Labs Sentinel Survey #3-2014

PURPOSE:

The Idaho Bureau of Laboratories appreciates your participation in the Sentinel Laboratory Preparedness Survey.  The objectives of this survey are:

    1. to assess the ability of sentinel laboratories to recognize agents of biological threat and emerging microbial pathogens.
    2. to assess the laboratory's resources available to perform testing related to potential biothreat (BT) agents.

    This survey includes an annual exercise to test packaging and shipping of infectious substances.  This exercise is optional and, per federal regulations, proficiency test specimens may only be sent as Category B, even if it is a suspected Category A agent.

    Information gathered from this survey will be used to evaluate and improve laboratory preparedness. It serves as a benchmark to determine the effectiveness of training provided to you and indicates how we may better serve you in the future.

    All results are confidential; results are not graded.  Following the survey, participating labs will receive a summary report which will include your laboratory's responses, the intended answer, and aggregate survey results. 

    To test communications between Laboratory Response Network (LRN) Sentinel Laboratories and Idaho’s LRN Reference Laboratory (IBL), exercise participants are required to contact their LRN Reference Laboratory if, after performing the established Sentinel Level Clinical Microbiology Laboratory Guidelines on an isolate, they are unable to rule out an agent of bioterrorism.  Please call or email Wendy Loumeau at 208-334-2235 ext. 258 or loumeauw@dhw.idaho.gov if you were unable to rule out a select agent for this challenge.  These guidelines are found at http://www.asm.org/index.php/guidelines/sentinel-guidelines.

    If a sentinel lab is unable to rule out a select agent on real samples, they are required to notify their LRN reference laboratory prior to sending samples. 

    LRN Reference Laboratory contact information for this challenge: Wendy Loumeau at 208-334-2235 ext. 258 or 
    loumeauw@dhw.idaho.gov    

1)  Laboratory Name:
 Response total
 
28
  • Statistics based on 28 respondents;
2)  Date specimens were received:
 Response total
 
28
  • Statistics based on 28 respondents;
3)  How does your laboratory process microbiological cultures? - Check all that apply.
 Response percentResponse total
All samples referred 

3.57%1
Gram stain 

50%14
Primary cultures set-up and incubated; growth referred 

25%7
Limited work up of primary cultures (throat and urine cultures) 

17.86%5
Complete work up of primary cultures 

75%21
________________________________________________________________


RESULTS FOR: #3a-2014

________________________________________________________________



4)  Growth on various media:
Growth
No growth
Not available
  Response total 
Blood agar
100%
(28)
0%
(0)
0%
(0)
Export28
Chocolate agar
100%
(27)
0%
(0)
0%
(0)
Export27
  • Statistics based on 28 respondents;
5) Growth on MacConkey agar:
 Response percentResponse total
Lactose fermenter 

53.57%15
Lactose non-fermenter 

32.14%9
No growth 

0%0
Test not available 

14.29%4
6)  Time to growth:
 Response percentResponse total
18-24 hours 

100%28
48 hours 

0%0
72 hours 

0%0
7)  Hemolysis on SBA:
 Response percentResponse total
Hemolytic 

7.14%2
Non-hemolytic 

92.86%26
________________________________________________________________

Gram Stain 
________________________________________________________________
8)  Gram reaction:
 Response percentResponse total
Gram positive 

14.29%4
Gram negative 

85.71%24
Not performed 

0%0
9)  Morphology:
 Response percentResponse total
Bacillus 

50%14
Coccus 

3.57%1
Coccobacillus 

42.86%12
Diplococcus 

3.57%1
10)  Size:
 Response percentResponse total
Tiny/Small 

42.86%12
Medium 

53.57%15
Large 

3.57%1
11)  Spores:
 Response percentResponse total
Present 

0%0
Absent 

50%14
Not performed 

50%14
12)  Chaining:
 Response percentResponse total
Present 

0%0
Absent 

57.14%16
Not performed 

42.86%12
________________________________________________________________

Biochemical Tests 
________________________________________________________________
13)  Indicate a response for each test below:
Positive
Negative
Not Performed
Test Not Available
  Response total 
Catalase
60.71%
(17)
0%
(0)
35.71%
(10)
3.57%
(1)
Export28
Oxidase
7.14%
(2)
60.71%
(17)
17.86%
(5)
14.29%
(4)
Export28
Indole
0%
(0)
35.71%
(10)
39.29%
(11)
25%
(7)
Export28
Urease
3.57%
(1)
21.43%
(6)
46.43%
(13)
28.57%
(8)
Export28
Motility
3.57%
(1)
14.29%
(4)
53.57%
(15)
28.57%
(8)
Export28
Satellitism
0%
(0)
3.57%
(1)
71.43%
(20)
25%
(7)
Export28
Beta-lactamase
10.71%
(3)
0%
(0)
67.86%
(19)
21.43%
(6)
Export28
Growth @ 25ºC
0%
(0)
0%
(0)
67.86%
(19)
32.14%
(9)
Export28
Growth @ 42ºC
3.57%
(1)
0%
(0)
64.29%
(18)
32.14%
(9)
Export28
  • Statistics based on 28 respondents;
14) Indicate a response for each test below:
Susceptible
Not susceptible
Not performed
Test not available
  Response total 
Amoxicillin clavulanate
0%
(0)
7.14%
(2)
57.14%
(16)
35.71%
(10)
Export28
Penicillin
0%
(0)
0%
(0)
62.96%
(17)
37.04%
(10)
Export27
Colistin disk
7.41%
(2)
0%
(0)
48.15%
(13)
44.44%
(12)
Export27
Polymyxin B disk
3.7%
(1)
0%
(0)
51.85%
(14)
44.44%
(12)
Export27
  • Statistics based on 28 respondents;
________________________________________________________________

Results
________________________________________________________________
15)  Was a commercial system used to identify this isolate?
 Response percentResponse total
Yes 

53.57%15
No 

46.43%13
16)  If YES, what system was used?
 Response percentResponse total
API - strip type: 

6.67%1
Vitek - card type: 

13.33%2
MicroScan - panel type: 

80%12
Other - specify: 

0%0
Comments 
8
17)  If YES, what did the automated system identify the organism to be?
 Response total
 
15
  • Statistics based on 15 respondents;
18)  Choose identification for Specimen #3a-2014 (select all that apply):
 Response percentResponse total
Gram-positive bacillus, refer to rule out B. anthracis 

3.57%1
Gram-negative coccobacillus, refer to rule out Brucella spp. 

3.57%1
Gram-negative bacillus/coccobacillus, refer to rule out Francisella tularensis 

0%0
Gram-negative bacillus, refer to rule out Yersinia pestis 

7.14%2
Gram-negative coccobacillus, refer to rule out Burkholderia mallei 

10.71%3
Gram-negative bacillus, refer to rule out Burkholderia pseudomallei 

3.57%1
Gram-negative bacillus/coccobacillus, refer to rule out Burkholderia pseudomallei/mallei 

3.57%1
Non-BT Culture 

78.57%22
19)  Please note any additional steps you would take in processing, identifying, or reporting this organism, including any phone calls you would make.
 Response total
 
12
  • Statistics based on 12 respondents;
IF YOUR LAB IS UNABLE TO RULE-OUT THE PRESENCE OF A SELECT AGENT, YOU SHOULD REFER IT TO IDAHO BUREAU OF LABORATORIES.  FOR THE PURPOSE OF THIS EXERCISE, CALL 208-334-2235 EXT 258 OR EMAIL LOUMEAUW@DHW.IDAHO.GOV. 

If you are unable to rule out a biothreat agent, you may participate in an optional Category B shipping exercise; ship isolate to Idaho Bureau of Laboratories, Attention:  Wendy Loumeau.
20)  Comments:
 Response total
 
5
  • Statistics based on 5 respondents;
________________________________________________________________



RESULTS FOR: #3b-2014


________________________________________________________________




21)  Growth on various media:
Growth
No growth
Not available
  Response total 
Blood agar
71.43%
(20)
28.57%
(8)
0%
(0)
Export28
Chocolate agar
92.86%
(26)
7.14%
(2)
0%
(0)
Export28
  • Statistics based on 28 respondents;
22) Growth on MacConkey agar:
 Response percentResponse total
Lactose fermenter 

0%0
Lactose non-fermenter 

0%0
No growth 

89.29%25
Test not available 

10.71%3
23)  Time to growth:
 Response percentResponse total
18-24 hours 

10.71%3
48 hours 

57.14%16
72 hours 

32.14%9
24)  Hemolysis on SBA:
 Response percentResponse total
Hemolytic 

0%0
Non-hemolytic 

96.43%27
No growth on SBA 

3.57%1
________________________________________________________________

Gram Stain
________________________________________________________________
25)  Gram reaction:
 Response percentResponse total
Gram positive 

7.14%2
Gram negative 

85.71%24
Not performed 

7.14%2
26)  Morphology:
 Response percentResponse total
Bacillus 

23.08%6
Coccus 

7.69%2
Coccobacillus 

69.23%18
Diplococcus 

0%0
27)  Size:
 Response percentResponse total
Tiny/Small 

96.15%25
Medium 

3.85%1
Large 

0%0
28)  Spores:
 Response percentResponse total
Present 

0%0
Absent 

39.29%11
Not performed 

60.71%17
29)  Chaining:
 Response percentResponse total
Present 

0%0
Absent 

50%14
Not performed 

50%14
________________________________________________________________

Biochemical Tests
________________________________________________________________
30)  Indicate a response for each test below:
Positive
Negative
Not Performed
Test Not Available
  Response total 
Catalase
64.29%
(18)
3.57%
(1)
25%
(7)
7.14%
(2)
Export28
Oxidase
0%
(0)
64.29%
(18)
21.43%
(6)
14.29%
(4)
Export28
Indole
0%
(0)
28.57%
(8)
46.43%
(13)
25%
(7)
Export28
Urease
0%
(0)
35.71%
(10)
39.29%
(11)
25%
(7)
Export28
Motility
3.57%
(1)
14.29%
(4)
57.14%
(16)
25%
(7)
Export28
Satellitism
3.57%
(1)
3.57%
(1)
71.43%
(20)
21.43%
(6)
Export28
Beta-lactamase
25%
(7)
7.14%
(2)
46.43%
(13)
21.43%
(6)
Export28
Growth @ 25ºC
0%
(0)
0%
(0)
67.86%
(19)
32.14%
(9)
Export28
Growth @ 42ºC
0%
(0)
0%
(0)
67.86%
(19)
32.14%
(9)
Export28
  • Statistics based on 28 respondents;
31) Indicate a response for each test below:
Susceptible
Not susceptible
Not performed
Test not available
  Response total 
Amoxicillin clavulanate
0%
(0)
0%
(0)
64.29%
(18)
35.71%
(10)
Export28
Penicillin
0%
(0)
0%
(0)
64.29%
(18)
35.71%
(10)
Export28
Colistin disk
0%
(0)
0%
(0)
57.14%
(16)
42.86%
(12)
Export28
Polymyxin B disk
0%
(0)
0%
(0)
57.14%
(16)
42.86%
(12)
Export28
  • Statistics based on 28 respondents;
________________________________________________________________

Results
________________________________________________________________
32)  Was a commercial system used to identify this isolate?
 Response percentResponse total
Yes 

14.29%4
No 

85.71%24
33)  If YES, what system was used?
 Response percentResponse total
API - strip type: 

0%0
Vitek - card type: 

40%2
MicroScan - panel type: 

40%2
Other - specify: 

20%1
Comments 
3
34)  If YES, what did the automated system identify the organism to be?
 Response total
 
4
  • Statistics based on 4 respondents;
35)  Choose identification for Specimen #3b-2014 (select all that apply):
 Response percentResponse total
Gram-positive bacillus, refer to rule out B. anthracis 

0%0
Gram-negative coccobacillus, refer to rule out Brucella spp. 

0%0
Gram-negative bacillus/coccobacillus, refer to rule out Francisella tularensis 

78.57%22
Gram-negative bacillus, refer to rule out Yersinia pestis 

3.57%1
Gram-negative coccobacillus, refer to rule out Burkholderia mallei 

0%0
Gram-negative bacillus, refer to rule out Burkholderia pseudomallei 

0%0
Gram-negative bacillus/coccobacillus, refer to rule out Burkholderia pseudomallei/mallei 

0%0
Non-BT Culture 

17.86%5
36)  Please note any additional steps you would take in processing, identifying, or reporting this organism, including any phone calls you would make.
 Response total
 
19
  • Statistics based on 19 respondents;
IF YOUR LAB IS UNABLE TO RULE-OUT THE PRESENCE OF A SELECT AGENT, YOU SHOULD REFER IT TO IDAHO BUREAU OF LABORATORIES.  FOR THE PURPOSE OF THIS EXERCISE, CALL 208-334-2235 EXT 258 OR EMAIL LOUMEAUW@DHW.IDAHO.GOV.

If you are unable to rule out a biothreat agent, you may participate in an optional Category B shipping exercise; ship isolate to Idaho Bureau of Laboratories, Attention:  Wendy Loumeau.
37)  Comments:
 Response total
 
7
  • Statistics based on 7 respondents;
Attestation: By signing below, I/we attest that the microbiology specimens #3a-2014 and #3b-2014 were processed in the same manner as patient specimens unless instructed otherwise.
38)  List All Testing Personnel:
 Response total
 
28
  • Statistics based on 28 respondents;
39)  Lab Manager:
 Response total
 
28
  • Statistics based on 28 respondents;
_____________________________________________________________________________________________


Specimen #3a-2014 and #3b-2014 Disposal
_____________________________________________________________________________________________
40)  Specimens and all related culture material generated in the identification of these organisms were disposed of in the manner checked below:
 Response percentResponse total
Autoclave 

3.57%1
Incineration 

7.14%2
Medical waste contract service 

89.29%25
Other 

0%0
41)  Person Submitting the Survey:
 Response total
 
28
  • Statistics based on 28 respondents;