Jan 21, 2010

Importance of Microbiology

*- Studying of microbiology is highly essential for the following :-
1- Lab Diagnosis of Infectious Diseases

*- This is by isolation & cultivation of the causative m.o. in addition to serological diagnosis.
2- Treatment of Infectious Diseases

*- This is by selection of sensitive & specific drugs as antibiotics
3- Prevention of Disease Spreading

*- This is by Immunization Program, through Vaccine preparation & Production (Active Immunization ) or Passive Immunization by Administration of specific anti-sera.

*- The Development of Microbiology in the last Century lead to a Revolution betterment in :
1- Human health & security
2- Doubling the average length of life
3- Safe of newly bron Childs

Jan 15, 2010

Development of Microbiology

Microoganisms wera first seen since 1675 by the Dutchmen anthony van Leeu-wen hock, his microscope magnified 200X & he Saw bodies of bout 1u
He found many m.0. in water, saliva & intestinal contents He saw bacteria as well as the larger m.o.
He founs the bacteria size as 1/6 of the RBCs size
He also recognized the bacterial shapes as:- Bacilli (rods) , Cocci (sphere) & Spirochetes (spiral filaments)
He also discovered the nutrient media for bacterial growth (Bacterial culture)
The mechanism of bacrerial reproduction by Asexual Fusion was discovered by De-Saussere, 1760
Robert Koch, in 1877 described a method for preparation & Examination of bacteria
This was by preparation of dried & fixed film staned with Aniline dyes in 1881, he found a simple method for isolating pure culture of bacteria on a solid media.

General Bacteriology & Mycology

Medical Microbiology is a branch of biological sciences dealing with studying of living pathogenic & non-pathogenic microorganisms (m o.) & their characters
Micro- = Minute
Bio- = Living
Ology- = Science
Medical- = Microorganisms of medical important
( m.o. causing diseases )

Applications of microbiology have given medicine its great successes in diagnosis, prevention, cure of disease

ISO 15189

ISO 15189:2003 Medical laboratories - Particular requirements for quality and competence specifies the quality management system requirements particular to medical laboratories. The standard was developed by the International Organisation for Standardisations's Technical Committee 212 (ISO/TC 212). ISO/TC 212 assigned ISO 15189 to a working group to prepare the standard based on the details of ISO/IEC 17025:1999 General requirements for the competence of testing and calibration laboratories. This working group included provision of advice to users of the laboratory service, the collection of patient samples, the interpretation of test results, acceptable turnaround times, how testing is to be provided in a medical emergency and the lab's role in the education and training of health care staff.
While the standard is based on ISO/IEC 17025 and ISO 9001, it is a unique document that takes into consideration the specific requirements of the medical environment and the importance of the medical laboratory to patient care.

Medical laboratory accreditation

Credibility of medical laboratories is paramount to the health and safety of the patients relying on the testing services provided by these labs. The international standard in use today for the accreditation of medical laboratories is ISO 15189 - Medical laboratories - particular requirements for quality and competence.
Accreditation is done by the Joint Commission, AABB, and other state and federal agencies. CLIA 88 or the Clinical Laboratory Improvement Amendments also dictate testing and personnel.
The accrediting body in Australia is NATA, all laboratories must be NATA accredited to receive payment from Medicare.

Scandal in the clinical lab industry - SmithKline Beecham

Scandal in the clinical lab industry - SmithKline Beecham

As medical technology advanced doctors were able to get more and more tests done in shorter and shorter amounts of time. Where in the past a doctor might order a potassium and glucose and it would take hours for the results, now a doctor can order a full chemistry panel of 20 or more different analytes and get the results in under an hour. The results are also much more accurate and reliable now than in the past. Thus, into the 1970s and 1980s the lab became a source of profit within the hospital structure. Some commercial labs began taking illegal and nefarious actions to increase their income. These practices included medicare and medicaid fraud by performing and billing for tests that the ordering physician never ordered, paying kickbacks to private doctor offices for sending their specimens to these reference labs, and other complicated criminal activity. These kickbacks included donuts, free computers, fax machines, and more. These events culminated mostly in the mid 1990s with the SmithKline Beecham (now GlaxoSmithKline) Clinical Laboratory (SBCL) scandal.[2] It is believed SBCL paid at least $325 million in penalties and the industry as a whole paid over $1 billion to insurance and government agencies that were defrauded. Ever since this time, the lab has become a source of expense and loss in the hospital budget (commercial labs have nothing to do with hospitals) and lab medicine's reputation was given a black eye. Now many labs have a compliance officer with mandatory annual meetings about compliance for all employees.

Result analysis, validation and interpretation

According to ISO 15189 norm, all pathological results must be verified by a competent professional. In some countries staff like clinical scientists do the majority of this work inside the laboratory with abnormal results referred to the relevant pathologist. In others, only medical staff (pathologist or clinical biologist) is concerned by this phase. It can be assisted by some software in order to validate normal or non modified results. Medical staff are sometimes also required in order to explain pathology results to physicians. For a simple result given by phone or for a technical problem it's a medical technologist explaining it to a registered nurse.
Departments in some countries are exclusively directed by a specialized Pathologist, in others a consultant, medical or non-medical, may be the Head of Department. Clinical Scientists have the right to interpret and discuss pathology results in their discipline in many countries, in Europe they are qualified to at least Masters level, may have a PhD and can have an exit qualification equivalent to medical staff e.g. FRCPath in the UK. In France only medical staff (Pharm.D. and M.D. specialized in Anatomical pathology or Clinical biology) can discuss pathological results, clinical scientists are not considered as a part of medical staff.