Art and Science of Laboratory Medicine

Art and Science of Laboratory Medicine

Sunday, August 28, 2016

Bacterial Culture Quiz

Can you identify these five bacteria growing on chromogenic agar plate?
Quiz by Eriq Khaled

Source: Facbook by Eriq Khaled Microbes

Deadly fungal infections acquire drug resistance

Scientists have warned that potentially deadly fungal infections are acquiring resistance to many of the medicines currently used to combat them. More than a million people die of fungal infections every year,including about 7,000 in the UK, and deaths are likely to increase as resistance continues to rise.

Researchers say the widespread use of fungicides on crops is one of the main causes of the rise in fungal resistance, which mirrors the rise of resistance to antibiotics used to treat bacterial infections in humans.

Read more:
Millions at risk as deadly fungal infections acquire drug resistance 

Source: The Guardian
Image: Rob Forman

Good Morning Scientists!

That´s how I feel every morning - with and without coffee

Source Reddit via orangeekraken

Contamination of Laboratory Equipment with Bloodborne Pathogens

Clinical laboratory workers encounter a variety of occupational hazards, including exposure to infectious agents. The routes of pathogen exposure associated with laboratory work include ingestion, inhalation, direct inoculation, and contamination of skin and mucous membranes. The accidental inoculation of infectious materials (i.e., via contaminated needles, broken glass, or other sharps) is the leading cause of laboratory-associated infections.

The fear associated with the recent Ebola virus epidemic triggered a renewed interest in occupationally acquired infections in healthcare workers in the US, including the safety of laboratory workers in handling samples from persons under investigation for Ebola virus disease. Individuals at risk for Ebola virus disease are also at risk for several other infectious diseases with overlapping symptom profiles (such as malaria, influenza, and bacteremia) thus obligating a number of diagnostic laboratory tests. In addition, the clinical management of patients with Ebola virus disease requires ongoing laboratory testing to optimize care (such as complete blood count, coagulation testing, electrolyte analysis, etc.). Laboratory testing for suspect or confirmed Ebola virus disease patients is unfamiliar to most healthcare workers in the US, and thus determining the safest approach to this testing generated anxiety and controversy.

Ebola virus and other emerging pathogens will continue to be encountered in the clinical laboratory. It is the joint responsibility of laboratorians and laboratory leadership to create a culture of safety and adherence to safety protocols, which are essential to reduce the risk of laboratory-acquired infections.

Read more:
Can't Touch This! Contamination of Laboratory Equipment with Bloodborne Pathogens

Source: Clinical Chemistry

Saturday, August 27, 2016

Laboratory Identification of Malaria Parasites


Microscopy (morphologic analysis) continues to be the "gold standard" for malaria diagnosis. Parasites may be visualized on both thick and thin blood smears stained with Giemsa, Wright, or Wright-Giemsa stains. Giemsa is the preferred stain, as it allows for detection of certain morphologic features (e.g. Sch├╝ffner’s dots, Maurer’s clefts, etc.) that may not be seen with the other two. Ideally, the thick smears are used to detect the presence of parasites while the thin smears are used for species-level identification. Quantification may be done on both thick and thin smears.

Molecular diagnosis

Morphologic characteristics of malaria parasites can determine a parasite species, however, microscopists may occasionally fail to differentiate between species in cases where morphologic characteristics overlap (especially Plasmodium vivax and P. ovale), as well as in cases where parasite morphology has been altered by drug treatment or improper storage of the sample. In such cases, the Plasmodium species can be determined by using confirmatory molecular diagnostic tests. In addition, molecular tests such as PCR can detect parasites in specimens where the parasitemia may be below the detectable level of blood film examination.

Antibody detection

Malaria antibody detection for clinical diagnosis is performed using the indirect fluorescent antibody (IFA) test. The IFA procedure can be used as a diagnostic tool to determine if a patient has been infected with Plasmodium. Because of the time required for development of antibody and also the persistence of antibodies, serologic testing is not practical for routine diagnosis of acute malaria. However, antibody detection may be useful for:
screening blood donors involved in cases of transfusion-induced malaria when the donor's parasitemia may be below the detectable level of blood film examination
testing a patient who has been recently treated for malaria but in whom the diagnosis is questioned

Read more:
CDC - DPDx - Malaria - Diagnostic Findings

Source: CDC

POC drug screening quiz

Why might some providers want to use point-of-care (POC) urinary drug screen testing in pain management clinics?
  • The most common reasons are convenience and fast turnaround time. Having immediate test results fosters patient engagement and satisfaction by reducing wait time and enabling practitioners to provide immediate consultations. The positive versus negative screen result is also easy for providers and patients to understand. 
  • Another reason is cost. In the eyes of general practitioners, it is
    cheaper to purchase urinary drug test cups than to send a test to a
    central or reference laboratory. However, proper pain management testing
    often requires additional mass spectrometry–based drug testing.
The utilization of a POC urinary drug screen test in a pain clinic is very limited and the information it provides is often not sufficient to enable proper patient consultation. Because most providers need assistance in interpreting toxicology tests, the use of POC urinary drug screening is likely to cause more confusion. AACC addresses this problem with a pain management compliance test that offers decision support for pain management drug testing.

Take the quiz and check your knowledge.

Related CLN article:
Pitfalls of Point-of-Care Urinary Drug Screening for Pain Management

Source: AACC

Friday, August 26, 2016

Agar Smiley

Emojis, the faces and smileys found on our phones and computers, have become a cultural phenomena affecting not only the way we communicate, but how we express our emotions. These icons have become widely used by celebrities, politicians, and major brands across the internet; Oxford dictionaries named ("Face with Tears of Joy") their Word of the Year for 2015. We chose to recreate some of our favorite emojis using six different bacterial species: Serratia marcescens, Chromobacterium violaceum, Escherichia coli, Micrococcus luteus, Micrococcus roseus, and Staphylococcus epidermidis

Read more
The Emojis of Our Lives

Source FB via ASM

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