10/11/17. Labs What does that really mean? Objectives. Presenters
|
|
- Nigel Johnston
- 5 years ago
- Views:
Transcription
1 Labs What does that really mean? 23rd Annual AONP Conference, MidWest City, Oklahoma 10/18/17, 4:30pm Jennifer Jameson, MT (ASCP) & Rochelle Colby (MLS) CM Objectives 1. Introduction 2. Laboratorians 3. Specimen Collection 4. General Laboratory (Blood Bank, Chemistries, Coag, Blood Gas, Point of Care (POC)) 5. Urinalysis 6. Microbiology 7. Hematology 8. Pathology 1 Presenters Jennifer Jameson MT(ASCP) 25 years of clinical experience 23 years in Microbiology 20 years at Cancer Treatment Centers of America Rochelle Colby MLS (ASCP)CM 7 years of clinical experience 3 years as Lead Hematology Tech 6 years at Cancer Treatment Centers of America 2 1
2 Who are we? Laboratorians MT/MLS/CLS/MLT Bachelor degree (MT/MLS/CLS) or associates (MLT) Medical Technologist, Medical Laboratory Scientist, Clinical Laboratory Scientist Medical laboratory scientist degree (Bachelor) programs are set up in a few different ways. In 3+1 programs, the student attends classroom courses for three years and complete a clinical rotation their final year of study. In 2+2 programs, students have already completed their lower division coursework and return to complete their last two years of study in a CLS program. In 4+1 program, students who have already completed an undergraduate program return to complete a year of medical laboratory training. The training is typically completed at a clinical site rather than a college. The core curriculum in medical technology generally comprises 20 credits in clinical chemistry, 20 credits in hematology, and 20 credits in clinical microbiology. Clinical Rotation Student experiences hands-on learning in each discipline of the laboratory and performs diagnostic testing in a functioning laboratory under supervision. With limited or no compensation, a student in the clinical phase of training usually works 40 hours per week for 20 to 52 weeks. National registry certification exam Administratively independent of the ASCP, the Board of Certification (BOC) has certified more than 450,000 people since it was founded in 1928 and represents the gold standard for certification of pathologists assistants and laboratory professionals 3 How do labs affect your diagnosis and treatment decisions? It is estimated that 70% of all health care decisions affecting diagnosis or treatment involve a pathology investigation. Decisions on an individual s diagnosis, treatment and subsequent therapeutic monitoring are often dependent on a range of pathology-based results. Lab and Pathology Results affect: 1. Imaging/Radiation 2. Pharmacy 3. Surgery 4. Nutrition 5. Oncology 6. Clinical Care Source Clin Biochem Rev Aug; 34(2): : 4 Ordering Lab Tests Order lab tests relative to patients clinical symptoms use to Rule out/rule in Correlate lab results with the clinical impression Use Positive Predictive Value the probability that subjects with a positive screening test truly have the disease Probability of False Positives - look at the whole picture 5 2
3 Lab Mantra Results are ONLY as good as the specimens that we get 1. Patient identification-- two identifiers 2. Source on specimen--write it on there and be specific 3. Date, time and collector s initials -- part of good technique 4. Transports/tube types a. tests can be temperature dependent b. some tests cannot have light exposure c. others need to be in preservative within minutes 5. Examples of what happens with poor collections 6. Redraws happen sometimes-- we want to make sure
4 Specimen Collection Importance of: Order of draw Transport media Timing Orders 9 General Lab - Chemistry **Methodologies are important** a.not all labs/tests are interchangeable for result comparison. Mar General Lab - Blood Bank Patient ID #1 (blood bank bracelets, scanning ID system) Most specimens only good for 72 hours Make sure to answer questions (past transfusions, pregnancy, transplants) 11 4
5 General Lab - Blood Gases sensitive specimens 12 General Lab - Point of Care 13 General Lab - Coagulation 14 5
6 Urinalysis 3 parts to UA a.physical Examination (Color, Clarity, etc) b.biochemical Examination (Blood, Leukocytes, Glucose, Protein etc.) c.microscopic examination (WBC, RBC, Bacteria, etc.) Urinalysis Collections Clean catch, cath, neph., suprapubic tap Contamination/obstructive analysis not properly collected/clean catch, sitting prior to analysis, drugs (pyridium) Differences between Macroscopic (dipstick) & Microscopic findings 17 6
7 Microbiology Step by Step overview MICs and more Blood Cultures Bacterial vs Viral Antibiotic Stewardship New tests/methodologies 18 Microbiology 19 Microbiology Setup 20 7
8 Microbiology Setup Incubate for 24 hours.. and you get.. 21 Microbiology Setup 22 Microbiology Setup 23 8
9 24 Microbiology Susceptibilities MIC = Minimal Inhibitory Concentration The lowest antimicrobial concentration that completely inhibits visible bacterial growth (this means the next well could have some tiny bit of growth). Given in units of mcg/ml. The amount of active drug in micrograms per amount of broth in milliliters (how the wand, bottle and panel all work together). This number is useful when the interpretation is Intermediate. If Susceptible, the drug can be used. If Resistant, it shouldn t be used. But Intermediate means if you can get the drug in a high enough concentration into the patient s system, you may be able to use the drug. But it isn t always safe to do this so consult with an ID expert or a Pharm D first (there s a whole other level of PK/PD and how drug diffuses throughout the body and a whole other lecture needed for that) Watching the MIC levels over time help us monitor resistance 25 Microbiology Susceptibilities MIC cont d Why do the MIC numbers vary? Depends on the bug AND the drug!! Example: A MIC of 8 for vancomycin versus Enterococcus is Intermediate. A MIC of <=32 for nitrofurantoin (Furadantin) versus Enterococcus is Susceptible. The MIC breakpoints (i.e. cut off values for S-I-R) are different for all the different classes of antibiotic. They are not comparable or interchangeable. Vancomycin is a glycopeptide and nitrofurantoin is in the class Nitrofurans. Example: To detect significant resistance to cefepime in Streptococcus pneumoniae, the dilution scheme uses a max concentration of 4 mcg/ml; however, to detect cefepime resistance in E coli, the required max concentration is 16 mcg/ml. Concentration of a drug level to detect resistance is different in each organism. 26 9
10 Microbiology Susceptibilities Kirby Bauer and Etest methods 27 Microbiology Blood Cultures Typically held 5 days total before final Contamination rates ideally should be at or below 3% (per CLSI guidelines) A contaminated culture costs both the hospital and the patient: with longer in-house stays greater antibiotic use increased diagnostic testing Should be calculated monthly to monitor the rate and to help educate those that draw them If you have a positive culture at 36 hours old, one bottle of 4, and gram stain shows Gram Positive Cocci. true positive? contaminant? Clinical symptoms and port vs peripheral draw tricky!!! CTCA s number one pathogen. coagulase negative Staphylococcus (we have a lot of VAD s and that means biofilm and that means colonization can turn to pathogen with immunosuppression) And don t forget fungus!! Yeast likes to live in plastic lines!! 28 Microbiology Bacterial vs Viral Flu season is coming up!! New guidelines coming out (compliance by Jan 2018) Culturing for viruses is almost obsolete. Best method is molecular (viruses are all DNA or RNA so easy to replicate them We ve seen viral throat infection that mimicked strep--beware!! 29 10
11 Microbiology Antibiotic Stewardship Here s some scary statistics about microbiology and antibiotic usage: An estimated 50% of antibiotic use in humans is unnecessary and inappropriate. Antibiotic-resistant bacteria cause over 2 million illnesses and 23,000 deaths annually in the US (as of 8/14/17). Antimicrobial resistance is an increasingly serious threat to health at the patient, community and global level. Prescribing of second-and third-choice drugs due to resistance of first-choice drugs resulting in less effective, more toxic and more expensive drugs being used. At current rates of antimicrobial resistance, we estimate that 2.5 million people will be lost to drug-resistant superbugs in 2020; 5.9 million will be lost in 2030; 15 million will be lost in The rate of resistance is increasing faster than new antimicrobials are being discovered (Methicillin introduced in 1960, resistance detected in 1962; Levofloxacin introduced in 1996, resistance detected in 1996). Source: and 30 Microbiology Antibiotic Stewardship This topic was important enough to be mentioned in the 2014 Presidential State of the Union address. By March of 2015, a National Action Plan, that charged key federal departments and agencies, was created to combat the rise of antibiotic-resistant bacteria. Most hospitals, by now, have implemented an Antibiotic Stewardship Program (ASP). This is usually led by Pharmacy and includes clinicians, Quality, Infection Prevention and Laboratory departments. What can you do to help? Get involved with your ASP and get educated (and educate your patients, too) Check culture results to make sure bug-drug combo is working D/C drugs that aren t needed Ask to see your lab s antibiogram (a chart that summarizes the percent of pathogens susceptible to different antibiotics; done retrospectively) 31 Microbiology Newer Methodologies 1. Stool lactoferrin -- replaces stool for polys 2. Cryptococcal Antigen -- replaces India Ink test 3. EIA/ELISA methods-- for common parasites 4. Chromogenic agar -- selective for certain organisms and will turn color when that organism grows 5. PCR/molecular -- best way to detect viruses, toxins, harder to grow organisms a. C difficile (need to be doing a 2-step algorithm--best practice) b. Respiratory pathogens c. Stool pathogens d. CSF pathogens 6. MALDI TOF -- Matrix-Assisted Laser Desorption/Ionization Time Of Flight-- basically a mass spectrometer with pulsing lasers and ion mirrors and electric fields that give you an organism identification (no susceptibility yet) in about 10 minutes!! The more that are put into use, the larger the database grows and the more reliable it becomes. In use around the country especially being placed into Health Depts 7. Check sensitivity and specificity before implementing a new system-- may not be the best choice for what your facility needs 32 11
12 Hematology 33 Hematology Top vs. Bottom instrument vs. manual diff - indications for manual Flow Cytometry - technology that is used to analyze the physical and chemical characteristics of particles in a fluid as it passes through at least one laser. Cell components are fluorescently labelled and then excited by the laser to emit light at varying wavelengths Top (Hemogram) Bottom (Differential) Suspect Flags (Manual Differential) Flow Cytometry - Differential Scattergram 35 12
13 36 Suspect flags from flow cytometry = manual differential review/differential 37 Possible Peripheral smear from previous scattergram Figure 1. Chronic phase of chronic myelogenous leukemia. The peripheral blood smear is characterized by an elevated white blood cell count showing a left shift in granulocyte maturation, with increased myelocytes. Eosinophilia and basophilia are characteristic (Wright- Giemsa stain, X 100) Source:
14 Hematology Left shift particular population is shifted towards more immature precursors (ie bands, metamyelocytes, myelocytes etc). Right Shift - Neutrophil count will be higher than normal range (predominant cell w/higher than normal absolute value) without the presence of immature cells (bands, metas, myelos) Source: 39 Hematology Toxic Changes: Matters for distinction of infection especially in leukopenic patients. 1. Will be noted on the manual differential 2. Dohle Bodies 3. Toxic Granulation 4. Vacuoles 40 Pathology Specimens in Pathology flow overview 1. Specimens received in the pathology lab 2. Specimen Macroscopically Examined "grossing" is the process by which pathology specimens are inspected with the bare eye to obtain diagnostic information, while being processed for further microscopic examination. Gather diagnostically critical information in this stage of processing, including the stage and margin status of surgically removed tumors 3. Specimen is then sectioned and processed (overnight process) 4. Once processed it is then thinly cut and placed on slide for microscopic evaluation 5. May need special stains identify organisms/diagnosis (add 1-2 days) 6. May be sent out for additional testing (add 1-2 days) 7. If Cancer and needs molecular testing it is sent out (add 1-2 weeks) **Note: Benign FNA or Biopsy does not rule out Cancer Examples of why: May have missed the spot when performing procedure, QNS sample for adequate processing, overwhelmed with inflammation so unable to accurately diagnose. Use Positive Predictive Value and clinical picture to decide if to re-biopsy 41 14
15 Questions? 42 15
WENDY WILLIAMS, MT(AMT) MSAH DIRECTOR LABORATORY AND PATHOLOGY SERVICES. Appalachian Regional Healthcare System apprhs.org
Incorporating Automation and Rapid Diagnostic Technologies into the Micro Lab's Lean Workflow to Boost Productivity, Shorten Length of Stay, and Improve Antibiotic Utilization WENDY WILLIAMS, MT(AMT) MSAH
More informationThe Nuts and Bolts of Antibiograms in Long-Term Care Facilities
The Nuts and Bolts of Antibiograms in Long-Term Care Facilities J. Kristie Johnson, Ph.D., D(ABMM) Professor, Department of Pathology University of Maryland School of Medicine Director, Microbiology Laboratories
More informationAntibiotic stewardship in long term care
Antibiotic stewardship in long term care Shira Doron, MD Associate Professor of Medicine Division of Geographic Medicine and Infectious Diseases Tufts Medical Center Boston, MA Consultant to Massachusetts
More information11/22/2016. Antimicrobial Stewardship Update Disclosures. Outline. No conflicts of interest to disclose
Antimicrobial Stewardship Update 2016 APIC-CI Conference November 17 th, 2016 Jay R. McDonald, MD Chief, ID Section VA St. Louis Health Care System Assistant Professor of medicine Washington University
More informationUnderstanding the Hospital Antibiogram
Understanding the Hospital Antibiogram Sharon Erdman, PharmD Clinical Professor Purdue University College of Pharmacy Infectious Diseases Clinical Pharmacist Eskenazi Health 5 Understanding the Hospital
More informationNursing Home Online Training Sessions Session 2: Exploring Antibiotics and Their Role in Fighting Bacterial Infections
National Nursing Home Quality Care Collaborative Nursing Home Online Training Sessions Session 2: Exploring Antibiotics and Their Role in Fighting Bacterial Infections Health Services Advisory Group (HSAG)
More informationCHAPTER:1 THE RATIONAL USE OF ANTIBIOTICS. BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY
CHAPTER:1 THE RATIONAL USE OF ANTIBIOTICS BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY Antibiotics One of the most commonly used group of drugs In USA 23
More informationRecommendations to take it forward!
Capacity Building and Strengthening of Hospital Infection Control to detect and prevent antimicrobial resistance in India AIIMS-ICMR-CDC EQAS Recommendations to take it forward! Top regional diagnostic
More informationConcise Antibiogram Toolkit Background
Background This toolkit is designed to guide nursing homes in creating their own antibiograms, an important tool for guiding empiric antimicrobial therapy. Information about antibiograms and instructions
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Preventing the Spread of Antibiotic Resistance and Improving Patient Care (Adapted from the Centers for Disease Control and Prevention) What is Stewardship? Antimicrobial stewardship
More informationRole of the nurse in diagnosing infection: The right sample, every time
BROUGHT TO YOU BY Role of the nurse in diagnosing infection: The right sample, every time The module has been written by Shanika Anne-Marie Crusz and Amelia Joseph Authors affiliation: Department of Clinical
More informationGeneral Approach to Infectious Diseases
General Approach to Infectious Diseases 2 The pharmacotherapy of infectious diseases is unique. To treat most diseases with drugs, we give drugs that have some desired pharmacologic action at some receptor
More informationImplementation and Optimization of Antibiotic Stewardship in Acute Care Hospitals: A Clinical Microbiology Laboratory Perspective
Implementation and Optimization of Antibiotic Stewardship in Acute Care Hospitals: A Clinical Microbiology Laboratory Perspective James E. Kirby, MD D(ABMM) Medical Director, Clinical Microbiology Beth
More informationAntimicrobial Stewardship Strategy: Antibiograms
Antimicrobial Stewardship Strategy: Antibiograms A summary of the cumulative susceptibility of bacterial isolates to formulary antibiotics in a given institution or region. Its main functions are to guide
More information8/17/2016 ABOUT US REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM
Mary Moore, MS CIC MT (ASCP) Infection Prevention Coordinator Great River Medical Center, West Burlington REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM ABOUT
More information6/15/2017 PART 1: THE PROBLEM. Objectives. What is Antimicrobial Resistance? Conflicts of Interest Disclosure Statement
Conflicts of Interest Disclosure Statement Getting a grasp on Antibiotic Use and Resistance: Principles of Antimicrobial Stewardship Speaker has nothing to disclose. Jacob M Kesner, PharmD UNMH PGY-2 Infectious
More informationBurn Infection & Laboratory Diagnosis
Burn Infection & Laboratory Diagnosis Introduction Burns are one the most common forms of trauma. 2 million fires each years 1.2 million people with burn injuries 100000 hospitalization 5000 patients die
More informationImpact of Antimicrobial Stewardship Program
Impact of Antimicrobial Stewardship Program Ripal Joshi, Pharm.D. AAHIVP Tampa General Hospital January 28, 2016 Objectives Provide an overview on antimicrobial stewardship programs (ASP) Describe the
More informationCentral Ohio Primary Care and Local Specialty Group Working Hand in Glove for Better Patient Outcomes!
Central Ohio Primary Care and Local Specialty Group Working Hand in Glove for Better Patient Outcomes! Rebecca Burk BS(QSM), Laboratory Manager, Central Ohio Primary Care Physicians, Inc. Contributing
More informationThe Royal College of Pathologists. Pathology: the science behind the cure. Careers in pathology
The Royal College of Pathologists Pathology: the science behind the cure Careers in pathology What is pathology? Pathology is the study of disease. Pathologists work with doctors and nurses in hospitals
More informationDrive More Efficient Clinical Action by Streamlining the Interpretation of Test Results
White Paper: Templated Report Comments Drive More Efficient Clinical Action by Streamlining the Interpretation of Test Results Background The availability of rapid, multiplexed technologies for the comprehensive
More informationThe Basics: Using CLSI Antimicrobial Susceptibility Testing Standards
The Basics: Using CLSI Antimicrobial Susceptibility Testing Standards Janet A. Hindler, MCLS, MT(ASCP) UCLA Health System Los Angeles, California, USA jhindler@ucla.edu 1 Learning Objectives Describe information
More informationCentral Nervous System Infections
Central Nervous System Infections Meningitis Treatment Bacterial meningitis is a MEDICAL EMERGENCY. ANTIBIOTICS SHOULD BE STARTED AS SOON AS THE POSSIBILITY OF BACTERIAL MENINGITIS BECOMES EVIDENT, IDEALLY
More informationTerry Talks Nutrition: Infectious microbes
Terry Talks Nutrition: Infectious microbes Meet the Microbes Microbes = very tiny living things that can only be seen under a microscope 4 types of disease-causing microbes Bacteria Viruses Yeast (fungi)
More informationASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies
ASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies Theresa Jaso, PharmD, BCPS (AQ-ID) Network Clinical Pharmacy Specialist Infectious Diseases Seton Healthcare Family Ascension
More informationExotic Hematology Lab Leigh-Ann Horne, LVT, CWR Wildlife Center of Virginia
Exotic Hematology Lab Leigh-Ann Horne, LVT, CWR Wildlife Center of Virginia lhorne@wildlifecenter.org Anne Lynch, LVT Cedarcrest Animal Clinic amllvt9@gmail.com Introduction While the general set-up for
More informationVaccination as a potential strategy to combat Antimicrobial Resistance in the elderly
Vaccination as a potential strategy to combat Antimicrobial Resistance in the elderly Wilbur Chen, MD, MS 22-23 March 2017 WHO meeting on Immunization of the Elderly The Problem Increasing consumption
More informationAntibacterial Agents & Conditions. Stijn van der Veen
Antibacterial Agents & Conditions Stijn van der Veen Antibacterial agents & conditions Antibacterial agents Disinfectants: Non-selective antimicrobial substances that kill a wide range of bacteria. Only
More informationWhat You Need to Know for the AP/CP Boards
What You Need to Know for the AP/CP Boards Betsy D. Bennett, M.D., Ph.D. Executive Vice President American Board of Pathology Requirements for Certification by the ABP Licensure Training Examination What
More informationProphylactic antibiotic timing and dosage. Dr. Sanjeev Singh AIMS, Kochi
Prophylactic antibiotic timing and dosage Dr. Sanjeev Singh AIMS, Kochi Meaning - Webster Medical Definition of prophylaxis plural pro phy lax es \-ˈlak-ˌsēz\play : measures designed to preserve health
More informationAntibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE
Antibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE Crisis: Antibiotic Resistance Success Strategy WWW.optimistic-care.org
More informationEDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update
EDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain
More informationUNDERSTANDING THE ANTIBIOGRAM
UNDERSTANDING THE ANTIBIOGRAM April Abbott, PhD, D(ABMM) Deaconess Health System Indiana University School of Medicine - Evansville Evansville, IN April.Abbott@Deaconess.com WHAT WE WILL COVER Describe
More informationOMICS International through its Open Access Initiative is committed to make genuine and reliable contributions to the scientific community.
About OMICS International OMICS International through its Open Access Initiative is committed to make genuine and reliable contributions to the scientific community. OMICS International hosts over 700
More informationAntibiotic Stewardship in the LTC Setting
Antibiotic Stewardship in the LTC Setting Joe Litsey, Director of Consulting Services Pharm.D., Board Certified Geriatric Pharmacist Thrifty White Pharmacy Objectives Describe the Antibiotic Stewardship
More informationEDUCATIONAL COMMENTARY CURRENT METHODS IN ANTIMICROBIAL SUSCEPTIBILITY TESTING
Commentary provided by: Linsey Donner, MPH, CPH, MLS (ASCP) CM Assistant Professor, Microbiology and Serology College of Allied Health Professions, Division of Medical Laboratory Science University of
More information3/10/2016. Faster Microbiology An Outcome Analysis. Disclaimer. Short Topic Objectives
Faster Microbiology An Outcome Analysis James E. Lee, Ph.D. Disclaimer The views expressed are those of the authors and do not reflect the official policy of the Department of the Army, Department of Defense
More informationSchedule of Accreditation
Schedule of Accreditation Organisation Name INAB Reg No Contact Name Address Saolta University Health Care Group Sligo University Hospital Microbiology Department 321MT Anne O'Toole Contact Phone No 071
More informationAntimicrobial Stewardship Programs The Same, but Different. Sara Nausheen, MD Kevin Kern, PharmD
Antimicrobial Stewardship Programs The Same, but Different Sara Nausheen, MD Kevin Kern, PharmD Antimicrobial Stewardship Programs The Same, but Different Objectives: Outline the overall function of an
More informationDefine evidence based practices for selection and duration of antibiotics to treat suspected or confirmed neonatal sepsis
GLOBAL AIM: Antibiotic Stewardship Perinatal Quality Improvement Teams (PQITs) will share strategies and lessons learned to develop potentially better practices and employ QI methodologies to establish
More informationChallenges and opportunities for rapidly advancing reporting and improving inpatient antibiotic use in the U.S.
Challenges and opportunities for rapidly advancing reporting and improving inpatient antibiotic use in the U.S. Overview of benchmarking Antibiotic Use Scott Fridkin, MD, Senior Advisor for Antimicrobial
More informationBlood Cells of Reptiles. Blood Cells of Reptiles. Blood Cells of Reptiles. Blood Cells of Reptiles. Blood Cells of Reptiles
INTRODUCTION TO REPTILE HEMATOLOGY & CYTOLOGY DVM. PhD Dec 14 2014 Leukocytes Thrombocytes Similar diagnostic principles as Mammals. Similar in function as Avian. Much more unknowns and variables in Reptiles.
More informationEducating Clinical and Public Health Laboratories About Antimicrobial Resistance Challenges
Educating Clinical and Public Health Laboratories About Antimicrobial Resistance Challenges Janet Hindler, MCLS MT(ASCP) UCLA Medical Center jhindler@ucla.edu also working as a consultant with the Association
More informationBurton's Microbiology for the Health Sciences. Chapter 9. Controlling Microbial Growth in Vivo Using Antimicrobial Agents
Burton's Microbiology for the Health Sciences Chapter 9. Controlling Microbial Growth in Vivo Using Antimicrobial Agents Chapter 9 Outline Introduction Characteristics of an Ideal Antimicrobial Agent How
More informationThe Spread of the Superbug
The Spread of the Superbug AST staff As technology continues to allow scientists to make medical advances that once were considered difficult, new threats to public health are rising. Superbugs are deadly
More informationStanding Orders for the Treatment of Outpatient Peritonitis
Standing Orders for the Treatment of Outpatient Peritonitis 1. Definition of Peritonitis: a. Cloudy effluent. b. WBC > 100 cells/mm3 with >50% polymorphonuclear (PMN) cells with minimum 2 hour dwell. c.
More informationMethicillin-Resistant Staphylococcus aureus
Methicillin-Resistant Staphylococcus aureus By Karla Givens Means of Transmission and Usual Reservoirs Staphylococcus aureus is part of normal flora and can be found on the skin and in the noses of one
More informationAntimicrobial Stewardship:
Antimicrobial Stewardship: Inpatient and Outpatient Elements Angela Perhac, PharmD afperhac@carilionclinic.org Disclosure I have no relevant finances to disclose. Objectives Review the core elements of
More informationGeriatric Mental Health Partnership
Geriatric Mental Health Partnership September 8, 2017 First, let s test your knowledge about antibiotics http://www.cdc.gov/getsmart/community/about/quiz.html 2 Get Smart Antibiotics Quiz Antibiotics fight
More informationAn Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings?
An Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings? Dr. Andrew Morris Antimicrobial Stewardship ProgramMt. Sinai Hospital University Health Network amorris@mtsinai.on.ca andrew.morris@uhn.ca
More informationNew Opportunities for Microbiology Labs to Add Value to Antimicrobial Stewardship Programs
New Opportunities for Microbiology Labs to Add Value to Antimicrobial Stewardship Programs Patrick R. Murray, PhD Senior Director, WW Scientific Affairs 2017 BD. BD, the BD Logo and all other trademarks
More informationAntibiotics. Antimicrobial Drugs. Alexander Fleming 10/18/2017
Antibiotics Antimicrobial Drugs Chapter 20 BIO 220 Antibiotics are compounds produced by fungi or bacteria that inhibit or kill competing microbial species Antimicrobial drugs must display selective toxicity,
More informationHot Topics in Antimicrobial Stewardship. Meghan Brett, MD Medical Director, Antimicrobial Stewardship University of New Mexico Hospital
Hot Topics in Antimicrobial Stewardship Meghan Brett, MD Medical Director, Antimicrobial Stewardship University of New Mexico Hospital Antimicrobial Stewardship Goals Primary Goal Optimize clinical outcomes
More informationMastitis and On-Farm Milk Cultures - A Field Study - Part 1
Mastitis and On-Farm Milk Cultures - A Field Study - Part 1 This two-part article discusses the results of a research project undertaken by Dr. Tim Olchowy, Senior Lecturer in Livestock Medicine, School
More informationUNDERSTANDING YOUR DATA: THE ANTIBIOGRAM
UNDERSTANDING YOUR DATA: THE ANTIBIOGRAM April Abbott, PhD, D(ABMM) Deaconess Health System Evansville, IN April.Abbott@Deaconess.com Special thanks to Dr. Shelley Miller for UCLA data WHAT WE WILL COVER
More informationGuidelines for Laboratory Verification of Performance of the FilmArray BCID System
Guidelines for Laboratory Verification of Performance of the FilmArray BCID System Purpose The Clinical Laboratory Improvement Amendments (CLIA), passed in 1988, establishes quality standards for all laboratory
More informationANTIBIOTIC STEWARDSHIP
ANTIBIOTIC STEWARDSHIP S.A. Dehghan Manshadi M.D. Assistant Professor of Infectious Diseases and Tropical Medicine Tehran University of Medical Sciences Issues associated with use of antibiotics were recognized
More informationQ1. (a) Clostridium difficile is a bacterium that is present in the gut of up to 3% of healthy adults and 66% of healthy infants.
Q1. (a) Clostridium difficile is a bacterium that is present in the gut of up to 3% of healthy adults and 66% of healthy infants. C. difficile rarely causes problems, either in healthy adults or in infants.
More informationStanding Orders for the Treatment of Outpatient Peritonitis
Standing Orders for the Treatment of Outpatient Peritonitis 1. Definition of Peritonitis: a. Cloudy effluent. b. WBC > 100 cells/mm3 with >50% polymorphonuclear (PMN) cells with minimum 2 hour dwell. c.
More informationVLLM0421c Medical Microbiology I, practical sessions. Protocol to topic J05
Topic J05: Determination of susceptibility of bacteria to antimicrobial drugs, assessments of resistance factors For study: textbooks, www, keywords e. g. Diffusion disc test ; E-test ; dilution micromethod
More informationPhysician Rating: ( 23 Votes ) Rate This Article:
From Medscape Infectious Diseases Conquering Antibiotic Overuse An Expert Interview With the CDC Laura A. Stokowski, RN, MS Authors and Disclosures Posted: 11/30/2010 Physician Rating: ( 23 Votes ) Rate
More informationEXPERIMENT. Antibiotic Sensitivity-Kirby Bauer Diffusion Test
EXPERIMENT Antibiotic Sensitivity-Kirby Bauer Diffusion Test Author Name Version 42-0238-00-02 Review the safety materials and wear goggles when working with chemicals. Read the entire exercise before
More informationWarm Up What recommendations do you have for him? Choose a partner and list some suggestions in your lab notebook.
Antibiotics 1. Warmup: Medical Scenario 2. Lecture: PPT Slides & Notes 3. Math Connection: Graphing Activity 4. Assessment: Final Recommendation for Medical Scenario Citing Evidence 5. Enrichment: Article
More informationThe Spread of the Superbug
The Spread of the Superbug AST staff As technology continues to allow scientists to make medical advances that once were considered difficult, new threats to public health are rising. Superbugs are deadly
More informationAntibiotics & Resistance
What are antibiotics? Antibiotics & esistance Antibiotics are molecules that stop bacteria from growing or kill them Antibiotics, agents against life - either natural or synthetic chemicals - designed
More informationCourse # Course Name Credits
Curriculum Outline: Course # Course Name Credits Term 1 Courses VET 100 Introduction to Veterinary Technology 3 ENG 105 English Composition 3 MATH 120 Technical Mathematics 3 VET 130 Animal Biology/ Anatomy
More informationAntibiotic Stewardship: The Facility Role and Implementation. Tim Cozad, LPN, Lead LTC Health Facilities Surveyor
Antibiotic Stewardship: The Facility Role and Implementation Tim Cozad, LPN, Lead LTC Health Facilities Surveyor Phase II CMS Regulatory Changes Current information available includes: New Survey Process
More informationMark Your Calendars Now! Next Event Ships: September 14, 2015
www.wslhpt.org 2601 Agriculture Drive Madison, WI 53718 (800) 462-5261 (608) 265-1111 Shipment Date: June 15, 2015 Questions or comments should be directed to Amanda Weiss at 800-462-5261 x51 or amanda.weiss@slh.wisc.edu.
More informationmicrobiology testing services
microbiology testing services You already know Spectra Laboratories for a wide array of dialysis-related testing services. Now get to know us for your microbiology needs. As the leading provider of renal-specific
More informationWHY IS THIS IMPORTANT?
CHAPTER 20 ANTIBIOTIC RESISTANCE WHY IS THIS IMPORTANT? The most important problem associated with infectious disease today is the rapid development of resistance to antibiotics It will force us to change
More informationANTIBIOTICS IN THE ER:
ANTIBIOTICS IN THE ER: EXPLORING THE ROLE OF ANTIMICROBIAL STEWARDSHIP IN THE EMERGENCY DEPARTMENT ANGELINA DAVIS, PHARMD, MS, BCPS (AQ-ID) LIAISON CLINICAL PHARMACIST DUKE ANTIMICROBIAL STEWARDSHIP OUTREACH
More informationAntimicrobial Stewardship in the Long Term Care and Outpatient Settings. Carlos Reyes Sacin, MD, AAHIVS
Antimicrobial Stewardship in the Long Term Care and Outpatient Settings Carlos Reyes Sacin, MD, AAHIVS Disclosure Speaker and consultant in HIV medicine for Gilead and Jansen Pharmaceuticals Objectives
More informationAmerican Association of Feline Practitioners American Animal Hospital Association
American Association of Feline Practitioners American Animal Hospital Association Basic Guidelines of Judicious Therapeutic Use of Antimicrobials August 1, 2006 Introduction The Basic Guidelines to Judicious
More informationPrinciples of Antimicrobial Therapy
Principles of Antimicrobial Therapy Doo Ryeon Chung, MD, PhD Professor of Medicine, Division of Infectious Diseases Director, Infection Control Office SUNGKYUNKWAN UNIVERSITY SCHOOL OF MEDICINE CASE 1
More informationCONTAGIOUS COMMENTS Department of Epidemiology
VOLUME XXVII NUMBER 6 July 2012 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine B. Dowell SM, MLS (ASCP); Sarah K. Parker, MD; James K. Todd, MD Each year the Children s Hospital Colorado
More informationBackground and Plan of Analysis
ENTEROCOCCI Background and Plan of Analysis UR-11 (2017) was sent to API participants as a simulated urine culture for recognition of a significant pathogen colony count, to perform the identification
More informationAntibiotics in vitro : Which properties do we need to consider for optimizing our therapeutic choice?
Antibiotics in vitro : Which properties do we need to consider for optimizing our therapeutic choice? With the support of Wallonie-Bruxelles-International 1-1 In vitro evaluation of antibiotics : the antibiogram
More informationSelective toxicity. Antimicrobial Drugs. Alexander Fleming 10/17/2016
Selective toxicity Antimicrobial Drugs Chapter 20 BIO 220 Drugs must work inside the host and harm the infective pathogens, but not the host Antibiotics are compounds produced by fungi or bacteria that
More informationAntibacterial Resistance: Research Efforts. Henry F. Chambers, MD Professor of Medicine University of California San Francisco
Antibacterial Resistance: Research Efforts Henry F. Chambers, MD Professor of Medicine University of California San Francisco Resistance Resistance Dose-Response Curve Antibiotic Exposure Anti-Resistance
More informationVeterinary Medical Terminology
Curriculum Outline: Course # Required courses prior to admission Credit hours BIO 0 Principles of Biology I with Lab 4 CHM 0 General Chemistry I with Lab 4 ENG 110 or 111 or 1 Freshman Composition or Composition
More informationOptimizing Antimicrobial Stewardship Activities Based on Institutional Resources
Optimizing Antimicrobial Stewardship Activities Based on Institutional Resources Andrew Hunter, PharmD, BCPS Infectious Diseases Clinical Pharmacy Specialist Michael E. DeBakey VA Medical Center Andrew.hunter@va.gov
More informationLEARNING OBJECTIVES ANTIMICROBIAL USES AND ABUSES INFECTIOUS DISEASE SCARES
LEARNING OBJECTIVES ANTIMICROBIAL USES AND ABUSES Goodbye to the Antibiotic Era? Glenn D. Bedsole, MD, FACP Infectious Disease Consultant 1. Be able to list 6 examples of resistant bacteria that present
More informationOverview of Antimicrobial Stewardship
Overview of Antimicrobial Stewardship Kurt B. Stevenson, MD, MPH Professor of Medicine and Epidemiology Colleges of Medicine and Public Health Medical Director, Antimicrobial Stewardship Program The Ohio
More information6.0 ANTIBACTERIAL ACTIVITY OF CAROTENOID FROM HALOMONAS SPECIES AGAINST CHOSEN HUMAN BACTERIAL PATHOGENS
6.0 ANTIBACTERIAL ACTIVITY OF CAROTENOID FROM HALOMONAS SPECIES AGAINST CHOSEN HUMAN BACTERIAL PATHOGENS 6.1 INTRODUCTION Microorganisms that cause infectious disease are called pathogenic microbes. Although
More informationTest Method Modified Association of Analytical Communities Test Method Modified Germicidal Spray Products as Disinfectants
Study Title Antibacterial Activity and Efficacy of E-Mist Innovations' Electrostatic Sprayer Product with Multiple Disinfectants Method Modified Association of Analytical Communities Method 961.02 Modified
More informationTREAT Steward. Antimicrobial Stewardship software with personalized decision support
TREAT Steward TM Antimicrobial Stewardship software with personalized decision support ANTIMICROBIAL STEWARDSHIP - Interdisciplinary actions to improve patient care Quality Assurance The aim of antimicrobial
More informationBacteriology. Mycology. Genova Diagnostics Europe Parkgate House 356 West Barnes Lane New Malden, Surrey. KT3 6NB. Order Number:
Genova Diagnostics Europe Parkgate House 356 West Barnes Lane New Malden, urrey. KT3 6NB Bacteriology Lactobacillus species 3+ Escherichia coli 4+ Bifidobacterium 3+ gamma haemolytic treptococcus NP 4+
More informationDO NOT WRITE ON or THROW AWAY THIS PAPER!
What Kills Bacteria? Lab Procedure Go to the following link: http://www.glencoe.com/sites/common_assets/science/virtual_labs/ls08/ls08.html or DO NOT WRITE ON or THROW AWAY THIS PAPER! Visit my eboard
More informationCan you treat mrsa with amoxicillin
Can you treat mrsa with amoxicillin 15-8-2017 Community-associated MRSA You can pick up MRSA outside the hospital, especially if you :. (a related drug developed to treat these germs). Amoxicillin and
More informationSource: Portland State University Population Research Center (
Methicillin Resistant Staphylococcus aureus (MRSA) Surveillance Report 2010 Oregon Active Bacterial Core Surveillance (ABCs) Office of Disease Prevention & Epidemiology Oregon Health Authority Updated:
More informationEuropean Antimicrobial Resistance Surveillance System (EARSS) in Scotland: 2004
European Antimicrobial Resistance Surveillance System (EARSS) in Scotland: 2004 SECOND ANNUAL REPORT MJ Coyne 1, SJ Dancer 1, G Edwards 2, 3, D Morrison 2. 1 Health Protection Scotland, 2 Scottish MRSA
More informationClinical Programme. Dermatology
2018 The diagnosis and management of skin represents a major component of small animal practice. Through lectures, case discussions and practical sessions, this modular programme will enable you to learn
More informationChapter 1 COPYRIGHTED MATERIAL. Introduction to Veterinary Pathology. What is pathology? Who does pathology?
What is pathology? Who does pathology? Chapter 1 Introduction to Veterinary Pathology Anatomic pathology Clinical pathology Microbiology Parasitology Immunology Toxicology Veterinary forensic pathology
More informationGeNei TM. Antibiotic Sensitivity. Teaching Kit Manual KT Revision No.: Bangalore Genei, 2007 Bangalore Genei, 2007
GeNei Bacterial Antibiotic Sensitivity Teaching Kit Manual Cat No. New Cat No. KT68 106333 Revision No.: 00180705 CONTENTS Page No. Objective 3 Principle 3 Kit Description 4 Materials Provided 5 Procedure
More informationAntibiotic Stewardship Program (ASP) CHRISTUS SETX
Antibiotic Stewardship Program (ASP) CHRISTUS SETX Program Goals I. Judicious use of antibiotics Decrease use of broad spectrum antibiotics and deescalate use based on clinical symptoms Therapeutic duplication:
More informationAntibiotic Resistance
Antibiotic Resistance ACVM information paper Background Within New Zealand and internationally, concerns have been raised about an association between antibiotics used routinely to protect the health of
More informationCONTAGIOUS COMMENTS Department of Epidemiology
VOLUME XXIX NUMBER 3 November 2014 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine Dowell SM MLS (ASCP), Marti Roe SM MLS (ASCP), Sarah Parker MD, Jason Child PharmD, and Samuel R.
More informationThe Rise of Antibiotic Resistance: Is It Too Late?
The Rise of Antibiotic Resistance: Is It Too Late? Paul D. Holtom, MD Professor of Medicine and Orthopaedics USC Keck School of Medicine None DISCLOSURES THE PROBLEM Antibiotic resistance is one of the
More informationInt.J.Curr.Microbiol.App.Sci (2017) 6(3):
International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 6 Number 3 (2017) pp. 891-895 Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2017.603.104
More informationAntimicrobials & Resistance
Antimicrobials & Resistance History 1908, Paul Ehrlich - Arsenic compound Arsphenamine 1929, Alexander Fleming - Discovery of Penicillin 1935, Gerhard Domag - Discovery of the red dye Prontosil (sulfonamide)
More information