On call microbiology

Out-of-hours bacteriology specimens

The on-call microbiology biomedical scientist (BMS) is on-call from home and covers both the City and QMC sites. The on-call BMS must be contacted about samples for processing on-call and can be reached via the hospital switchboard. They may not always be able to answer immediately if in transit or processing a specimen.

The following specimens can be processed out-of-hours. Contact the on-call BMS after the specimen has been taken.

  • Cerebrospinal fluids (CSFs)
  • Operative specimens (pus/tissue)
  • Fluids from normally sterile sites e.g. joint/pleural/peritoneal fluids
  • Mid stream urines from children where management will be affected by microscopy result and suprapubic aspirate (SPAs)
  • Broncho-alveolar lavage (BAL) for bacteriology (PCR for PCP and viruses is not available out-of-hours)
  • Corneal scrapes and vitreous taps

Specimens not normally processed out-of-hours without medical approval include:

  • Swabs
  • Urine samples from adults
  • Tracheal aspirate/sputa
  • Faeces (C.diff testing is done on a Saturday morning routinely and on Sunday by specific request) CAPD fluids
  • Blood cultures - which should be taken to the laboratory by a porter and placed in the out-of-hours incubator on A floor, QMC or outside Clinical Pathology reception, City

The on-call BMS cannot be expected to look up results.

If any requests fall outside these guidelines, the requesting doctor should discuss with the on-call medical microbiologist.

On-call medical microbiology/virology advice

The on-call medical microbiologist is on call from home and covers both the City and QMC campuses.  They can be contacted via the hospital switchboard for urgent clinical advice, advice about urgent infection control issues and to discuss needlestick injuries from high risk patients.  They do not have access to results.

Before telephoning for advice it is expected that the referring clinician will have:

  • Discussed with their seniors if appropriate and if after midnight must have been sanctioned by a registrar/consultant if a junior trainee is making the call.  (This has been agreed by the Hospital at Night Operational Group.)
  • Made a clinical assessment of the patient
  • Sent the correct samples
  • Checked NOTIS for recent results including bloods
  • Looked for information on the antibiotic guidelines or the microbiology intranet site

Out-of-hours virology and serology specimens

The laboratory operates a Saturday/Sunday and Bank Holiday day-time service for the following tests:

  • Urgent HIV tests and Hepatitis B surface antigen
  • PCR on NPAs or other respiratory samples for influenza A, RSV and other respiratory viruses

The on-call medical microbiologist (via switchboard) should be alerted in the morning regarding these urgent virology tests to ensure a same-day result.