Lab Matters Spring 2019 - Page 20

GLOBAL HEALTH Sierra Leone’s Antimicrobial Resistance Surveillance Strengthens with Microbiology and Bacteriology Lab Activations by Lucy Atieno, PhD, QMS consultant, Global Health To support the Sierra Leone Ministry of Health and Sanitation (MoHS) in a bid to set up a functional microbiology laboratory and address the priority of antimicrobial resistance surveillance, APHL installed a microbiology unit at two adjacent referral hospitals in May 2017: the Ola During Children’s Hospital (ODCH) and Princess Christian Maternity Hospital (PCMH). The clinical setup of these facilities ensured that sample availability would not pose any challenges. Creating the Laboratories The project began with clearing, cleaning and redesigning the provided workspace to make sure the minimum specifications for a microbiology and, especially, bacteriology laboratory were met. APHL ensured the facility had the key supplies and equipment to provide necessary testing services. A training program was created for relevant staff that included standard procedures for optimal lab operability. When APHL started at this facility, there were no ongoing culture or quality management system (QMS) activities; this was primarily due to lack of relevant training and/or practical experience of staff working in bacteriology. The Microbiology laboratory at ODCH before workstation set up Table 1: Current Status of Testing at ODCH/PCMH Microbiology Laboratory (February 2018) Examination Procedure (s) Current Status Urinalysis and Urine Culture Urine Microscopy, Biochemistry and Culture tests available and running. Cultures can be done for Urinary Enterobacteriaceae. Stool Microscopy and Culture Stool Microscopy and culture tests available and running. Cultures can be done for all Pathogenic Enterobacteriaceae, Campylobacteriacea and Vibrionaceae CSF Culture/Gram Stain, Cell Counts and India Ink Preparations Culture, Cell Counts and Gram Stain are currently available. Organisms that can be isolated include: Group B Streptococci, E. coli and other coliforms, Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumoniae. Urogenital Swab Cultures/Wet Preparations and Gram Stain Culture, Wet preparations and Gram Stain is currently available. Organisms that can be isolated include: Neisseria gonorrhoeae, Beta Haemolytic Streptococcus Group and Staphylococcus aureus. Respiratory Samples for Culture and Gram Stain Culture and Gram Stain is currently available. Pus Samples for Culture and Gram Stain Culture and Gram Stain is currently available. Accomplishments Over a period of nearly two years, the ODCH/PCMH microbiology laboratory has acted as a training hub for both MoHS staff and medical laboratory science (MLS) students from the College of Medicine and Allied Health Sciences (COMAHS). The training covered theoretical seminars and QMS activities. LAB MATTERS Spring 2019 Bacteria that can be isolated include: Group A Streptococcus, Pseudomonas aeruginosa, Haemophilus influenzae, Streptococcus pneumoniae and Staphylococcus aureus. Bacteria that can be isolated include: Staphylococcus aureus, Serratia marcescens, Enterococcus species, Streptococcus pyogenes, Streptococcus pneumoniae, Enterobacteriaceae and Pseudomonas species Effusions (Synovial Fluids, Pleural Culture, Cell Count, wet preparations and Gram Stain is currently Fluids, Pericardial Fluids Ascitic available. Fluids and Hydrocele Fluids) Bacteria that can be isolated include: Staphylococcus aureus, Serratia marcescens, Enterococcus species, Streptococcus pyogenes and Streptococcus pneumoniae. Blood Culture 18 The Microbiology lab at ODCH after workstation set up. Test currently NOT available. PublicHealthLabs @APHL APHL.org