5th week of SIP

hello! how's everyone? hope you guys are doing great. coz i'm pretty much enjoying my attachment here( somewhere)..hehe
well it has been 5 weeks since we started our SIP..how time flies..
for the past 5 weeks, i was posted to Microbiology department as well as Haematology, micro being my longest stay for 3 1/2 weeks..
so im going to focus on micro for this entry..

the micro department here is pretty much on its own. it has a place by itself unlike the rest of the department. it is always these same people that will be runnig the tests for the patient. they are like our specialist team. unlike the rest of the department, micro is manually run. they are not automated except for blood culture where we use a machine called BATEC. i will talk about it more as in the later part. basically, there are three sections in micro- processing, reading for urine culture and reading for miscellaneous culture.

in micro, we process the order entry on our own. before entering the patient's demographic information, we will make sure that the name on the request form matches the one labeled on the specimen. then we will enter into the LISS. after which we will do the requested tests. there are many tests that is performed by the medical technologist. hence i will only mentioned a few test here( if i mentioned every single test, i believe you people will get bored reading it). so one of the test is urine culture. urine culture require two agar plates- TSA blood and Cled. we divide the TSA plate into 4 and the Cled into 2. the streaking for the urine test is as follows:

streaking on Cled plate

streaking on TSA blood

the next test is MRSA. for MRSA, we only use one plate which is mannitol. we divide the plate into three and the streaking is a follow:

streaking on Mannitol plate

we also do wound culture. wound culture requires 4 plates- TSA blood, Scandler blood, MacConkey and PEA. the streaking is the same as on mannitol.

apart from the test that requires culturing of specimen, here in micro we also performed test using kits. one of the test that uses kit is the test for S.pneumonia and Legionella in urine specimen. the test is very simple to performed.
1) we use the cotton bud and dip into the urine sample.
2)we place the cotton bud in the kit test.
3)we place three drops of reagent into the hole provided, two drops for Legionella (different reagent for different test)
4)we leave it for 15 mins before reading the kit
5)if only the control line appears, it is negative, we both the control line and the positive line appears means its positive

the next test kit is for the detection of Clostridium difficile toxin A and B.
the test is not that easy as compared to the test earlier. basically there are 4 reagent use in this test- dilute, conjugate, wash buffer and substrate.
1)first we put 500ul of dilute and 1 drop of conjugate into a test tube.
2)then we take about 5mg of stool and mix it with the two reagent. ( there must be no clump of stool presence in the mixture)
3) pipette about 1ml of the mixture into the test kit(the small hole) and wait for 10 minutes
4) when 15 mins is up, pipette 300ul of wash buffer into the kit (the big hole) as well as 2 drops of substrate
5)leave it for 10 mins before reading the result
6) the interpretation of the result is the same as the test mentioned earlier.

*i know pictures will help. but i cant find one on the net that resemble the test kit that i mentioned. i will try to get the pics and post it here ASAP. ok..sorry

as promise, i will now talk about the blood culture process. the blood will come in 'blood bottles',
one has a blue cap and the other is gold cap. it is recommended to send the blood in both bottles. if only one bottle is sent, we can still run the test. so after entering the information into LISS, we will incubate the 'blood bottles' in Batec. Batec is a specialized machine for blood cultures. we have to incubate the 'blood bottles' for 5 days. no bacteria grow after 5 days will indicate a negative results. for positive blood, it will shows the results anytime between the 5 days. if the blood is positive, we will then have to culture them on the appropriate agar plates.

blood bottles


all the cultures process will have to be incubated overnight. reading will only be done the next day.

reading of the plates includes identifying the bacteria that is present. plates where colonies are seen (more than 20 colonies) will have to be followed up with various test for identification purpose.
example of the tests are catalyse,oxidase,staph-plus,indole and many more.
each test have its own specificity for identifying the bacteria.


sutiana
0604651J
TG01