PCP Testing Update
 
 
The HPA Laboratory at Manchester Royal Infirmary provides a molecular testing service for Pneumocystis jiroveci infection, which operates 6 days a week, Monday to Saturday inc.
 
The following samples will be accepted –
  • BAL
  • Well-taken sputum samples
  • Nose & throat swabs
  • Blood in EDTA
 
The best samples for diagnostic purposes are BAL and well-taken sputum. Positivity in blood indicates systemic infection, but a negative does not rule out Pneumocystis pneumonia.
 
Salivary ‘sputa’ and nose/throat swabs are more difficult to interpret.
 
As P.jiroveci is a ubiquitous organism, it may be present in respiratory samples from healthy people, so, it is important to check the level of positivity, reflected in the number of PCR cycles required for detection (CT value). A CT value greater than 30 indicates a low-level positive and may represent ‘colonisation’ rather than infection. Obviously, a positive in blood would always be significant.
 
It goes without saying that all results should be interpreted in the light of clinical findings.

 

As part of our continual process of service improvement, this May has seen the introduction of a fully automated enzyme immunoassay system, in microbiology, for the detection of Cryptosporidium and Giardia in faecal samples. This replaces the painstaking, traditional microscopic method, giving greater sensitivity and specificity of results as well as a shorter turnaround time. It has the added benefit of minimising staff handling of samples, so improving laboratory safety. There will be no change in the appearance of the laboratory reports to our clients, but the quality & consistency of results will be significantly improved.

 

The Department of Sexual Medicine (DOSM) offer an HIV Point of Care testing service particularly to high risk group patients. The Inverness Medical Determine® testing kit is used and this detects antibodies to HIV 1/2. It is currently offered on 3 sites: Hawthorn House at Heartlands Hospital and at 2 Outreach Clinics at the Terrence Higgins Trust and at the Drake Unit at Birmingham Chest Clinic, both based in the city centre. Patients must talk to a Health Advisor before taking the test and the results are available within 15 minutes.

The Department of Sexual Medicine (DOSM) has its own Sexual Health website packed with information on STIs and  testing services. Please visit the website here.

Quality Assurance

-Each kit of 20 tests is tested using an Internal Quality Control by the Serology laboratory before being issued to DOSM to ensure that it is working correctly.

-Clinical staff are trained by laboratory staff before they can perform the test in the clinical setting.

- Standard Operating Procedures and test worksheets are issued by the laboratory.

-External Quality Assessment samples for HIV are tested twice a year by both the laboratory and by DOSM.

 

Please also refer to the Trust  Point of Care testing policy: Here

 

We are pleased to inform you that we have obtained a Gen-Probe TIGRIS DTS Automated Analyser and that we are switching all our Chlamydia and N Gonorrhoeae NAAT testing to the Gen-Probe APTIMA COMBO 2 Assay, this will take effect from Monday 22nd February 2010. This change will allow us to streamline our Chlamydia testing service by increasing our sample throughput, with increased specificity and with no loss in sensitivity. The APTIMA Combo 2 assay will detect all strains of Chlamydia trachomatis including the new variant (nv(CT)) and will specifically detect Neisseria gonorrhoeae rather than Neisseria species. It will also reduce the number of equivocal and inhibitory results.
 
It will however, involve a change in transport media for the swab and urine specimens. The sampling kits will be provided in the usual manner via requisition forms and they require the swabs/ urine samples to be placed directly in the sample transport media (lysis buffer). This immediately lyses the sample thus stabilizing the specimens and negating the necessity of rapid transport of the sample to the laboratory. Any samples requiring C. trachomatis / N. gonorrhoeae testing NOT received in the appropriate lysis buffer after 1st March will NOT be tested. You will still require a stock of Red Topped Transport Media for any samples requiring Genital Herpes or Genital Ulcer Screening.

More Articles...

Latest Service News

Latest Blog Postings

Requesting

Transport of Samples to Laboratories

How to Find The Laboratories

Patient Information