is preferable to storage at room temperature Minimum volume of sample Minimum volume 500ul Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Copies
106. dentifiers from unique identification number eg hospital number Last name First name Date of birth The request form data MUST match the above information on the specimen or be labelled with another suitable unique identifier Drug administered dose time of last dose time of specimen in relation to dose for therapeutic drug monitoring Multiple specimens taken at different times ona patient MUST be labelled on the specimen container with the time 24 hr clock when the specimen is taken The request form should be labelled accordingly Printed 24 7 2015 3 54 AM Authorised by Dr AJL Turner No analysis will be performed The event may be reported as an incident on the Trust incident report system Where the specimen is repeatable reproducible no analysis will be performed and the specimen will be discarded Where the specimen is unrepeatable unreproducible the risk to the patient of rejection of the specimen must be weighed against the risk of acceptance of a wrongly labelled specimen local procedures will be followed Laboratory Medicine will accept no responsibility for specimens analysed which initially failed to meet the acceptance criteria and will issue a disclaimer on such reports A lack of patient or specimen information may result in the laboratory not conducting the analysis examination Examples could include no swab site indicated no dates and times of sampling no clinical details given
107. e container Clean container for CSF including preservatives Specimen Type Clotted Blood CSF Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum 1 5 mL blood volume of 0 5 mL CSF sample Special All samples are suitable for overnight refrigeration only they must not precautions be stored over a weekend Laboratory Information Turn round time 5 days Turn round time to 7 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Dried Blood Spot Syphilis antibody This service is designed for those patients on whom it is difficult to obtain venous blood especially for intra venous drug users Contact the laboratory for supply of postal packs containing all necessary items for using this service Paediatric infant packs are available on request General Information Back to Index Collection Envelope with dessicant container including preservatives Specimen Dried blood spot card Type Collection Sample Collection 1 Disposable gloves should be worn for the whole 7 Safely discard the lancet in Procedure to prote
108. e 19 December 2014 Page 88 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Epstein Barr Virus EBNA confirmation General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum 2mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement U mL units Turnaround time 3 days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 89 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Epstein Barr virus viral load Molecular Microbiology General Information Back to Index Collection container CE marked leak proof container including preservatives Specimen Type EDTA blood Specimen transport A
109. e points Factors known to All samples are suitable for overnight refrigeration only they must not significantly affect be stored over a weekend the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Copy no FREE TO PRINT Edition no 6 Page 203 of 221 Author Microbiology Management Team Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Authorised by Dr AJL Turner Wounds Skin Superficial Non surgical Bacteriology Infections of the skin and subcutaneous tissues are caused by a wide range of organisms Organisms isolated from a clinically infected wound may be clinically significant but this decision needs to be made in conjunction with clinical details Examination of biopsies might be more effective for diagnosis than swabs See Tissue amp Biopsy Section General Information Back to Index Specimen Unless otherwise stated swabs for bacterial and fungal culture should then container be
110. e inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 44 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner BK virus PCR Molecular Microbiology General Information Back to Index Collection container including preservatives CE marked leak proof container or 5mL EDTA blood collection tube Specimen Type EDTA whole blood CSF urine Specimen transport Compliance with current postal and transportation regulations is essential Clinical samples should be collected into a leak proof container in a sealed plastic bag Appropriate hazard labelling according to local policy should be applied Specimens should be transported and processed as soon as possible If processing is delayed refrigeration is preferable to storage at room temperature Minimum volume of sample Minimum volume 500ul Special precautions All samples are suitable for overnight refrigeration only they must n
111. e only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 181 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Streptococcal serology including anti streptolysin O and anti streptodornase B General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant with transport IATA packing instruction 650 Minimum 2 mL blood tube volume of sample Special Single or paired sera collected 7 days apart precautions Laboratory Information Measurement ASD U mL units ASO IU mL Biological Not applicable reference units Turn round 5 days Turn round time to 7 days time for Final result calendar Provisional days result calendar days Clinical Information Clinical Not applicable decision points Factors known Haemolysis to significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 182 of 221 Author Microbiology Management Team
112. eactve C 2 Hepatts C GENOTYPE O aHW sereen C 4 Hepattis 8 Screen surface antigen and ant core O 1 Former iou O Zoro C 3 Sood Transtusion C 4 Brood Product or Transpiant Reopient zo C 6 Other Known Risk spectty PTT TTT THE CHRISTIE Virology Request C Lene Fsnplatery Trad titin C Patean C Upper aapa Tretia C Pyeti D laroanpnded C Myraeita Arianiti C Mecetegiad Otsas phe dad Z Want Bori ane Prockcts phe cated C epep O aghi ernie C i is O Taam eco C m aen O m e Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 26 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 4 3 3 VEU Request Forms The forms for the requesting of VEU investigations have been developed to be consistent with other MMMP request forms You are strongly requested to use these new forms in preference to any other including previous versions of VEU request forms please destroy all previous versions in order to improve the way in which your requests are dealt with VACCINE PREVENTABLE SEROLOGY X Latoratory Number PTTL Time PTL Sender s Referral Number Clinical Features FILL BOXES UKETHIS X ee Give detalis Post vaccination a ee Gve detalis Jone
113. eam Authorised by Dr AJL Turner Contact Details External Numbers Internal Numbers Prof Ray Borrow 0161 276 8850 68850 Head of VEU Consultant Clinical Scientist Dr Jamie Findlow 0161 701 5303 15303 Deputy Head of VEU Clinical Scientist Dr Emma Newton 0161 276 6791 66791 Clinical Serology Clinical Scientist SEU Mirs Nicola Boothman 0161 276 5697 65697 PA Unit Administrator i Mrs Nilofer Razzaq 0161 276 5697 65697 PA Unit Administrator Mrs Debbie Cummings 0161 276 6793 66793 PA Unit Administrator VEU Fax No 0161 276 5744 Po Postal Address Vaccine Evaluation Unit MMMP 2 4 Floor CSB2 PO Box 209 Manchester Royal Infirmary Oxford Road Manchester M13 9WL Courier Delivery Address Vaccine Evaluation Unit MMMP 2 Floor CSB2 Manchester Royal Infirmary Oxford Road Manchester M13 9WL DXAddress Manchester Medical Microbiology Partnership DX6962410 Manchester 90 M Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 19 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 4 1 7 MYCOLOGY REFERENCE CENTRE MANCHESTER Introduction The clinical Mycology Reference Centre Manchetser MRCM is situated on the second floor of the Education amp Research Centre at Wythenshawe Hospital UHSM Trust The MR
114. eneral Information Back to Index Collection container including preservatives Clotted blood sample tube no preservative Specimen Type Clotted Blood serum paired sera Specimen transport Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Minimum volume of sample Minimum volume 0 6mL Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units SBA Titres expressed as the reciprocal of the final serum dilution giving 50 killing at 60 minutes calculated from the number of colony forming units cfu in the control Biological reference units Not applicable Turnaround time 28 Working Days Clinical Information Clinical decision points For putative protection against serogroup B the SBA titre must be 2 4 for at least 2 of the 3 strains used Factors known to significantly affect the results As this is a killing type assay using live bacteria antibiotics can impact on results A control to monitor this is included in the assay The effect and impact of Eculizumab therapy on this assay is currently under investigation Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO
115. ential Clinical samples should be collected into a sterile leak proof container in a sealed plastic bag Appropriate hazard labelling according to local policy should be applied Specimens should be transported as soon as possible Minimum Minimum volume 500ul volume of sample Special If processing is delayed refrigeration is preferable to storage at room precautions temperature Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 84 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Laboratory Information Measurement Threshold cycle CT units Biological Not applicable reference units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to All samples are suitable for overnight refrigeration only they must not significantly be stored over a weekend affect the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay To
116. esses are as follows Manchester Medical Microbiology Partnership PO Box 209 Clinical Sciences Centre Manchester Royal Infirmary Oxford Road Manchester M13 9WL Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 5 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Manchester Medical Microbiology Partnership DX6962410 Manchester 90 M The Microbiology Department at University Hospital of South Manchester is situated in the Clinical Sciences Building at Wythenshawe Hospital on Southmoor Road The postal and DX addresses are as follows Microbiology Department Clinical Sciences Centre Wythenshawe Hospital Southmoor Road Wythenshawe Manchester M23 9LT Manchester Medical Microbiology Partnership DX6968006 Northenden 90 M The Mycology Reference Centre Manchester MRCM is situated in the Education and Research Centre Wythenshawe Hospital The postal and DX addresses are as follows Mycology Reference Centre Manchester MRCM 2nd Floor Laboratory Education and Research Centre Wythenshawe Hospital Southmoor Road Manchester M23 9LT Manchester Medical Microbiology Partnership DX6968006 Northenden 90 M 3 0 QUALITY ASSURANCE The department has full Clinical Pathology Accreditation CPA UK Reference No 0635 for microbiology serv
117. esults Any recent antimicrobial therapy can have a significant effect on blood culture results by decreasing the sensitivity of the test This may be of particular importance in those patients receiving prophylactic antibiotics and who are at high risk of bloodstream infections If patients have received previous antimicrobial treatment bacteraemia should be considered even if blood culture results are negative There is a direct relationship between blood volume and yield with approximately a 3 increase in yield per mL of blood cultured False negatives may occur if inadequate blood culture volumes are submitted Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 47 of 221 Author Microbiology Management Team Limitations Authorised by Dr AJL Turner It is estimated that 2 5 of positives samples may be missed if bottles are pre incubated these organisms may fail to trip the threshold algorithm of the continuous monitoring blood culture machine This may occur with Abiotrophia species nutritionally variant streptococci S pneumoniae which have undergone a degree of autolysis and fastidious organisms which are unable to grow on routine solid culture media Organisms may include e Campylobacter species e Helicobacter species e Capnophilic orga
118. ex Collection container including preservatives Intravascular cannulae Tips should be collected in CE marked leak proof container Specimen Type Line tips eg CVP or Hickman lines Collection Collect specimens in appropriate CE marked leak proof containers and transport specimens in sealed plastic bags Specimen transport Specimens should be transported and processed as soon as possible If processing is delayed refrigeration is preferable to storage at ambient temperature Minimum volume of sample Cut off 4 cm of the tip Special precautions Disinfect the skin around the cannula entry site remove cannula using aseptic technique and cut off 4cm of the tip into an appropriate CE marked leak proof container using sterile scissors Place in sealed plastic bags for transport Cannulae should only be sent if there is evidence of infection Laboratory Information Measurement units Not applicable Biological reference units Not applicable Turn round time for Provisional result calendar days 24 hrs Turn round time to 48 72 hrs Final result calendar days Clinical Information Clinical decision points Not applicable Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Copy no FREE TO PRINT Edition no 6 Date of issue 19 December
119. fect the results Haemolysis Assay interference and generation of anomalous results can occur when a patients sample contains Heterophile antibodies Animal serum products from routine exposure to animals Human mouse monoclonal antibodies patients who receive Preparations of mouse monoclonal antibodies for diagnosis or therapy Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 106 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis A virus HAV IgM Virology General Information Back to Index Collection container 6mLclotted blood tube including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen transport Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Minimum volume of 2 mL sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Turn round time for 3 days Turn round time to 4 days Provisional result Final result calendar calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haem
120. for Tropical Diseases Mortimer Market Capper Street Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street Valid on day of issue only London WCI1E 6JB CPA 2354 London WCI1E 6JB CPA 2354 London WCI1E 6JB CPA 2354 London WCI1E 6JB CPA 2354 Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 218 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Great Ormond Street Hospital NE Great Ormond Street Thames Regional Genetics Service VZ antibodies typing Hospital Laboratories PHE Microbiology Services Porton Down Salisbury West Nile Virus RIPL Porton Down Wiltshire SP4 O0JG CPA 1612 Gastrointestinal bacterial reference unit GBRU PHE Colindale Bacteriology 61 Colindale Avenue LONDON Yersinia PHE Colindale NW9 5HT CPA 1683 PHE Microbiology Services Porton Down Salisbury Yellow Fever RIPL Porton Down Wiltshire SP4 0JG CPA 1612 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 219 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by
121. ge 81 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Ear Bacteriology General Information Back to Index Collection container Collect swabs into Amies transport medium with charcoal and including transport in sealed plastic bags Numbers and frequency of preservatives specimen collection are dependent on clinical condition of patient Fine wire swabs can be used for inner ear swabs these swabs do not contain any charcoal media as such they should be transported promptly to the laboratory to prevent dessication Specimen Type Ear Swab T AE SENES pr Collection For investigation of fungal infection scrapings of material from the ear canal are preferred although swabs can also be used Specimen transport Collect specimens in appropriate CE marked leak proof containers e g at room and transport specimens in sealed plastic bags temperature or Collect swabs into Amies transport medium with charcoal and within 4 hrs transport in sealed plastic bags For investigation of fungal infection use an appropriate method to transport scrapings of material from the ear canal Minimum volume of Not applicable sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Not applicable Biological reference No
122. gent tests time 2 hrs turnaround time Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 174 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results The Clinitest hCG Pregnancy Test is not validated for use with urine samples containing preservatives Skin cleansers containing chlorhexadine may affect the accuracy of the result High protein concentrations eg blood staining will cause a falsely elevated Specific Gravity result Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 175 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Q Fever Coxiella burnettii IgG and IgM Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Paired sera preferred Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA p
123. gt 0 1 of IU mL considered protective points Factors known to none known significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 188 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Throat Swab for Culture Bacteriology General Information Back to Index Collection container Collect specimens in appropriate CE marked leak proof containers including and transport specimens in sealed plastic bags preservatives Collect swabs into Amies transport medium with charcoal and transport in sealed plastic bags b Specimen Type Swab Collection Throat swab taken from the tonsillar area and or posterior pharynx should be taken avoiding the tongue and uvula Specimen transport Specimens should be transported and processed as soon as possible Minimum volume of Not applicable sample Special precautions Fastidious anaerobes such as Fusobacterium necrophorum will not be recovered from samples that are delayed When Diptheria is suspected advice from a Consultant Microbiologist should be sought prior to sample submission Scarlet fever presentations should be noted on the request form as they are notifiable Pharyngeal swabs for N meningitidis carriage sh
124. gy Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 150 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Mycoplasma pneumoniae particle agglutination Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Venous Blood Type Collection 6mL blood tube Paired sera preferred Specimen Ambient temperature via porter courier Royal Mail or DX compliant with transport IATA packing instruction 650 Minimum 3mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement Not applicable units Turn round 3 days Turn round time to 4 days time for Final result calendar Provisional days result calendar days Clinical Information Clinical Not applicable decision points Factors Haemolysis known to significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 151 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Mumps IgM V
125. h alcohol wipe then dry Avoid strong repetitive pressure N making it can damage the area A N NOTE FILL each circle with 4 Break the Seal by Twisting blood Failure to do so may PNU reduce the sensitivity of the D screening tests eS 5 Hold the lancet with two 9 Leave the card to dry for a minimum of 30 minutes aoe E 10 Place card along with one bag of desiccant in the plastic carrier attached to the request from zA 11 Ensure the required details 6 Gently apply pressure until 7 en have been entered on both the the lancet is activated a request form and the dried A click sound will blood spot card Place the re S quest card in the envelope pro vided and send back to the laboratory Specimen transport No special needs Minimum volume of 7mm Dried blood spot sample Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 119 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Special precautions Ensure blood spot has dried and submit with dessicant pouch enclosed Laboratory Information Measurement units Not applicable Biological reference Not applicable units Turn round time for 4 days Turn round time to 6 days Provisional result Final result calendar calendar d
126. hen be placed in Amies transport medium with charcoal Specimen Specimens should be transported and processed as soon as possible If transport processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Minimum volume Not applicable of sample Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round time 48 hrs Turn round time to 48 72 hrs for Provisional Final result calendar result calendar days days Clinical Information Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 165 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Clinical decision Not applicable points Factors known to Special considerations to minimise deterioration significantly affect If processing is delayed refrigeration is preferable to storage at the results ambient temperature Delays of over 48hr are undesirable Limitations Back to Index Nasal swabs should not be taken to investigate the presence of Bordetella pertussis Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of iss
127. hey have procedures in place for the protection of information We also have specialist laboratories within the DLM and we receive specimens from around the country Therefore our laboratories have procedures in place for the protection of information When specimens are sent to a referral laboratory we need to send some patient identifiers such as name and date of birth In some tests it is essential to send further information for example symptoms or travel information to allow the referral laboratory to interpret the results for the individual patient In some tests ethnic origin and family details may need to be shared with the referral laboratory Consent to a specimen being taken and analysed is implied by the patient presenting to the point of specimen collection The responsibility for obtaining informed consent for the tests s resides with the individual ordering the test Informed Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 220 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner consent should cover all the tests being done implications of their results and disclosure of clinical and personal details to personnel in the requesting organisation and any other healthcare organisations involved in providing the test 9 2 Laborato
128. his leads to progressive pulmonary disease associated with pulmonary infections which are the major cause of morbidity and mortality in CF patients The major pathogens are S aureus H influenzae usually non encapsulated in CF patients S pneumoniae Burkholderia and Pseudomonads particularly mucoid P aeruginosa strains Strains of P aeruginosa with differing antibiotic susceptibilities may be isolated from a single sample General Information Back to Index Collection container Collect specimens in appropriate CE marked leak proof containers including and transport specimens in sealed plastic bags preservatives Sputum Pleural Fluids BALs Cough Swabs Paediatric CF ys Specimen Type Respiratory specimens Soutum and Cough Swabs Paediatric use only Collection Use aseptic technique Specimen transport Specimens should be transported and processed as soon as possible Paediatric postal samples should be submitted using the kit provided by the Microbiology Laboratory Minimum volume of 5mL sample Special precautions Some complex identification can take several weeks to confirm identity If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Not applicable Biological reference Not applicable units Printed 24 7 2015 3 54 AM Valid on day of issue only Manches
129. ical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 172 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Pneumocystis jirovecii PCR Molecular Microbiology General Information Back to Index Collection CE marked leak proof container container including preservatives Specimen Type EDTA blood BAL sputum Specimen Ambient or refrigerated transport Minimum 500ul volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement Threshold Cyle CT units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to False negative results may occur for a variety of reasons for example significantly inappropriate timing of sample collection inappropriate sample affect the results presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 A
130. ical decision points Not applicable Factors known to The Modified Hodge Test MHT may produce false positive significantly affect the results within isolates that are high level ESBL producers results Occaccisonally isolates can excrete a substance that inhibits the growth of E coli such isolates will be referred for PCR confirmation as the MHT is invalid Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 57 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Chlamydia trachomatis antibody Serology General Information Back to Index Collection container 6mL clotted blood tube including preservatives Specimen Type Venous Blood Collection 6mL clotted blood tube Specimen transport No special needs Type and volume of 2mL sample Special precautions All samples are suitable for overnight refrigeration only they must not be stored over a weekend Laboratory Information Turnaround time 3 days Clinical Information Clinical decision points Not applicable Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRI
131. icantly affect not be stored over a weekend the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 194 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Toxoplasma avidity General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen No special needs transport Minimum volume 2 mL of sample Special All samples are suitable for overnight refrigeration only they must not precautions be stored over a weekend Laboratory Information Measurement Low avidity High avidity units Turn round time 5 days Turn round time to 7 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to
132. ices Quality assurance schemes such as NEQAS QCMD and IQA help make sure the department s high quality standards are maintained An experienced consultant team offers support to clinicians and service users 24 hours a day seven days a week The team provides information related to using the service interpretation of test results and clinical advice on therapy prophylaxis and immunisations Training is accredited by the Institute of Biomedical Science IBMS for biomedical scientist specialist training and by The Royal College of Pathologists for medical training We also support Manchester Metropolitan University delivering training in biomedical science and Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 6 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner have a long standing relationship with The University of Manchester for research and development and post graduate training and supervision 3 1 QUALITY POLICY QUALITY POLICY OF THE MANCHESTER MEDICAL MICROBIOLOGY PARTNERSHIP The Manchester Medical Microbiology Partnership MMMP is a collaboration between the Central Manchester University Hospitals NHS Foundation Trust CMFT and Public Health England PHE MMMP protects the population from infection by detecting diagnosing monitoring and
133. id on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 104 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Gastric Biopsies for Helicobacter pylori Bacteriology General Information Back to Index Collection CE marked leak proof containerin a sealed plastic bag The biopsy should container be placed in a small sterile container such as a bijou bottle containing a including small amount approximately 100uL of sterile isotonic saline to preserve preservatives moisture Specimen Type Gastric biopsies This is the specimen of choice for the culture of H pylori Collection Before antimicrobial therapy where possible Gastric biopsy specimens are usually taken from the gastric antrum at endoscopy and sometimes from the body depending on location of inflammation Specimen Specimens should be transported and processed as soon as possible transport preferably within 6h Minimum At the discretion of the endoscopist as it depends on the individual volume of patient sample Special It is important to maintain a moist atmosphere during transport precautions Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turnaround time Culture result within 10 days Clinic
134. ids Prosthetic amp Natural Cardiac pacemaker site aspirates Stem Cell fluids The FAN green top bottle contains a charcoal neutralising agent and is suitable for PD fluids General Information Back to Index Collection Collect specimens in BactAlert bottle using aseptic technique container including preservatives Specimen Type Venous blood arterial blood peripheral blood sterile fluids Collection A blood culture set is defined as one aerobic Blue Top and one anaerobic Purple top bottle For infants and neonates a single aerobic bottle Yellow top may be requested Small volume sterile fluids such as Pacemaker fluids amp Stem cells can use single aerobic bottle Yellow top Take two consecutive sets from two separate venepuncture sites during any 24hr period for each septic episode For neonates take a single aerobic bottle or special low volume bottle Take two sets during the first hour in cases of severe sepsis prior to commencing antibiotic treatment provided this does not significantly delay antibiotic administration Take at least three sets during a 24hr period where the patient has suspected infective endocarditis m anaerobic purple top bottle Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Edition no 6 Page 46 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Depar
135. ied Blood Spot Virology This service is designed for those patients on whom it is difficult to obtain venous blood especially for intra venous drug users Contact the laboratory for supply of postal packs containing all necessary items for using this service Paediatric infant packs are available on request General Information Back to Index Collection Envelope with dessicant container including preservati ves Specimen Dried blood spot card Type Collection 1 Disposable gloves should be worn for the whole to protect you and to protect the sample from degradation 2 Ensure the patients hands are clean frien cold ask the patient to rub them together It is important the puncture site is warm 3 Identify and clean the puncture site Use one of the outer 3 fingers Avoid finger pad and nail bed Clean site with alcohol wipe then dry 4 Break the Seal by Twisting ae SZN E RE rai Laky when this has k K IPN 5 Hold the lancet with two angee apace e puncture site Sample Collection makapa container K araea 5 circles on the card To en blood flow 9 Leave the card to dry for a minimum of 30 minutes EES ce E plastic carrier attached to the request from 11 Ensure the required details have been entered on both the request form and the dried blood spot card Place the re quest card in the envelope pro vided and send back to the laboratory
136. infection may be difficult to detect clinically in patients whose joints are already inflamed due to rheumatological conditions This is important because these patients are at increased risk of joint sepsis General Information Back to Index Collection Use aseptic technique container Collect specimens in appropriate CE marked leak proof containers and including transport specimens in sealed plastic bags preservatives Specimen Type Universal container Amniotic fluid bursa fluid pericardial fluid synovial joint fluid peritoneal fluid ascites pleural fluid Capped Syringes Vitreous aspirates amp other intra ocular fluids should be injected into a Blood Culture bottle set with a small syringe of fluid submitted for a Gram stain The needle MUST be removed before submission for the laboratory li A Ng A NERA A Collection Collect specimens before antimicrobial therapy where possible Specimen Specimens should be transported and processed as soon as possible transport Minimum volume Ideally a minimum volume of 1 mL of sample Large volume specimens such as peritoneal fluid and ascitic fluid may contain very low numbers of organisms which are usually received in adequate quantities and require concentration to increase the likelihood of successful culture Small volume fluids such as synovial fluids may be received in inadequate volumes which may impede the recovery of organisms Pri
137. ing Severe Acute Respiratory Syndrome Schistosomiasis antibodies Shigella Salmonella Printed 24 7 2015 3 54 AM PHE Colindale PHE Colindale Hospital for Tropical Diseases PHE Colindale Gastrointestinal bacterial reference unit GBRU PHE Colindale Bacteriology 61 Colindale Avenue LONDON NW9 5HT Tel 020 8200 4400 Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue London NW9 5HT Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street London WCIE 6JB Gastrointestinal bacterial reference unit GBRU PHE Colindale Bacteriology 61 Colindale Avenue LONDON NW9 5HT Tel 020 8200 4400 CPA 1683 CPA 2904 CPA 2354 CPA 1683 Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 217 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Strongyloides antibodies Toxocara Trichinosis Trypanosomiasis Printed 24 7 2015 3 54 AM Hospital for Tropical Diseases Hospital for Tropical Diseases Hospital for Tropical Diseases Hospital for Tropical Diseases Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street Clinical Parasitology Department 3rd Floor The Hospital
138. ion points Not applicable Factors known to significantly affect the results Haemolysis mutation Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 108 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis B virus HBV confirmation Virology This test consists of HBsAg anti HBcore and anti HBsand may also include tests for Hepatitis B e antigen Hepatitis B e antibody and Hepatitis B core IgM General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum volume 2 mL of sample Special If processing is delayed refrigeration is preferable to storage at precautions ambient temperature Delays of over 48hr are undesirable Laboratory Information Turnaround time 3 days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Hepatitis B virus HBV core antibody Dr
139. irology General Information Back to Index Collection 6mL clotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum 2mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement Not applicable units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 152 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Mycology Culture and Microscopy Bacteriology Infection by dermatophytes is cutaneous and generally restricted to the non living cornified layers in patients who are immunocompetent This is because the dermatophyte group of fungi are generally unable to penetrate tissues which are
140. ithin two hours of taking excluding blood cultures must be stored in a fridge at 4 C until transported to the laboratory Non urgent specimens collected outside routine laboratory working hours may be stored overnight in the refrigerator with the exception of blood cultures Blood cultures should never be refrigerated but sent directly to the laboratory reception Please contact the laboratory if there are specific questions regarding transportation of specimens 4 4 2 URGENT SAMPLES If a result is required urgently and the sample will arrive during working hours the laboratory MUST be notified by telephone so that we can prioritise your request The result will be phoned through to the requesting doctor so please ensure that contact details are provided on the request form 4 4 3 SAMPLES SUBMITTED OUT OF HOURS ON CALL Urgent specimens out of hours should not be sent before agreement with the laboratory on call staff Urgent specimens must be sent to the laboratory immediately and arrangements made with the portering service All samples should be packaged and transported as above If you need to submit a sample out of normal working hours for testing on call please contact the Biomedical Scientist on call via the hospital switchboard 0161 276 1234 4 4 4 OUTBREAK SAMPLES In addition to its clinical diagnostic microbiology role the PHE lead laboratory in Manchester provides a range of public health microbiology services These incl
141. k to Index Specimen Type and Nose and or throat swab virus transport medium collection container BAL Sputum sterile container NPA Sterile container Specimen transport Ambient or refrigerated Minimum volume of Minimum volume 500uL sample Special precautions None known Laboratory Information Measurement units Threshold cycle CT Turn round time to 2 3 days Final result calendar days Clinical Information Clinical decision Not applicable points Factors known to All samples are suitable for overnight refrigeration only they must significantly affect not be stored over a weekend the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 51 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Peritoneal Fluids Bacteriology Continuous ambulatory peritoneal dialysis
142. l result Final result calendar calendar days days Clinical Information Clinical decision points Not applicable Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Edition no 6 Page 180 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Rubella IgM Virology General Information Collection container including preservatives Back to Index 6mLclotted blood tube Specimen Type Venous Blood 6mL blood tube Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Minimum volume of 2 mL sample Special precautions Collection Specimen transport All samples are suitable for overnight refrigeration only they must not be stored over a weekend Laboratory Information Measurement units IU mL Turn round time for Provisional result calendar days 3 days Turn round time to Final result calendar days 4 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results Haemolysis Printed 24 7 2015 3 54 AM Back to Index Valid on day of issu
143. lace in sealed plastic bags Sample pus if present otherwise sample any lesions or inflamed areas A tongue depressor or spatula may be helpful to aid vision and avoid contamination from other parts of the mouth Specimen transport Use aseptic technique Unless otherwise stated swabs for bacterial e g at room and fungal culture should then be placed in Amies transport temperature or medium with charcoal within 4 hrs Minimum volume of Not applicable sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 147 of 221 Author Microbiology Management Team Laboratory Information Authorised by Dr AJL Turner Measurement units Not applicable Biological reference Not applicable units Turn round time for 24 hrs Turn round time to 48 72 hrs Provisional result Final result calendar calendar days days Clinical Information Clinical decision Not applicable points Factors known to Collect specimens before antimicrobial therapy where possible significantly affect Specimens should be transported and processed as soon as the results possible Prin
144. le site body fluids can be treated with acid if necessary Collect aseptically as much eg gt 6mL in adults CSF sample as possible into a CE Marked leak proof container in a sealed plastic bag If only a small volume is available after initial lumbar puncture and the findings of cell counts and protein suggest TB meningitis asecond procedure should be considered to obtain a larger volume to improve chances of achieving positive cultures It should be noted that pleural or pericardial fluids are not very sensitive samples for the detection of M tuberculosis and that a concurrent pleural or pericardial biopsy taken with the fluid is more useful A negative result on these fluids does not rule out the diagnosis Minimum 1ImL of Sputum volume of 5mL of BAL sample 6mL of CSF Special For the initial diagnosis of mycobacterial infection all specimens should be precautions fresh and taken whenever possible before anti tubercular treatment is started Other antimicrobials may also have significant anti mycobacterial activity notably the fluoroquinolones such as ciprofloxacin levofloxacin or moxifloxacin and the macrolides such as clarithromycin or azithromycin Laboratory Information Measurement Not Applicable units Biological Not Applicable reference units Turnaround 24 hrs to 6 weeks time Mycobacterium PCR available within 3 days Printed 24 7 2015 3 54 AM Valid on day of issue only
145. less than 1 day old to minimise contamination Purulent specimens are best Three samples of gt 5mL should be collected approximately 8 24 hours apart with at least one from early morning Samples taken early morning ie shortly after patient waking have the greatest yield When the cough is dry physiotherapy postural drainage or inhalation of nebulised saline sputum induction before expectoration may be helpful Bronchoalveolar lavage bronchial washings Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 162 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner These may be sent if spontaneous or induced sputum is unavailable or if such specimens are AFB smear negative Note Contamination of the bronchoscope with tap water which may contain environmental Mycobacterium species should be avoided Minimum sample size is preferably SmL Urine specimens Whole urine specimens should be collected in the early morning on three consecutive days in a CE marked leak proof container that does not contain boric acid and placed in a sealed plastic bag Sterile site body fluids Sterile site body fluids CSF pleural fluid etc will normally not require decontamination and can be inoculated directly to neutral media However steri
146. lly we would like to thank you in anticipation of your cooperation in using these forms in the correct way therefore greatly improving the quality and speed of the service we can provide Printed 24 7 2015 3 54 AM Valid on day of issue only MOLECULAR MICROBIOLOGY OLE REQUEST E ETATEN C T a o Printed 24 7 2015 3 54 AM Valid on day of issue only eer SEROLOGY REQUEST Printed 24 7 2015 3 54 AM C susp o 2 o a Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 24 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner VIROLOGY amp SEROLOGY REQUEST Clinical Features C Asymptomatic C Symptomatic GENITOURINARY INVESTIGATION x FILL BOXES LIKE THIS Serological Tests 7 mis clotted amp iood FILL BOXES LIKE THIS C cmv immunty igs EBV Immunity IgG Hepatitis A immunity 19G Hepatitis 5 surface Antigen Screen Hepatitis 5 core Antibody C Hepatitis 5 surface Antibody C Hepatitis c Screen C Measies immunity 196 Molecular Tests f uncertain contact laboratory for detalis of appropriate specimen C Adenovirus PCR Chiamydia GC TMA CMV Viral Load Hepatitis B Viral Load Hepatitis B Genotype Hepatitis 8 Resistance Hepatitis C Viral Load Hepatitis C Genotype Herpes simplex 1 amp 2 PCR C HIVRNA
147. logy Services Porton Down Salisbury Wiltshire SP4 0JG RIPL Porton Down PHE Microbiology Services Porton Down Salisbury Wiltshire SP4 0JG Brucella Reference Unit Aintree University Hospital RIPL Porton Down Royal Liverpool AMRHAI PHE Colindale Bacteriology 61 Colindale Avenue LONDON PHE Colindale NW9 5HT National CJD Surveillance Unit Western General Hospital Western General Edinburgh PHE Microbiology Services Porton Down Salisbury RIPL Wiltshire SP4 0JG PHE Bristol Myrtle Road Bristol mycology Kingsdown Public Health England Colindale 61 Colindale Avenue London NW9 5EQ PHE Colindale CPA 2792 CPA 1612 CPA 1612 CPA 0453 CPA 1834 Laboratory work recognised by WHO amp follow CPS standards inspected by HSE amp perform well in European QC schemes CPA 1612 CPA 0042 Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 208 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner PHE Bristol Myrtle Road Chlamydiophila pneumoniae Kingsdown Ab PCR Bristol PHE Colindale CPA 0042 PHE Bristol Myrtle Road Cryptococcal Antigen Bristol mycology Kingsdown CPA 0042 Cryptosporidium Reference Unit CRU Swansea NPHS Microbiology Swansea Singleton Hospital Sketty Swansea Cryptosporidium Swansea SA2 8QA CPA 2913 Clinical Parasit
148. lood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum 2mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision points Not applicable Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 169 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Human Parvovirus B19 IgM Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum 2mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautio
149. lood tube Specimen No special needs transport Minimum volume 2 mL of sample Special All samples are suitable for overnight refrigeration only they must not precautions be stored over a weekend Laboratory Information Measurement mIU mL units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days If urgent please contact the laboratory for 4 hours turnaround Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 201 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Varicella zoster IgM Virology General Information Back to Index Collection 6mL clotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen No special needs transport Minimum 2mL volume of sample Special None known precautions Laboratory Information Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information
150. lotted Blood serum paired sera Special precautions If the serum bactericidal activity is reported with the comment SBA titre includes non complement mediated lysis then the result must be interpreted with caution If in doubt please telephone 0161 276 6791 for advice Laboratory Information Measurement units SBA titres expressed as the reciprocal of the final serum dilution giving 50 killing at 60 minutes calculated from the number of colony forming units cfu in the control Biological reference units Not applicable Turnaround time 28 Working Days Clinical Information Clinical decision points The putative protective SBA titre for serogroup Cis gt 8 A cut off of 2 8 is currently considered protective for serogroups A Y and W Factors known to significantly affect the results As this is a killing type assay using live bacteria antibiotics can impact on results A control to monitor this is included in the assay Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 155 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Functional antibody to Neisseria meningitidis serogroup B by Serum Bactericidal Antibody Assay SBA G
151. luding preservatives Specimen Dried blood spot card Type Collection Sample Collection 1 Disposable gloves should be wom for the whole procedure to protect you and to protect the sample from degradation 2 Ensure the patients hands are clean If the hands are cold ask the patient to rub them together It is important the puncture site is warm 3 Identify and clean the puncture site Use one of the outer 3 fingers Avoid finger pad and nail bed Clean site with alcohol wipe then dry 4 Break the Seal by Twisting 5 Hold the lancet with two 7 Safely discard the lancet in a sharps container 8 Spot blood onto each of the 5 circles on the card To en 9 Leave the card to dry for a minimum of 30 minutes 10 Place card along with one bag of desiccant in the plastic carrier attached to the request from 11 Ensure the required details a have been entered on both the i request form and the dried blood spot card Place the re quest card in the envelope pro vided and send back to the laboratory Specimen No special needs transport Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 134 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Minimum 7mm Dried blood spo
152. ly Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 116 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis B virus viral load Molecular Microbiology Indications for testing e Detection of viraemia in patients with chronic hepatitis B infection e Investigation of possible transmission of hepatitis B e g following exposure to blood or body fluids of an infected patient e Monitoring effectiveness of anti viral therapy in patients with chronic hepatitis B infection e Measurement of hepatitis B viral load in e antigen negative hepatitis B infected health care workers who perform exposure prone procedures Health Service Circular 2000 020 General Information Back to Index Collection container CE marked leak proof container including preservatives Specimen Type EDTA blood Collection Freshly drawn blood in EDTA Specimen transport Ambient or refrigerated Quantitative PCR e 5mL of freshly drawn whole blood in EDTA or 2mL of plasma that has been separated within 6 hours of being drawn and which has not been frozen and thawed Plasma should be stored at 4 C and dispatched as soon as possible Haemolysed specimens can be inhibitory where this is unavoidable such as with post mortem samples the laboratory should be contacted 0161 276 8843 The dynamic range for this
153. mL Biological reference units Not applicable Turn round time for Provisional result calendar days Turn round time to Final result calendar days 3 days 4 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 140 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Legionella urinary antigen detection Virology General Information Back to Index Collection CE marked leak proof container container including preservatives Specimen Type Urine Collection Urine Specimen No special needs transport Minimum 1ImL urine volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays
154. mber 2014 Page 143 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Measles virus PCR Molecular Microbiology General Information Back to Index Collection CE marked leak proof container container including preservatives Specimen Type EDTA blood Urine Specimen Ambient or refrigerated transport Minimum 500uL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement Threshold Cycle CT units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to False negative results may occur for a variety of reasons for example significantly inappropriate timing of sample collection inappropriate sample affect the results presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition n
155. mbient or refrigerated Minimum volume of 500ul sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Copies mL Turn round time for 3 days Turn round time to 4 days Provisional result Final result calendar calendar days days Clinical Information Clinical decision points Not applicable Factors known to False negative results may occur for a variety of reasons for significantly affect the example inappropriate timing of sample collection inappropriate results sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Copy no FREE TO PRINT Edition no 6 Page 90 of 221 Author Microbiology Management Team Date of issue 19 December 2014 Document no MMMP QU MAN1 Authorised by Dr AJL Turner Eye and Canalicular Pus Bacteriology General Information Back to Index Collection container including preservatives Collect specimens other than swabs into appropriate CE marked leak proof containers and pla
156. n Down Salisbury Wiltshire SP4 0JG Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue London NW9 5HT CPA 1683 CPA 1683 CPA 2354 CPA 1612 CPA 2904 Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 210 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street Hospital for Tropical London Fasciola Diseases WCIE 6JB CPA 2354 Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street Hospital for Tropical London Filaria Diseases WCIE 6JB CPA 2354 Antimicrobial Reference Lab Med Micro Dept North Bristol NHS Trust Southmead Hospital Old pathology block Ganciclovir levels Southmead Bristol Bristol BS10 5NB CPA 0038 PHE Bristol Galactomannan Aspergillus Myrtle Road antigen Bristol Mycology Kingsdown CPA 0042 Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Hospital for Tropical Capper Street Giardia Diseases London CPA 2354 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December
157. n lower reproducibility Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 130 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner HIV confirmation screen test plus at least 2 further tests for HIV 1 2 General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum volume 2 mL of sample Special If processing is delayed refrigeration is preferable to storage at precautions ambient temperature Delays of over 48hr are undesirable Laboratory Information Turn round time 4 days Turn round time to 6 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 131 of 221 Docume
158. ncture site down Avoid finger pad and nail bed 4 Apply intermittent pressure Clean site with alcohol wipe then dry strong pressure dN milking it can damage the area A 5 Hold the lancet with two m 9 Leave the card to dry for a minimum of 30 minutes A fingers and place at the f aN puncture site NI 10 Pisco cad tard wits sao beg ot desiccant in the gt A plastic carrier attached to the req REN 11 Ensure the required details T 6 Gently apply pressure until have been entered on both the Se 4 Q rnn request form and the dri cl soul blood spot card Place the re be heard when this has q SA quest card in the envelope pro happened vided and send back to the Ds laboratory Specimen transport No special needs Minimum volume of 7mm diameter blood spot sample Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 114 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Special precautions Ensure blood spot has dried and submit with dessicant pouch enclosed Laboratory Information Measurement units Not applicable Biological reference Not applicable units Turn round time for 3 days Turn round time to 4 days Provisional result Final result calendar calendar days days
159. nical decision points Not applicable Factors known to significantly affect the results Collect specimens before antimicrobial therapy where possible Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 149 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Mumps IgG Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum 2mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement AU mL units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiolo
160. nisms e Slow growing anaerobes Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 48 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Bordetella pertussis culture Bacteriology Whooping cough is a highly contagious disease that is caused by the fastidious Gram negative coccobacillus Bordetella pertussis In some cases this syndrome may also be caused by Mycoplasma pneumoniae and by viruses such as adenoviruses and enteroviruses It is advisable to take two pernasal swabs one for the culture of Bordetella species and the other for viral culture however nasal swabs for PCR are preferred General Information Back to Index Collection container A pernasal swab Dacron with flexible wire shaft including preservatives Specimen Type 4 Collection A pernasal swab Dacron with flexible wire shaft is inserted through a nostril and advanced along the floor of the nose until it reaches the nasopharynx It has been suggested that the swab be held against the posterior nasopharynx for up to 30 seconds or until the patient coughs In practice it is more likely that a patient will only be able to tolerate this for a few seconds Specimen transport Collect swabs into Amies transport medium with charcoal and trans
161. no MMMP QU MAN1 Authorised by Dr AJL Turner Adenovirus Molecular Microbiology General Information Back to Index Collection container including preservatives CE marked leak proof container Collection EDTA Blood EDTA Tube Eye swab Virus Transport Media Specimen transport Ambient or refrigerated Compliance with current postal and transportation regulations is essential Clinical samples should be collected into a leak proof container in a sealed plastic bag Appropriate hazard labelling according to local policy should be applied Specimens should be transported and processed as soon as possible Minimum volume of sample Minimum volume 500ul Special precautions If processing is delayed refrigeration is preferable to storage at room temperature Laboratory Information Measurement units Threshold cycle CT Biological reference units Not applicable Turn round time for Provisional result calendar days Turn round time to Final result calendar days 3 days 4 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which
162. not fully keratinised ie deeper tissues and organs However reactions to such infections can range from mild to severe depending upon the host s immune response the virulence of the infecting species the site of infection and environmental factors General Information Back to Index Collection Specimens received in sterile containers in sealed plastic bags container Dermapak collection kits are available from the Microbiology Department including preservatives Specimen Hair Skin Nails Type Collection Specimens should be collected into folded paper square Dermapak collection kits secured and placed in a plastic bag designed specifically for the collection and transport of skin nail and hair samples Skin scrapings and plucked hairs are the ideal specimens for diagnosing scalp infections but in addition a sterile disposable toothbrush can be used for the collection of samples These should be transported to the laboratory in a sterile plastic receptacle If sufficiently long hairs should be plucked with forceps and wrapped in black paper or commercial transport packs together with flakes of skin Specimen Specimens should be kept at room temperature and transported and transport processed as soon as possible Samples should be allowed to dry out and kept at room temperature Provided the samples are kept dry the fungus will remain viable for several months Minimum Not applicable volume of sample
163. ns temperature Delays of over 48hr are undesirable Laboratory Information Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision points Not applicable Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Copy no FREE TO PRINT Edition no 6 Page 170 of 221 Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Human Parvovirus B19 viral load Molecular Microbiology Slapped cheek syndrome Fifth disease General Information Back to Index Collection CE marked leak proof container container including preservatives Specimen EDTA blood Amniotic Fluid Type Specimen Ambient or refrigerated transport Minimum 500ul volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement Copies mL units Turnaround 2 3 days time Clinical Information Clinical Not applicable decision points Factors False negative results may occur for a variety of reasons
164. nsport Compliance with current postal and transportation regulations is essential Clinical samples should be collected into a sterile leak proof container in a sealed plastic bag Specimens should be transported and processed as soon as possible If processing is delayed refrigeration is preferable to storage at room temperature Type and volume of A liquid specimen of 1 2 mL is sufficient for culture and toxin sample detection 1 gram large pea size of unformed specimen Special precautions Formed stools are unsuitable for investigation for C difficile Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 61 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Laboratory Information Measurement units Not applicable Biological reference Not applicable units Turn round time for 24 hrs Turn round time to 48 72 hrs Provisional result Final result calendar calendar days days Clinical Information Clinical decision points Not applicable Factors known to The detection of C difficile is dependent on the number of significantly affect the organisms present in the sample reliable results are dependent results on correct specimen collection handling and storage Limitations Inte
165. nstance for the commoner microbiology enquiries These are available on the intranet at the following address http cmhtweb cmht nwest nhs uk directorates micro default as e Newor junior doctors should discuss queries with their own clinical team before calling the Medical Microbiologist e For Medical Microbiology advice for the more complicated cases the Medical Microbiology team should be contacted on extension 66333 or via switchboard e For Infection Control advice alone the Infection Control Nurses can be contacted on extension 64042 or via switchboard e Clinical advice on Mycology results problems is available from Dr A Dodgson 0161 276 6010 or Dr K Dodgson 0161 276 5746 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 8 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Additional tests e Additional tests can be requested by contacting the laboratory most samples are stored for a maximum of 7 days Results All urgent results will be telephoned when requested or if there is a clinically significant resultA Microbiologist or BMS will contact the requesting ward Results are not routinely faxed but this can be arranged on a restricted basis For other results enquiries during normal working hours Tel 0161 276 4281 Out of hour
166. nt ALL Edition no 6 Date of issue 19 December 2014 Page 92 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Faeces Culture Bacteriology All diagnostic faecal samples except single organism screens are tested for the following organisms Campylobacter sp Salmonella sp E coli VTEC including 0157 amp Shigella sp Faecal samples submitted from patients that have a foreign travel history will also be examined for Vibrio sp including Vibrio cholera Foodborne outbreak samples submitted through the local environmental health team may have additional culture performed for Staph aureus Bacillus sp and Clostridia sp Additional screening for Yeast sp and Vancomycin Resistant Enterococci VRE is performed on selected Immunocompromised patient groups under the guidance of the IPC Team General Information Back to Index Collection container Collect specimens in appropriate CE marked leak proof including preservatives Specimen Type Faeces Collection Specimen may be passed into a clean dry disposable bedpan or similar container and transferred into an appropriate CE marked leak proof containers and place in sealed plastic bags Specimen transport If processing is delayed refrigeration is preferable to storage at ambient temperature Minimum volume of A liquid specimen of 1 2 mL is sufficient sample 1 gram large pea size of solid specimen Special
167. nt no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner HIV p24 Antigen Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Venous Blood Type Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant with transport IATA packing instruction 650 Minimum 3mL volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement pg mL units Turn round 4 days Turn round time to 6 days time for Final result calendar Provisional days result calendar days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results Not known Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Copy no FREE TO PRINT Edition no 6 Page 132 of 221 Author Microbiology Management Team Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Authorised by Dr AJL Turner HIV resistance integrase tropism Molecular Microbiology General Information Back to Index Collection container including preservatives CE marked le
168. nted 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Edition no 6 Page 95 of 221 Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement X10 L for cell count units Biological Not applicable reference units Turn round time for Provisional result calendar 30 60 mins for microscopy when requested as Urgent Turn round time to Final result calendar days 48 72hrs 24 hrs for culture days Clinical Information Clinical decision points Back to Index Not applicable Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 96 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Genital Specimens for Culture Bacteriology General Information Back to Index Collection CE marked leak proof container container including preservatives Specimen Type High vaginal swab HVS vaginal discharge vulval swab labial swab cervical swab
169. o 6 Date of issue 19 December 2014 Page 144 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Meningococcal DNA detection by PCR including Pheumococcal PCR The Meningococcal Reference Unit provides a separate manual that is distributed to all users of the unit and is also available on MRU User Manual General Information Back to Index Collection EDTA Blood tube container CE marked leak proof container including preservatives Specimen Type EDTA blood CSF pleural fluid Where a CSF sample is available this should be sent in addition to an EDTA blood sample Collection CE marked leak proof container Specimen Ambient or refrigerated transport Specimen type and transport e EDTA blood sample collected on admission should be sent to the Meningococcal Reference Unit MRU if PCR confirmation is required Heparinised clotted blood serum or citrated samples can be tested but EDTA is preferred e Whole CSF i e an uncentrifuged specimen should be sent in small sterile containers such as a sterile 2mL screw capped vial rather than universal containers Minimum Minimum volume of 500uL volume of sample Special Remember to also collect blood cultures and a throat swab for precautions bacteriology and label these clearly for meningococcal investigation Laboratory Information Measurement Threshold Cycle CT units Biological Not a
170. od sample tube no preservative container including preservatives Specimen Type Clotted Blood serum Specimen Compliance with current postal and transportation regulations is transport essential Clinical samples should be collected into a leak proof container in a sealed plastic bag Specimens should be transported and processed as soon as possible Type and volume Clotted Blood serum Minimum volume 0 1mL of sample Special If processing is delayed refrigeration is preferable to storage at precautions ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement ug mL units Biological Not applicable reference units Turnaround time 28 Working Days Clinical Information Clinical decision IgG of 2 0 15 g mL for short term protection IgG of 1 00 ug mL for points long term protection Factors known to None known significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 100 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis B virus HBV e antigen HBeAg and e antibody Anti HBe General Information Collection container including preservatives Specimen Type Back to Index
171. of containers and place in sealed plastic bags Specimen type Abscess pus abscess swab deep seated pus swab post operative wound swab wound exudates Specimen Specimens should be transported and processed as soon as possible transport The volume of specimen influences the transport time that is acceptable Large volumes of purulent material maintain the viability of anaerobes for longer Minimum Minimum volume of 1mL of pus volume of sample Swabs should be well soaked in pus Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round time 24 hrs Turn round time to 48 72 hrs for Provisional Final result calendar result calendar days days Printed 24 7 2015 3 54 AM Valid on day of issue only Clinical Information Clinical decision Not applicable points Factors known to The recovery of anaerobes is compromised if the transport time significantly exceeds 3 hr affect the results Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Edition no 6 Page 41 of 221 Author Microbiology Management Team Department ALL Date of issue 19 December 2014 Document
172. of over 48hr are undesirable Laboratory Information Turnaround time Please contact laboratory to arrange urgent test 3 hrs Routine testing is 24 hrs Clinical Information Clinical decision Not applicable points Factors known to Not known significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Edition no 6 Page 141 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Measles IgG Virology General Information Collection container including preservatives Specimen Type Back to Index 6mLclotted blood tube Venous Blood 6mL blood tube Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 2mL Collection Specimen transport Minimum volume of sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units AU mL Turn round time for Provisional result calendar days 3 days Turn round time to Final result calendar days 4 days Clinical Information Clinical decision points Not applicable Fac
173. of the central nervous system A minimum of 0 5mL of whole CSF Do not centrifuge Use a small capacity screw capped container Special precautions Samples should be stored at 4 C and dispatched as soon as possible after being drawn If longer storage is unavoidable serum or plasma may be stored frozen but should not be repeatedly frozen and thawed In special circumstances 0 5mL of serum or plasma can be tested but for such small volumes avoid using a large container use a small capacity container with a screw cap such as an Eppendorff tube Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 43 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Laboratory Information Measurement units Threshold cycle CT Biological reference Not applicable units Turn round time for 4 days Turn round time to 5 days Provisional result Final result calendar days calendar days if urgent please contact the laboratory Clinical Information Clinical decision Not applicable points Factors known to All samples are suitable for overnight refrigeration only they must significantly affect not be stored over a weekend the results False negative results may occur for a variety of reasons for exampl
174. oglobulin service Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 14 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Contact the Consultant on call via the CMFT Switchboard 0161 276 1234 who will arrange issue with the duty BMS as appropriate Contact Details Dr Andrew Turner 0161 276 8853 68853 Clinical Lead Consultant Medical Virologist Dr Ken Mutton 0161 276 8853 68853 Consultant Medical Virologist Dr Mubiraz Husain 0161 901 4774 14774 Consultant Medical Virologist Dr Louise Hesketh 0161 901 0188 10188 Consultant Clinical Scientist Dr Malcolm Guiver 0161 276 8853 68853 Consultant Clinical Scientist Head of Molecular Diagnostics Miss Andrea Reid 0161 276 8853 68853 Secretary Miss Christel Matthews 0161 276 8787 68787 Secretary Mr Peter Tilston 0161 276 8849 68849 Clinical Scientist Resistance testing Dr Alex Sargent 0161 276 8680 68680 Clinical Scientist HPV lead Mr Benjamin Brown 0161 276 8680 68680 Clinical Scientist Mr David Ellis 0161 276 8838 68838 Laboratory Manager Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 15 of
175. ogy Acanthamoeba Bacteriology Acute haemorrhagic cystitis Molecular Microbiology Adenovirus PCR Molecular Microbiology Adenovirus Respiratory Infection Molecular Microbiology Adenovirus 40 41 Enteric PCR Molecular Microbiology Anti HCVantibody screen and confirmation Virology Anti Hepatitis Bs antibody Virology Anti HIV 1 and 2 antibody and p24 antigen screen Virology ASO Aspergillus PCR Molecular Microbiology Astrovirus PCR enteric Molecular Microbiology Avian influenza Molecular Microbiology B Bacteraemia Bacteriuria Bordetella pertussis Bacteriology Bordetella pertussis PCR molecular microbiology Bartonella Virology referral Biopsies Bacteriology BK virus PCR Molecular Microbiology Blastomyces Virology referral Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 33 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Blepharitis Blood culture Bacteriology Bloodstream Infection Bocavirus PCR Molecular Microbiology Referral Brucella Virology referral Burns G Campylobacter serology Virology referral Candida PCR Molecular Microbiology Candida precipitins Virology referral Candidosis CAPD Bacteriology Carbapenemase producing enterobac
176. ogy Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 67 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Cryptococcus Antigen Virology General Information Back to Index Collection CE marked leak proof container container including preservatives Specimen Type Clot or CSF Specimen No special requirements transport Minimum 150ul volume of sample Laboratory Information Measurement Positive or Negative or titre Units Turnaround 24 hrs time Clinical Information Factors known None known to significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 68 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner CSF Bacteriology Meningitis is defined as inflammation of the meninges This process may be acute or chronic and infective or non infective Many infective agents have been shown to cause meningitis including viruses bacteria fungi and parasites Royal Manchester Childrens Hopsital is a specialist paediatric neurology centre as such CSF obtained from ventricular shunts and shunts removed during revision may also be submitted
177. ology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street Hospital for Tropical London Cysticercosis Diseases WCI1E 6JB CPA 2354 Virus Reference Department Microbiology Services PHE Colindale Delta Antigen Hepatitis D 61 Colindale Avenue delta Antibody PCR PHE Colindale London NW9 5HT CPA 2904 PHE Microbiology Services Porton Down Salisbury Dengue Fever RIPL Porton Down Wiltshire SP4 0JG CPA 1612 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Copy no FREE TO PRINT Edition no 6 Page 209 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner CPA UKAS accreditation E coli 0157 E coli VTEC antibodies Echinococcus hydatid Ehrlichia Enterovirus typing Printed 24 7 2015 3 54 AM PHE Colindale PHE Colindale Hospital for Tropical Diseases RIPL Porton Down PHE Colindale Gastrointestinal bacterial reference unit GBRU PHE Colindale Bacteriology 61 Colindale Avenue LONDON NW9 5HT Tel 020 8200 4400 Gastrointestinal bacterial reference unit GBRU PHE Colindale Bacteriology 61 Colindale Avenue LONDON NW9 5HT Tel 020 8200 4400 Clinical Parasitology Department 3rd Floor The Hospital for Tropical Diseases Mortimer Market Capper Street London WCI1E 6JB PHE Microbiology Services Porto
178. olysis significantly affect Assay interference and generation of anomalous results can the results occur when a patients sample contains Heterophile antibodies Animal serum products from routine exposure to animals Human mouse monoclonal antibodies patients who receive Preparations of mouse monoclonal antibodies for diagnosis or therapy Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Copy no FREE TO PRINT Edition no 6 Page 107 of 221 Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Hepatitis B virus HBV surface antigen HBsAg General Information Collection container including preservatives Specimen Type Back to Index 6mLclotted blood tube Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum volume 2 mL of sample Special If processing is delayed refrigeration is preferable to storage at precautions ambient temperature Delays of over 48hr are undesirable Laboratory Information Turn round time for Provisional result calendar 3 days Turn round time to 4 days days Final result calendar days Clinical Information Clinical decis
179. ot be stored over a weekend Laboratory Information Measurement units Copies mL Biological reference units Not applicable Turn round time for Provisional result calendar days Turn round time to Final result calendar days 3 days 4 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 45 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Blood Cultures Bacteriology Bloodstream Infection Sepsis Neonatal Sepsis Infective endocarditis Prosthetic valve endocarditis PVE Bacteraemia The Blood Culture system can also be used for small volumes of sterile fluid to aid the recovery of fastidious organisms for example but not limited to Vitreous aspirates Joint Flu
180. ould be clearly labelled Pharyngeal swabs for N gonorrhoeae carriage are not advised inoculation directly onto culture media at the time of collection within a GUM clinic is recommended Laboratory Information Measurement units Not applicable Biological reference Not applicable units Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 189 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Turn round time for 48 hrs Turn round time to 48 72hrs Provisional result Final result calendar calendar days days Clinical Information Clinical decision points Not applicable Factors known to Collect specimens before antimicrobial therapy where possible significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Copy no FREE TO PRINT Edition no 6 Page 190 of 221 Author Microbiology Management Team Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Authorised by Dr AJL Turner Tips Intravascular cannulae Bacteriology Please note the tips from Urinary catheters are not suitable for Microbiological analysis General Information Back to Ind
181. pecial Ensure blood spot has dried and submit with dessicant pouch enclosed precautions Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round 3 days Turn round time to 4 days time for Final result calendar Provisional days result calendar days Clinical Information Clinical Not applicable decision points Factors Spots too small not all spots filled with blood known to significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 186 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Syphilis Treponema pallidum screen Virology General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood CSF Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum volume 2 mL of sample Special All samples are suitable for overnight refrigeration only they must not precautions be stored over a weekend Laboratory Information Turn round time 3 days Turn round time to 4 days for Provi
182. plasma can be tested but for such small volumes avoid using a large container but use a small capacity container with a screw cap such as an Eppendorff tube Minimum volume of 3 0 mL sample Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units mL Wild type resistant mutation Biological reference Not applicable units Turn round time for 5 days Turn round time to 7 days Provisional result Final result calendar calendar days days Clinical Information Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 79 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Clinical decision Not applicable points Factors known to False negative results may occur for a variety of reasons for significantly affect example inappropriate timing of sample collection inappropriate the results sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24
183. port in sealed plastic bags If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Minimum volume of Not applicable sample Special precautions Laboratory Information Measurement units Not applicable Turnaround time 7 days Clinical Information Clinical decision points Not applicable Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 49 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Factors known to Pernasal swabs significantly affect the The only swab fibre recommended for diagnosis of whooping results cough is Dacron B pertussis has a stronger affinity for Dacron than for plain cotton wool or for treated cotton wool and its use improves recovery of the organism It is also less inhibitory for PCR techniques Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 50 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Bordetella pertussis PCR Molecular Microbiology General Information Bac
184. pplicable reference units Turn round 1 2 days Turn round time to 3 days time for Final result calendar Provisional days result calendar days Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 145 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Turnaround Same day if received by 10 00am me Results on specimens received up to 10 00am on Monday Friday are normally available between 4 30pm and 5 00pm on the same day Positive results will be telephoned following serogroup confirmation up to 5 30pm or as soon as possible on the morning of the next working day when printed reports will also be sent out Urgent turn round times Arrangements to accept couriered urgent samples for PCR or other investigations must be agreed with the MRU before the samples are sent Failure to do so may result in the specimen s not being tested in a timely fashion Clinical Information Clinical Not applicable decision points Factors known Any specimens for PCR tests should be stored at 4 C and not frozen prior to significantly io transport affect the It The likelihood of a positive result decreases as the interval of sampling results after starting antibiotics lengthens Samples for PCR taken more
185. r possible Signed on behalf of the Manchester Medical Microbiology Partnership Dr AJ Turner Date 30 05 14 Head of Unified Services Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 7 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 4 0 INFORMATION FOR HEALTHCARE PROFESSIONALS 4 1 OPENING HOURS CLINICAL ADVICE AND RESULTS LINE 4 1 1 MICROBIOLOGY DEPARTMENT CMFT Laboratory opening hours The laboratory is open Monday to Friday 8 00am 5 00pm Outside of working hours contact the on call Biomedical Scientist through Switchboard 0161 276 1234 for urgent requests Saturday 8 30am 12 30noon Sunday 8 30am 12 30noon The total workload is approximately 600 000 specimens per annum Clinical Advice For clinical advice during normal working hours Mon Fri Tel 0161 276 6333 For CMFT users please check the ICE interface for results in the first instance e General culture results are available 24 hours after specimen receipt at the earliest and sensitivities usually after a further 24 hours For samples such as blood cultures and CSF the Microbiologist will usually inform the clinicians of initial significant results as soon as they are known e Internal users please refer to the antibiotic guidelines in the first i
186. re antimicrobial therapy where possible known to significantly Specimens should be transported and processed as soon as possible to affect the prevent deterioration results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 205 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 7 0 REFERRAL LABORATORIES Department for Bioanalysis amp Horizon Technologies PHE Colindale 61 Colindale Avenue LONDON 16S Panbacterial PCR PHE Colindale NW9 5HT CPA 2792 PHE Bristol Myrtle Road 18S Panfungal PCR Bristol Mycology Kingsdown CPA 0042 Antimicrobial Reference Laboratory Southmead Bristol Aciclovir levels Southmead Bristol CPA 0038 Anaerobic Reference Laboratory University Hospital of Wales Heath Park CARDIFF Actinomyces Cardiff CF4 4XW CPA 2913 Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue Adenovirus typing PHE Colindale London NW9 5HT CPA 2904 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 206 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner ve CPATORAS accreditation
187. rn round time to Final result calendar days 4 days 5 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results False negative results may occur for a variety of reasons for example inappropriate timing of sample collection inappropriate sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 137 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Human papilloma virus Molecular Microbiology General Information Back to Index Collection container Surepath container including preservatives i Specimen Type Cervical smear swabs biopsies paraffin wax sections Specimen transport Ambient or refrigerated Minimum volume of 600 l sample Laboratory Information Measurement units Threshold cycle CT Turnaround time PCR result available in 3 4 days genotype available within 2 weeks Clinical Information Clinical decision Not applic
188. rner Herpes simplex 1 2 antibody type specific IgM and total antibody General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum volume 2 mL of sample Special If processing is delayed refrigeration is preferable to storage at precautions ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Copy no FREE TO PRINT Edition no 6 Page 129 of 221 Author Microbiology Management Team Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Authorised by Dr AJL Turner HHV6 amp 7 PCR Molecular Microbiology General Information Back to Index Collection container including preservatives CE marked leak proof container
189. robiology Management Team Authorised by Dr AJL Turner In order to provide the most clinically beneficial operationally efficient and cost effective service the laboratory employs a number of multiplex assays and testing algorithms which are based on UK Standards for Microbiology Investigations it is normal practice to use these even when not all tests within the multiplex or algorithm are requested It is our policy to report all results along with the requested result to provide as much information as possible to aid diagnosis Backto Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 179 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Rubella IgG Virology General Information Back to Index Collection container 6mLclotted blood tube including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen transport Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Minimum volume of 2mL sample Special precautions All samples are suitable for overnight refrigeration only they must not be stored over a weekend Laboratory Information Measurement units IU mL Turn round time for 3 days Turn round time to 4 days Provisiona
190. rpretation of toxin results in children less than 2 years old should be treated with caution Clostridium difficile Ribotyping Service The Manchester Laboratory has been identified as one of six Regional Laboratories to provide a Clostridium difficile ribotyping service as part of the Clostridium difficile Ribotyping Network CDRN Ribotyping will be provided for the North West Region and we will eventually have funding for up to 1 000 isolates per year Prior to sending your specimens to Manchester please contact ALL of the named individuals listed below via email to ensure that specimens comply with the acceptance policy and that the CDRN forms are completed with all of the information needed The current turn around time is 14 days Dr E Kaczmarski Tel 0161 276 5699 ed Kaczmarski phe gov uk Dr A Dodgson Tel 0161 276 6010 andrew dodgson cmft nhs uk Dr K Dodgson Tel 0161 276 5746 kirsty dodgson cmft nhs uk Dr A Birtles Tel 01612765689 andrew birtles cmft nhs uk Specimens will not be accepted unless all patient sample data has been entered onto the CDRN web system and the sample is accompanied by a completed Specimen Request Form generated from the CDRN web system Copies of the following documents are available using the links below a Guidance document with selection criteria b Guidance document for access to the ribotyping service c Clostridium difficile specimen request form one form for each specimen Printed 24 7 201
191. ry Policy on Protection of Personal Information The laboratory adheres to Central Manchester University Hospital FoundationTrust s policies on data protection and disclosure The following policy can befound on the Trust intranet site Confidentiality Code of Conduct and Information Disclosure Policy ON4 3437 In addition the Trust also produces a patient information leaflet entitled YourlInformation which can be accessed by clicking on the following link http www cmft nhs uk media 4448 TIG 2039 2008 pdf 9 3 THE HUMAN TISSUE ACT AND THE MMMP Central Manchester University Hospitals NHS Foundation Trust and the University Hospital of South Manchester NHS Foundation Trust are licensed by the HTA to undertake examinations of post mortem samples submitted by clinical consultants and pathologists the MMMP falls within this scope Under the license the samples may be retained until the examination has been completed and in line with the sample retention policies It is the obligation of the requesting clinician or pathologist to ensure that examination of samples they submit to MMMP have been requested by the coroner or appropriate consent has been obtained from the deceased person or their relatives Only the specific examinations requested by the sending clinician or pathologist may be performed It must be assumed that the coroner has not asked for any other examinations to be performed and consent has not been obtained for any
192. s amp Brooks 01706 645088 z uu SE O z to te Serological Tests 7 micenea seoa FILL BONES LIKE THS X EE EA Coo e s z D N Date of iin NHS Number o serogroup C mge W Meningococcal serogroup A bartera and 19G A T be Gender District Number ABS eoe Dee 8 t g 3 Hopal Reference Number C Meringococcal serogroup W135 tacteseidal and ig 2 iy j CI Ha mophius Intuenzae type B ig We i Address See ooon AJB EASSEAL SPEOMEN FORM PATENT NO 2221208 B Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 27 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner 4 4 TRANSPORT SERVICES INCLUDING ANY SPECIAL HANDLING NEEDS E G HG3 PATHOGENS 4 4 1 TRANSPORTATION OF ROUTINE SAMPLES TO THE LABORATORY All users of these laboratory services are advised to refer to Transport of Infectious Substances Best Practice Guidance for Microbiology Laboratories on the www dh gov uk website for up to date information on the correct procedures for submitting samples All specimens should be transported to the laboratory as rapidly as possible after collection to avoid compromising results Specimens may be transported via normal portering rounds during the normal working day Generally specimens that are not sent w
193. s E PHE Colindale CPA 2904 Virus Reference Department Microbiology Services PHE Colindale 61 Colindale Avenue London NW9 5HT Herpes simplex acyclovir resistance phenotypic PHE Colindale CPA 2904 St James s Hospital Herpes simplex acyclovir James s Street resistance genotypic St James Dublin Dublin 8 Ireland CPA 2901 PHE Bristol Myrtle Road Histoplasmosis PHE Mycology Bristol Kingsdown CPA 0042 HIV2 PCR VL puck S S OE SS SSS Virus Reference Department Microbiology Services PHE Colindale HTLV 1 2 Antibodies PCR Colindale Colindale 61 Colindale Avenue viral load Imperial London NW9 5HT CPA 2904 Clinical Parasitology Department 3rd Floor Hydatid Cysts Echinococcus Hospital for Tropical The Hospital for Tropical Diseases antibodies Diseases Mortimer Market CPA 2354 Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Leptospira antibodies PCR Leishmania Lymphogranuloma Venereum PCR Lyme Disease Printed 24 7 2015 3 54 AM Copy no FREE TO PRINT Edition no 6 Page 213 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Hereford RIPL Hospital for Tropical Diseases PHE Colindale Capper Street London WCIE 6JB Leptospira Reference Unit Dept of Microbiology The County Hospital Union Walk Hereford Herefordshire HR1 2ER CPA 1180 Clinical
194. s If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Threshold Cycle CT Biological reference Not applicable units Turn round time for 3 days Turn round time to 4 days Provisional result Final result calendar calendar days days Clinical Information Clinical decision Not applicable points Factors known to False negative results may occur for a variety of reasons for significantly affect example inappropriate timing of sample collection inappropriate the results sample presence of virus below the detectable limit of the assay New and emerging variants may also occur which may not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Limitations Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 99 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Haemophilus influenzae type b IgG Antibody Determination Vaccine Evaluation Unit Haemophilus influenzae type b IgG antibody determination by flow analysis assay bead assay General Information Back to Index Collection Clotted blo
195. s Pathogens are handled at a higher containment level to safeguard both laboratory staff and other downstream workers The information is also of benefit to the patient ensuring that appropriate testing is performed to safeguard the patient and benefit their patient journey Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 6 0 REPERTOIRE OF TESTS A Z Copy no FREE TO PRINT Edition no 6 Page 32 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner ABCDEFGHIJKLMNOPQRSTUVW XYZ Find a test or clinical condition using the A Z list With each test we provide the following information where appropriate Name of test Measurement Biological Clinical decision Type and and clinical units reference units points volume of condition sample Collection Specimen Turnaround Factors known Examinations container transport time to significantly sent to referral affect the clearly results identified For more information on any of these tests see the Lab Tests Online UK website Almost all the examinations that we use are NICE accredited UK Standards for Microbiology Investigations SMI hosted by by Public Health England formerly Health Protection Agency see UK Standards For Microbiology Investigations A Abscesses and Deep Seated Wound Infections Bacteriol
196. s Service The Microbiology out of hours service is an Emergency Service A limited number of investigations are offered out of normal laboratory hours i e 17 00 08 30 weekdays 12 30 to 08 30 Saturdays and 08 30 to 08 30 Sundays and Bank Holidays where urgent results are required The duty BMS can be contacted through MRI switchboard 0161 276 1234 The following tests are available as appropriate e Paediatric Emergency Admission urines Children lt 3yrs old e Paediatric Emergency Admission urines Children gt 3yrs old with a Dipstick positive for Leucocytes or Nitrates e CSF Cell Count amp Culture Samples requiring TB investigations cannot be processed out of hours Ascitic Peritoneal Fluid Cell Count amp Culture e Joint Fluids Gram stain amp Culture Crystal investigations are performed by Histopathology e Sterile Fluids from all areas will be considered for processing after discussion with the BMS on call samples requiring investigations that require lone containment level 3 working will not be performed Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 9 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Contact Details Dr Andrew Dodgson 0161 276 6010 66010 Clinical Lead Consultant Microbiologist Infection Control
197. se destroy all previous versions in order to improve the way in which your requests are dealt with Please note the following instructions for use compliance with these will also greatly improve the quality of the service we can deliver to you and ensure the reports reach you in a timely manner a There are now six types of request form i One for general Molecular Microbiology for GP s and Hospitals ii One for general Serology for GP s and Hospitals iii One specifically for Sexual Health Clinics including FPC services iv One specifically for Antenatal screening services v Dried blood spot vi The Christie b Because the forms will be scanned electronically it is important that All information on the forms must be in block capitals and must be kept within the boxed areas provided Please do not write over the lines of the boxed areas The tests required are selected by marking the boxes with an X If addressograph labels are used which we recommend they should be placed within the L marks that surround this section of the form All labels attached to the forms must be properly aligned in the appropriate position on the request form DO NOT use or cover any of the areas that state For Laboratory Use these areas are only for use by this laboratory c Details of our specimen acceptance policy can be found on the reverse of the form along with other useful information Fina
198. sional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 187 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Tetanus IgG Antibody Determination Vaccine Evaluation Unit Tetanus IgG antibody determination by flow analysis assay bead assay General Information Back to Index Collection Clotted blood sample tube no preservative container including preservatives Specimen Type Clotted Blood serum paired sera Collection Clotted Blood serum paired sera Specimen At ambient temperature via porter courier Royal Mail or DX transport compliant with IATA packing instruction 650 Minimum volume Clotted Blood serum paired sera Minimum volume 0 1mL per of sample serogroup Special All samples are suitable for overnight refrigeration only they must not precautions be stored over a weekend Laboratory Information Measurement ug mL units Biological Not applicable reference units Turnaround time 28 Working Days Clinical Information Clinical decision IgG of
199. stic bags including preservatives Specimen Type Please state anatomical site on request form Collection Use aseptic technique Specimen Specimens should be transported and processed as soon as possible transport Minimum volume Not applicable of sample Special If processing is delayed refrigeration is preferable to storage at precautions ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round time 24 hrs Turn round time to 48 72 hrs for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Collect specimens before antimicrobial therapy where possible significantly affect Specimens should be transported and processed as soon as possible the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 71 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Cystic fibrosis Bacteriology Cystic fibrosis CF is caused by a defect in the CF transmembrane conductance regulator gene that affects the transport of ions and water across the epithelium T
200. sts will be available within 5 working days after receipt of the specimen in the laboratory and may be available within 24 hrs by prior arrangement with the laboratory Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results Haemolysed specimens can be inhibitory where this is unavoidable such as with post mortem samples the laboratory should be contacted 0161 276 8843 Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Hepatitis C qualitative PCR and genotype if HCV antibody is reactive Dried Blood Spot This service is designed for those patients on whom it is difficult to obtain venous blood especially for intra venous drug users Contact the laboratory for supply of postal packs containing all necessary items for using this service Paediatric infant packs are available on request General Information Back to Index Collection Envelope with dessicant container including preservatives Specimen Dried blood spot card Type Collection Sample Collection 1 Disposable gloves should be worn for the whole baseboard procedure to protect you and to protect he sample from a sharps contai 2 Ensure the patients hands are clean If the hands are cold ask the patient to rub them together It is important the puncture site is warm 3 Identify and clean the site kapse Use one of
201. t applicable units Turn round time for 24 hrs Turn round time to 48 72 hrs Provisional result Final result calendar Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 82 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner calendar days days Clinical Information Clinical decision Not applicable points Factors known to Collect specimens before antimicrobial therapy where possible significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Enteric Virus Panel Virology Multiplex PCR including 1 2 3 4 5 Adenovirus 40 41 Astrovirus Rotavirus Sapovirus Norovirus G1 and G2 Rotavirus sapovirus astrovirus and adenovirus are major causes of acute gastroenteritis The majority of infections occur in infants and young children Infections in the elderly are also reported for these agents and chronic infections can result in immunocompromised patients Norovirus is the cause of epidemic gastroenteritis General Information Back to Index Specimen Type Faeces collected in a CE marked leak proof container and container Specimen Compliance with current postal and transportation regulations is transport ess
202. t card volume of sample Special Ensure blood spot has dried and submit with dessicant pouch enclosed precautions Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round 3 days Turn round time to 4 days time for Final result calendar Provisional days result calendar days Clinical Information Clinical Not applicable decision points Factors Spots too small not all spots filled with blood known to significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 135 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner HIV screen 4 generation HIV1 and 2 antibody and p24 antigen General Information Back to Index Collection 6mL blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen Ambient temperature via porter courier Royal Mail or DX compliant transport with IATA packing instruction 650 Minimum 2mL volume of sample Special All samples are suitable for overnight refrigeration only they must not precautions be stored over a weekend Laboratory Information Measurement Not appli
203. ted blood agar blood agar or Dorset egg slopes after establishing growth by overnight incubation at 37 C On occasion it may be necessary to submit an unincubated culture This can save time but requires a heavy inoculum to ensure survival in transport Please indicate on the request form if the material slope has not been incubated Short term storage of sloped cultures is optimal at 30 C if there are delays before submission Minimum Not applicable volume of sample Special The MICs routinely determined on submitted isolates are penicillin precautions cefotaxime rifampicin ciprofloxacin and sulphonamide sulphamethoxazole using Etest Biomerieux gradient diffusion methodology Other antibiotic susceptibility tests may be performed on request Laboratory Information Measurement mg L units Biological Not applicable reference units Turnaround 48 hrs if requested time Routine final report is issued within 1 2 weeks Printed 24 7 2015 3 54 AM Valid on day of issue only Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results None Known Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 160 of 221 Document no MMMP QU MAN1 Author
204. ted 24 7 2015 3 54 AM Back to Index Valid on day of issue only Copy no FREE TO PRINT Edition no 6 Page 148 of 221 Author Microbiology Management Team Manchester Medical Microbiology Partnership Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Authorised by Dr AJL Turner MRSA Bacteriology Most MRSA infections are healthcare associated but an increasing number of infections are community acquired with patients having no established risk factors for acquisition of MRSA While infections with community acquired MRSA CA MRSA are usually mild they can be severe General Information Back to Index Collection container Collect swabs dry or into Amies transport medium with charcoal including preservatives Specimen Type Swab from Nose Groin and manipulated wound sites Perineal swabs will be accepted if agreed with your local IPC Team b Collection Use aseptic technique Specimen transport Specimens should be transported and processed as soon as possible Minimum volume of sample Not applicable Special precautions If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Measurement units Not applicable Turnaround time Negative screen at 24 hrs Positive MRSA result with sensitivities at 48hrs Clinical Information Cli
205. ter Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 72 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Turnaround time Negative results available at 48 hours and positives generally within 5 days Clinical Information Clinical decision Not applicable points Factors known to Specimens should be transported and processed as soon as significantly affect possible The recovery rate of Haemophilus sp is reduced the the results longer the time taken to transport the specimen Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 73 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Cytomegalovirus CMV IgG avidity General Information Back to Index Collection 6mLclotted blood tube container including preservatives Specimen Type Venous Blood Collection 6mL blood tube Specimen No special needs transport Minimum volume 2ml Venous Blood of sample Special If processing is delayed refrigeration is preferable to storage at precautions ambient temperature Delays of over 48hr are undesirable Laboratory Information Turn round time
206. teriaceae screen Bacteriology Carbapenemase producing enterobacteriaceae screen Wythenshawe Laboratory Cellulitis Cerebrospinal fluid Chickenpox Chlamydia Antibodies Chlamydia and Gonococcal TMA Aptima Molecular Microbiology Chlamydia TMA confirmation Virology Chlamydia Gonococcal Virology Clostridium difficile Bacteriology CMV Cytomegalovirus IgG Virology CMV Cytomegalovirus IgM Virology CMV Cytomegalovirus IgG avidity Virology CMV Cytomegalovirus viral load Molecular Microbiology CMV Cytomegalovirus genotypic antiviral Resistance Coccidioides Virology referral Conjunctivitis Bacteriology Contact Lens Bacteriology Corneal Scrape Bacteriology Corneal Scrape Virology Coxiella burnetii see Q fever CPE screen Bacteriology CPE screen Wythenshawe Laboratory Cryptococcus antigen Virology CSF Microcopy culture Bacteriolo Culture Bacteriology Culture Wounds Skin Superficial Non surgical Bacteriology Cystic Fibrosis Bacteriology D Dermatological specimens hair skin nails Diphtheria IgG antibody determination Vaccine Evaluation Unit Dried Blood Spot Hepatitis B core antibody Virology Dried Blood Spot Hepatitis B surface antigen Virology Dried blood Spot Hepatitis C antibody Virology Dried blood Spot Hepatitis C RNA Screening Virology Dried blood Spot Hepatitis C Genotyping Virology Dried Blood Spot
207. the North West and beyond Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 4 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team 2 0 Authorised by Dr AJL Turner LOCATION OF MMMP AND CONTACT DETAILS Microbiology services at CMFT are based in the Clinical Sciences Centre marked by the pink dot on the map below The CMFT site is an amalgam of Manchester Royal Infirmary Manchester Royal Eye Hospital St Marys Womens amp Infants Hospital Royal Manchester Childrens Hospital University Dental Hospital and Trafford Hospitals I Il III Central Manchester University Hospitals Tet 0161 276 1234 G Meee The Microbiology Department at Central Manchester Foundation Trust is situated on the second and third floors of Clinical Science Buildings CSB 1 2 3 The Meningococcal Reference Unit and Vaccine Evaluation Unit are also situated within the 2 Floor of CSB 2 The Virology Department at Central Manchester Foundation Trust is situated on the third floor of Clinical Science Buildings CSB1 amp CSB2 Specimen reception amp serology are based in CSB1 and Molecular Diagnostics is based in CSB2 The clinical sciences buildings can be accessed from The Boulevard during normal working hours Visitors should report to reception on arrival The postal and DX addr
208. tment ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Specimen Collect specimens before antimicrobial therapy where possible transport e g at Samples should be taken as soon as possible after a spike of fever room Samples should not be refrigerated temperature or within 4 hrs Inoculated bottles should be incubated as soon as possible and within a maximum of four hours The four hour turnaround time from collection to incubation for blood culture samples reflects their clinical significance Type and volume of sample Adults Purple top and Blue top bottles Inoculate up to 10mL to each bottle Children Yellow top bottle Inoculate up to 4mL Neonates Yellow top bottle Inoculate preferably 1 2mL Do not exceed the manufacturers recommended maximum volume for each bottle as shown on label Special precautions Use aseptic technique Inspect the blood culture bottles for damage Ensure that the blood culture bottles have not exceeded their expiry date Do not re sheathe needles Laboratory Information Measurement Growth detected or not detected units Biological Not applicable reference units Turn round time for Provisional result calendar days 24 hrs Turn round time to Final result calendar days 6 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the r
209. tors known to significantly affect the results Haemolysis Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Edition no 6 Page 142 of 221 Author Microbiology Management Team Authorised by Dr AJL Turner Department ALL Date of issue 19 December 2014 Document no MMMP QU MAN1 Measles IgM Virology General Information Collection container 6mLclotted blood tube including preservatives Specimen Type Back to Index Venous Blood 6mL blood tube Ambient temperature via porter courier Royal Mail or DX compliant with IATA packing instruction 650 Minimum volume of 2ml Venous Blood sample Special precautions Collection Specimen transport If processing is delayed refrigeration is preferable to storage at ambient temperature Delays of over 48hr are undesirable Laboratory Information Turn round time for Provisional result calendar days 3 days Turn round time to Final result calendar days 4 days Clinical Information Clinical decision points Not applicable Factors known to significantly affect the results Haemolysis Printed 24 7 2015 3 54 AM Back to Index Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 Dece
210. ude Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 28 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner e A full range of tests to investigate any event or outbreak of possible public health significance in the community e Advice on the best diagnostic strategies to be adopted e Advice on interpretation of test results and additional investigations that may be helpful e Support to incident outbreak investigation teams e Prompt communication of results in agreement within published turnaround times e Follow up clearance testing of patients or contacts of patients in whom organisms of public health importance are detected e Support for trusts HPUs in the specialist investigation of health care associated infection The laboratory is able to deal with samples from outbreaks arising in primary or secondary care and there is a single notification system in place to inform the laboratory of all types of outbreaks e g respiratory enteric More detailed information can be found in the Public Health Microbiology User Services Handbook including the outbreak request referral form at http www PHE org uk ProductsServices MicrobiologyPathology SpecialistMicrobi ologyServices PublicHealthLaboratories PublicHealthLabsNorthWest 4 4 5 PACKAGING OF HIG
211. ue 19 December 2014 Page 166 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Ova Cysts and Parasites Bacteriology As part of our quality improvements for the Parasitology service within the Microbiology department at CMFT we have outlined the current testing requirements in order to provide an efficient service for the investigation of ova cysts and parasites OCP from samples other than blood Our aim is to clarify the requesting and selection of appropriate enteric samples for the examination of ova cysts and parasites Back to Index Pathogen Sample Comment required Cryptosporidiumsp Faeces There is NO NEED to request OCP amp All enteric samples for bacterial culture Giardia lamblia will automatically be tested for these Other parasitic 3 faecal OCP investigation must be requested infestations samples Samples labelled and dated over a period 1 of 3 2 of 3 and 3 of 3 other than of 10 days Information required Cryptosporidiumsp e Foreign travel history amp e Blood eosinophil count Giardia lamblia e Duration of diarrhoea e Presence absence of abdominal symptoms e Evidence of malabsorption Threadworm Perianal Rotate a saline moistened swab around E vermicularis ova Swab in the anus of the child first thing in the saline morning Bilharzia Urine Sample collected between 10am and Schistosoma 2pm Alternatively a 24hr collection
212. ure to do so pm EAJ reduce the sensitivity of the OQO screening tests 9 Leave the card to dry for a minimum of 30 minutes 10 Place card along with one bag of desiccant in the plastic carrier attached to the request from 11 Ensure the required details Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 125 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Specimen No special needs transport Minimum 7mm Dried blood spot card volume of sample Special Ensure blood spot has dried and submit with dessicant pouch enclosed precautions Laboratory Information Measurement Not applicable units Biological Not applicable reference units Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Spots too small not all spots filled with blood significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 126 of 221 Document no MMMP QU MAN
213. utions temperature Delays of over 48hr are undesirable Laboratory Information Turn round time 3 days Turn round time to 4 days for Provisional Final result calendar result calendar days days Clinical Information Clinical decision Not applicable points Factors known to Haemolysis significantly affect the results Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Hepatitis B virus HBV surface antigen HBsAg Dried Blood Spot Virology This service is designed for those patients on whom it is difficult to obtain venous blood especially for intra venous drug users Contact the laboratory for supply of postal packs containing all necessary items for using this service Paediatric infant packs are available on request General Information Back to Index Collection Envelope with dessicant container including preservatives Specimen Dried blood spot card Type Collection Sample Collection 1 Disposable gloves should be worn for the whole 7 Safely discard the lancet in y procedure to protect you and to protect the sample from a sharps container LLN degradation r 2 Ensure the patients hands are clean If the hands are OR aere It is important the gt gt puncture site is warm 8 SS ee 3 Identify and clean the 5 circles on the card To en Ly reapers sure enough blood flow A outer 3 fingers Hold the pu
214. wards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index In order to provide the most clinically beneficial operationally efficient and cost effective service the laboratory employs a number of multiplex assays and testing algorithms which are based on UK Standards for Microbiology Investigations it is normal practice to use these even when not all tests within the multiplex or algorithm are requested It is our policy to report all results along with the requested result to provide as much information as possible to aid diagnosis Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 85 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Enterovirus and Parechovirus PCR Molecular Microbiology Encephalitis meningitis General Information Back to Index Collection CE marked leak proof container container including preservatives Specimen Type EDTA blood CSF Swab Specimen Ambient or refrigerated transport Minimum Minimum 500u volume of sample Special If processing is delayed refrigeration is preferable to storage at ambient precautions temperature Delays of over 48hr are undesirable Laboratory Information Measurement Threshol
215. we Hospital University Hospital of South Manchester e Virology Department including Molecular Diagnostics CMFT e Meningococcal Reference Unit MRU CMFT e PHE Vaccine Evaluation Unit VEU CMFT e Mycology Reference Centre Manchester MRCM Wythenshawe Hospital University Hospital of South Manchester 1 1 Roles and functions To provide a clinical and public health microbiology service including an infection control service jointly managed by CMFT and PHE Provide microbiology support and advice to the Public Health England Centres PHECs Local Authorities and Port Health Authorities in the North West Provide expert microbiological advice during outbreaks and other incidents of infectious disease Contribute to the development of local regional and national guidelines and policies Provide community and health care associated infection HCAI surveillance data Host the following PHE units Meningococcal Reference Unit MRU which provides national microbiological and surveillance data on meningococcal infections Vaccine Evaluation Unit VEU which studies the efficacy of meningococcal pneumococcal and other vaccines e g human papillomavirus HPV vaccines Sero epidemiology Unit SEU which provides serological data on the epidemiology of infection Provide a Clostridium difficile ribotyping service CDRN for the North West Provide specialist virology and molecular diagnostic services for Greater Manchester
216. y Management Team Authorised by Dr AJL Turner Corneal Scrape Bacteriology Keratitis is an inflammation of the cornea which is a serious condition requiring prompt and meticulous investigation and may progress to perforation and blindness if treatment is unsuccessful Predisposing factors include prior ocular disease wearing contact lenses and use of topical corticosteroids The condition may be caused by a wide range of bacteria fungi and parasites Agar plates for bacterial fungal or acanthamoebal culture which are inoculated directly at the patient s side are incubated immediately on receipt in the laboratory General Information Back to Index Collection Kits are available 24 hours a day from the stock fridge within Autolab container reception MRI should infection with fungi or Acanthamoeba be suspected including additional kits are available from the Autolab reception preservatives The Scrape kit contains Blood blobs a chocolate plate a glass slide within slide carrier and an instruction sheet Manenester Meas te rattotogy Partnerab m Sanne astro ate of mae 14 Maron 2082 per Daemons r mmer me The kit label indicates when the kit expires kits should not be used after the expiry date and unused kits should be returned to microbiology Specimen Aqueous and vitreous humour corneal scrapings Type Collection Use aseptic technique For each scrape of the eye a fresh needle must be used 1
217. y not be detected by this assay Towards the limit of detection of an assay sampling variation will result in lower reproducibility Back to Index Printed 24 7 2015 3 54 AM Valid on day of issue only Manchester Medical Microbiology Partnership Copy no FREE TO PRINT Department ALL Edition no 6 Date of issue 19 December 2014 Page 54 of 221 Document no MMMP QU MAN1 Author Microbiology Management Team Authorised by Dr AJL Turner Rapid Routine Carbapenemase Producing Enterobacteriaceae CPE Screen Bacteriology CMFT In response to the increasing numbers of CPE producing clinical isolates of Enterobacteriaceae the Infection Control Consultant and Microbiology department have produced a protocol for CPE screening and detection The isolation of a clinical CPE isolate prompts the Infection Prevention amp Control Team to screen all possible patient contacts to reduce the transmission of resistance enzymes within the Trust Rapid amp routine CPE screens are processed on a molecular platform culture is only performed on positive samples for epidemiological amp monitoring purposes General Information Back to Index Collection container Swab Double headed Red topped swab available from including preservatives Microbiology Please note Charcoal swabs are unsuitable for this test and will not be processed Specimen Type Screening of faeces rectal swabs Specimen transport If processing is delayed

Pathology Services User Manual - Central Manchester University

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