Samples included in Clinical Bacteriology Surveys
- Each Proficiency Testing survey consists of 5 samples for culture (1 to 5), identification, and susceptibility testing; a smear for Gram staining (plus two extra smears for Supplementary Gram program orders), and a Paper Challenge.
- The number of samples per shipment that a laboratory receives depends on the laboratory’s category.
- Each sample has a simulated patient history and suspected diagnosis attached to it to guide sample processing and interpretation.
Sample-1 – Clinical Relevancy challenge
This type of challenge is usually a urine, throat, or vaginal sample. This challenge may contain identification, colony count (urines), and susceptibility testing components however the main objective is the evaluation of the results in the context of the patient history and sample composition.
Sample -2 & -3 – Identification +/- Susceptibility challenges
These challenges cover samples such as wounds, stools, respiratory samples, and other type of samples able to be processed by intermediate complexity laboratories. Interpretation and reporting of results is still guided by the concept of Clinical Relevancy (see below).
Sample -4 & -5 – Identification +/- Susceptibility challenge
These challenges may include blood cultures and CSF and other critical specimens usually processed only by high complexity laboratories.
Gram smears simulate all kind of samples, from sputum to joint fluids. Smears are prepared with real cells (epithelial, white blood cells, red blood cells) so both bacteria and cells components can be evaluated.
Supplementary Gram (1 and -2)
The supplementary Gram Smear program focuses on simulated CSF, joint fluid, and other sterile fluid samples.
Paper Challenges test the early or pre-analytical phase of laboratory testing and post-analytical reporting errors. The paper challenge consists of a simulated ‘clinical scenario’ associated with a number of alternative choices for response. There are two paper challenges per survey year.
Useful laboratory information in microbiology must provide more than just an accurate assessment of sample flora. Specimens must be processed in a timely fashion and on appropriate media in order to optimize finding critical pathogens. Pathogens need to be recognized and be differentiated from normal flora. Information needs to be interpreted in a clinical meaningful manner, and antibiotic susceptibility testing must be performed using clinically appropriate drug selections. The product of such combined and integrated efforts results in clinically relevant microbiology.