Microbiologist Information and Courses from MediaLab, Inc.

In follow-up to the observations of the ESBL screening test, the following antibiotic susceptibility profile was later reported: Ampicillin = R; Cefazolin = R; Cefoxitin 1 = S; Ciprofloxacin 0.25 = S; Gentamicin 1 = S; Ceftazidime 32 = R; Imipenem The susceptibility of the 2nd generation drug cefoxitin, with resistance of the 1st generation cefazolin and the 3rd generation ceftazidime, is another way in addition to the screening test in which ESBL activity may be detected. It is recommended that clinical microbiologists check the antibiotic susceptibility profiles for possible ESBL activity of clinically significant isolates of K. pneumoniae and E. coli.Most automated systems have built in methods for automatically detecting an ESBL isolate, or provide an "alert" that such a strain may be present.

Busy hospital laboratory in a 350 bed urban hospital that provides laboratory testing for the hospital and for the hospital's outreach testing laboratory. A medical technologist in the microbiology department receives a call from a friend who works in a laboratory in a physician office. The physician is not a regular client of the laboratory currently but uses another laboratory for most of their work. The microbiologist knows that the sales department would like to get this account. The friend explains to her that she is doing a quality control check on her in-office microbiology testing and her regular laboratory will do it but is going to charge her for it. She asks the microbiologist if she will do it for free since it is quality control, not Medicare and is not going to be billed to anyone.She tells the microbiologist that she would like to use the hospital lab for everything but her doctor insists on using the competitor. She indicates that the favor might help get the doctor to try the hospital laboratory for other tests. The microbiologist should:Correct Answer: Explain to her friend that if the hospital does the tests for no charge on the promise of other referrals, both the physician office and the hospital could be liable for violations of the antikickback statute.Discussion: The antikickback statute is implicated in this scenario because the free testing is solicited on the condition that other referrals may occur as a result of providing the favor. In fact, the solicitation itself is a violation of the law. The fact that Medicare patients are not specifically mentioned in the scenario is not sufficient to remove the risk. The technologist should also report the incident to the Compliance Officer and seek advise about what documentation, if any, should be kept concerning the incident.

A busy laboratory is located in a 350 bed urban hospital that provides laboratory testing for the hospital and for the hospital's outreach testing program. A medical technologist in the microbiology department receives a call from a friend who works in a laboratory in a physician office. The physician is not a regular client of the laboratory currently but uses another laboratory for most of their work. The microbiologist knows that the sales department would like to get this account. The friend explains to her that she is doing a quality control check on her in-office microbiology testing and her regular laboratory will do it but is going to charge her for it. She asks the microbiologist if she will do it for free since it is quality control, not Medicare, and is not going to be billed to anyone.She tells the microbiologist that she would like to use the hospital lab for everything but her doctor insists on using the competitor. She indicates that the favor might help get the doctor to try the hospital laboratory for other tests. How should the microbiologist respond to this request?Correct Answer: Explain to her friend that if the hospital does the tests for no charge on the promise of other referrals, both the physician office and the hospital could be liable for violations of the antikickback statute.Discussion: The antikickback statute is implicated in this scenario because the free testing is solicited on the condition that other referrals may occur as a result of providing the favor. In fact, the solicitation itself is a violation of the law. The fact that Medicare patients are not specifically mentioned in the scenario is not sufficient to remove the risk. The technologist should also report the incident to the Compliance Officer and seek advise about what documentation, if any, should be kept concerning the incident.

Hazardous material classifications are consistent across all agencies who regulate commercial shipping and are based on criteria developed by the United Nations (UN) Committee of Experts working with the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), medical professionals, microbiologists, transportation professionals, and packaging technical experts. These requirements can be found in the 13th and 14th editions of the United Nations Recommendations for the Transport of Dangerous Goods, the 2005 - 2006 edition of the International Civil Aviation Organization Technical Instructions for the Safe Transport of Dangerous Goods by Air (ICAO Technical Instructions), and the International Maritime Organization (IMO) Dangerous Goods Code. The classification system for Division 6.2 Infectious Substances includes two catergories, known simply as Category A and Category B.

The culture smear is used to determine the staining characteristic, size, shape and cellular arrangement of the unknown organism. This data helps the microbiologist to decide on additional culture and identification methods. By correlating the Gram stain reaction, size, shape, and cellular arrangement of the organism with colony morphology and growth requirements, the microbiologist may be able to tentatively identify the organism. This information may help the physician to optimize treatment until definitive culture and antibiotic susceptibility results become available. Gram stain reaction and bacterial shape must be included in the report.The cellular arrangement is usually not included in the report since it may vary depending on the culture medium (liquid or solid) used to isolate the organism. The following 12 screens contain additional ungraded practice questions pertinent to the material covered.