Listed below are the proposed elements that a proficiency testing scheme may need to include in order to provide a suitable program for this testing module.

Sample Type

Medical laboratories and in particular microbiology departments are familiar with handling lyophilized samples. There are other alternatives that would still be acceptable, including bioballs.

Clinical Scenarios

1. Specimens recovered from a human source, e.g. indwelling catheters, prostheses or other tubing (tracheal tubing).
2. Environmental swabbing only in the context of a response to infection control investigations or outbreaks, e.g. spore strips, air strips (but not sterility testing or environmental screening), MRSA/VRE/other antibiotic resistant organisms.
3. Endoscope and bronchoscope testing with medical or clinical significance in line with SNZ HB 8149: Microbiological Surveillance of Endoscope and Bronchoscopes.
4. Dialysis Waters as part of testing protocols from dialysis units.
5. Blood transfusion bags for isolates of clinical significance in the investigation of possible transfusion reaction.

Please note:
Scenarios not intended to be covered include tests for sterility, routine environmental surveillance (air sampling, settle plates, general swabbing), hydrotherapy pool water and drinking water.

Sample Organisms

The samples should include organisms ranging from common coagulase negative staphylococci to mycobacteria and enteric pathogens. It would also be advisable to include negative samples (i.e. sterile water). The testing should be either detection, identification and sensitivity or as in the case of the dialysis waters, quantitative counts.

Examples:
Endoscopes - coliforms, E. faecalis, (with some surprises occasionally such as Salmonella).
Duodenoscopes - P. aeruginosa, H. pylori.
Bronchoscopes - coagulase negative staph, atypical mycobacteria, pseudomonads.
Infection Control - MRSA, VRE, Acinetobacter.
Renal waters - quantitative counts of RO water for E. coli, P. aeruginosa, coagulase negative staphylococci at <200 cfu/mL and >200 cfu/mL.
- dialysate consider the same organisms but with quantities of <2000 cfu/mL and >2000 cfu/mL.
- RO water from a processing unit: E. coli, P. aeruginosa.

Timings and Cycles

It would be appropriate to provide laboratories with three to four cycles per year and to include two to three samples. A suggestion is one from each category and to cover all the categories in a year. The renal water samples should probably be an additional option as only those laboratories associated with dialysis units will perform this work.

Contact

If you are able to assist please contact the NATA PT Coordinator Edita Grujic at: This e-mail address is being protected from spambots. You need JavaScript enabled to view it