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Microbiology Test Results: What do they mean?
Christie Massen M.S., MLS(ASCP)Microbiologist III – QA/CLIA Coordinator
North Dakota Department of Health Division of Laboratory Services - Microbiology
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Objectives• Upon completion of this presentation, participants
will be able to:o Summarize various microbiological testing methods.o List the components of a laboratory report.o Interpret various microbiology test results.o Summarize antibiotic susceptibility testing and results.o Compare various serological test results.
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Infectious Diseases
• Bacterial• Viral• Fungal• Parasitic
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Supporting Laboratory Results
• Bacterialo Identification of bacteriao Increased WBC Counto Increased Neutrophil Counto Left-shift in Neutrophil Cell
Lineo Increased CRPo Increased Sed-Rate
• Fungalo KOH Prep Testo Identification of fungal
elements
• Viralo Identification of viruso Normal or Decreased WBC
Counto Increased Lymphocyte Count
• Parasitico Identification of parasiteo Increased Eosinophil Count
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Laboratory Reports
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Bacterial Culture• Pros
o Identify the isolateo Very specific
• Conso Lengthyo Normal flora
• Grow and isolate bacteria• Various media• Identify a pathogen
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Biochemical Testing
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Identification
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Antibiotic Susceptibility Testing
• Determine antibiotic susceptibility or resistance
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Antibiotic Susceptibility Testing
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Case 1
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Case 1: Report
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Case 2
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Case 2: Report
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Modified Hodge Test• Purpose:
o Detection of carbapenemase production in identified organisms
• Interpretation: o Positive
• Clover leaf-like indentation along the streak line
o Negative • No growth along the streak line
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Case 3
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Case 3: Report
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Virology
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Virology Culture• Cytopathic Effect (CPE)
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Case 4
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Case 4: Report
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Parasitology & Mycology
• Direct Examination• Macroscopic and Microscopic
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Molecular Testing• DNA Probes
• DNA sequencingo Nucleic acid sequences (16s)o Whole genome sequencing
• Nucleic Acid Amplification Testing (NAAT)o Polymerase Chain Reaction (PCR)o Ligase Chain Reaction (LCR)o Transcription Mediated Amplification (TMA)
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PCR• Developed in 1985• First NAA method
• How it works:o DNA Polymerase replicates the target DNA molecules
• RNA can be replicatedo Heat and cool cycles utilizedo DNA Primers hybridize the target and initiate polymerization of new
DNA Moleculeso End product: Billions of copies of the target DNAo Read for presence of DNA target
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Immunology Test Methods
• Test Methods:o Agglutinationo Nephlometryo Double Diffusiono Radial Immunodiffusiono Electrophoresiso Western Bloto Flocculationo ELISAo Immunoflorescence assayo Radioimmunoassay
• Detects:o Antigenso Antibodies
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Antibody Review
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Antibody Review
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Case 5
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Case 5: Report
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Case 6
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Case 6: Report
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Case 7
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Case 7: Report
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Case 8
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Vaccine Preventable Disease
Case 8: Report
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Questions?
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References• Kiser, K.M., Payne, W.C., & Taff, T.A. (2011). Clinical
Laboratory Microbiology: A Practical Approach. Upper Saddle River, NJ: Pearson Education.
• Amjad, A., Mirza, I.A., Zia, F. (2011). Modified Hodge test: A simple and effective test for detection of carbapenemase production. Iran Journal of Microbiology. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330182/
• New Directions in Molecular Testing: An Educational Guide for Clinical Laboratory Professionals. Gen-Probe Inc. Retrieved from: www.gen-probe.com