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

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. ....