Sunday, August 21, 2011

Role of laboratory in infection control programs

The microbiology laboratory can support the ICP by the following ways (Mc Gowan & Weinstein, 1992).
- Ensure high quality performance in the laboratory. Because the surveillance system uses the results of cultures and other tests ordered by physicians for the diagnosis and treatment of patients. Additional laboratory tests may be necessary for epidemiologic purposes.
- Designate at least one person from the microbiology laboratory to be the consultant to ICP and to serve a member of the infection control committee. Conversely, the representative should keep ICP informed about changes in the laboratory that may affect surveillance. This person should be selected for his knowledge of and interest in infection control.
- Make laboratory test results available in an organized, accessible and timely manner. This design of record-keeping system should accommodate the needs of ICP.
- Provide training on basic microbiology for ICP staff to interpret the results of cultures and other tests in order to conduct surveillance.
- Monitor laboratory results for unusual findings. The laboratory should watch for clusters of pathogens that may indicate an outbreak, the emergence of multidrug resistant organisms, and the isolation of highly infectious, unusual, or virulent pathogens, the laboratory staff is usually the first to recognize these unusual events, and reporting them early to the ICP may avert a serious problem.
- Microbiology laboratories are asked to perform environmental cultures to assess microbial contamination of inanimate objects or the level of contamination in certain areas of the hospital. Such cultures must be coordinated with ICP to ensure that it is performed only when indicated and that the specimens are processed appropriately. Routine environmental cultures are recommended only for monitoring autoclaves and water used to prepare dialysis fluid. Environmental cultures, including personnel cultures should not be done unless epidemiologic evidence indicates an environmental source of the pathogen. Under these circumstances, information about the etiologic agent can often lead to a clearer understanding about the source of infection and mode of transmission. Occasionally, a culture of a device used on an infected patient can locate the source of infection; e.g. the method for culturing intravascular catheter tips to determine a vascular site infection has been found to be useful (Maki, 1992).
- In collaboration with the ICP, the laboratory should develop a system for storing epidemiologically important strains of pathogens from nosocomial infections by subculturing them and maintaining them in a viable state. The collection should be discarded when they are no longer needed.
- Take proper action when contamination of a commercial product is suspected. If contamination is suspected, the hospital laboratory should not attempt to culture the product or device, since special techniques and equipment are required. Instead notify your state health department.

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