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259 - La revisione degli standard organizzativi della diagnostica delle micobatteriosi presso il Laboratorio dell’Ospedale di Rovereto

Rivista: RIMeL - IJLaM, Vol. 1, N. 4, 2005 (MAF Servizi srl ed.)

P. Gualdi, R. Maffei, M. Schinella

Revision of the operating procedures concerning the
diagnosis of Mycobacteria infection in the laboratory
of the Hospital of Rovereto
Background. To assess the diagnosis of mycobacterial infection,
for laboratories it is necessary and compulsory to
assure appropriate procedures in terms of quality and safety,
adapting facilities and working conditions.
The aim of the present work was to show the improvement
which has been completed in the laboratory of Rovereto
from January ’96 to December ’04. This assessment
was to optimise the diagnostic procedures of mycobacterial
disease and to obtain a) accordance to law n° 626
(9/19/94) concerning the improvement of safety and health
in the working environment; b) accordance to diagnostic
guide-lines; c) compliance to standards included in
accreditation/certification procedures.
Methods. Samples belonging to either hospitalised or outpatients
were analysed during the above mentioned times.
Different diagnostic steps were considered: pre analytical
phase, fluidification and decontamination, microscopy and
culture. The operative flow and its modifications in the
course of the last 8 years were described.
Results. Pre analytical phase: written guide lines concerning
sample collection, transport and acceptance, were defined.
Fluidification and decontamination: percentage of contaminated
samples and corrective decisions were reported
concerning either the preoperative phase (sample prefluidification,
more elevated NaOH concentration, time control)
or laminar flow box utilisation (filter utilisation and
replacement). Microscopy: samples examination obtained following fluidification/
decontamination and fluorochrome stained
smears, achieved the sensitivity, reduced the time reporting
(24 hours) and increased the operators’ safety by using a
staining box. ....

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