The Royal Hospital

Microbiology

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The Department of Microbiology deals with the diagnosis and antimicrobial management of infectious diseases. Various specimens are examined for direct evidence of infection by using microscopy and culture or by indirect evidence such as detection of antigens or antibodies to the infecting agent. The department also monitors the antibiotic usage in the Hospital and provides consultation to the ICU and clinicians on the appropriate antibiotic of choice given the specific clinical situation. Infection control policies have been put in place, and there is an intensive surveillance program to detect and investigate every incident of cross-infection. Hospital-associated infection rates are continuously monitored and prompt action is taken to control outbreaks.

rh_dep_bloodcultureThe service consists of:
Microscopic examination and culturing human samples from different body sites
Identification of cultured organisms
Antibiotic sensitivity testing
Immunological and virological testing
PCR and other miscellaneous tests are referred to the Public Health Reference Laboratory, Sultan Qaboos University Hospital or France.


LOCATION
Located on Level 2 of the main building, opposite to the Post Graduate Centre.

STAFF
One senior consultant, one senior specialist, one specialist, one chief MLSO, two senior MLSOs, two senior lab technicians and twenty two technicians man the Department. The senior staffs presently include:
Dr. Amina Al Jardani, MD, FRCPC (Canada), Sr. Consultant
Dr Jalila Al lawati, MD, DCH, DTM&H, FRCPath (UK), Sr Specialist
Dr Fatma Al Yaqoobi, MD, MSc Microbiology, FRCPath (UK)
Mr Ibrahim Ramadan Al-Baluchi, Diploma (IHS), Chief MLSO
Ms. Rahma Al Lamki, Diploma (IHS), BSc biomedical science, Lab Supervisor
Mr Michael Rich, MSc, FIBMS, CSsi, FIQA, Lab Supervisor

rh_dep_autobacterialFACILITIES
The department occupies an area of approximately 460 sq. meters and is sub-divided into sections for: , blood and CSF, sputum, swabs and fluids, stool and urine cultures, serology and immunology and media Sections.

 

Major items of equipment used include: Olympus microscopes, anaerobic work station, automated BD Phoenix bacterial identification and sensitivity testing equipment, epi-center for surveillance, , incubators, fume cupboard, , Architect i1000 analyser for serology, , autoclaves, Organon tek. BD BACTEC 9240 system,  media preparing machine.

WORKING HOURS
The Microbiology laboratories function 24 hours a day, 7 days a week. The main shift operates during normal hospital working hours (7:30 a.m to 2:30 p.m), when the majority of the staff is present to process all types of specimens. During the off duty hours (Afternoon shift from 2:00 p.m to 9:00 p.m; Night shift from 8:00 p,m to 8:00 a.m) 1 technician remains to deal with urgent specimens only. Doctors and Supervisors (1st, 2nd and 3rd) cover the morning shifts on the weekends and remain on call over phone during off duty hours.

rh_dep_seranalyzWORKLOAD
The annual workload includes approximately  101099 tests in Microbiology (including infection control specimens (144732 Welcans Units) and 34208 tests in Serology/ immunology (equivalent to 16101 Welcans units).

NATURE OF WORK

Specimens are examined microscopically and cultured using standard microbiological procedures. The medical staff interprets the results and only clinically significant microbial isolates are further identified and tested for susceptibilities to various antimicrobial agents. The medical staff will finally inform the clinician and have a clinical dialogue regarding microbiological input. He/ She will also liaise with the infection control department about any relevant issues.  In the serology section, specimens are examined for microbial antigens and/or specific microbial antibodies. Each test is well controlled according to approved procedures. The indication to serological tests will be verified by the medical staff and the final report will be released in the patient medical record.

STANDARD OPERATING PROCEDURES (SOPs)
Fully documented and updated SOPs are present and accessible in the department.

TRAINING
The department provides training for the trainees from the Institute of Health Service (IHS), and also for certain students from other Universities during their internship rotation. Additionally OMSB and SQUH microbiology residents receive training too. The Laboratory has been approved by the UK Royal College of Pathologists as a training centre for the membership examination.

QUALITY ASSURANCE AND QUALITY CONTROL

The department has an internal Quality Assurance Programme, supervised by a MLSO. In addition to the National Quality Control Programme, the laboratory participates in an external (Australian Royal College of Pathologists) Q.C. programs which have certified the performance of the Department as very good - excellent (85 - 90 %). Surveys are received on a monthly basis. The results are sent back to the organisers who send reports back by email. 

EDUCATION AND RESEARCH ACTIVITIES

Residents in Microbiology are trained in this department. A few research projects are carried out at minimum cost with the objective of improving patients' care. The following is the list of published papers and research activities in line:
Published articles:

  • Elhag KM, AL Jardani A, Al Yaqoobi F, & Mohsin N. The first glycopeptides intermediate Staphylococcus in Oman. Clinical Microbiology and Infection 2000;6: 173-4
  • Al lawati Jalila, Elhag KM, Jaffar MA, Al Saidi AMO. Linezolid as a therapeutic agent for Staphylococcal infections refractory to vancomycin treatment. Oman Medical Journal 2006; 21:1, 50-4
  • Al-Yaqoubi M, Elhag M. Susceptibilities of Common Bacterial Isolates from Oman to Old and New Antibiotics. Oman Medical Journal 2008
  • Porton A, Poirel L, Elhag K, Al Yaqoobi F, Normann P. VEB-6 Extended spectrum beta lactamases producing Proteus mirabilis from Sultanate of Oman. International Journal of Antimicrobial Agents 2009; 34:5, 493-4
  • Al Lawati J, Al Tamtami N, Al Qasmi A, Al Jardani A, Al Abri Saif, Al Busaidy S. Hospitalised patients with Influenza A (H1N1) in the Royal hospital, Oman. SQUMJ 2010; Vol 10, Issue 3
  • Al-Yaqoubi M, Elhag k. Serotype prevalence and penicillin susceptibility of Streptococcus pneumonia in Oman. OMJ April 2008

Articles awaiting publication:

  • Al Tamtami N, Al Abri S, Al lawati J. Coagulase negative Staphylococcus in Native valve endocarditis
  • Al Aremi H, Al Jardani A, Rich Micheal. Inducible Clindamycin resistance in MRSA starins

Research in pipeline:

  • Molecular characterization of Multi Drug Resistant Acinetobacter baumanii
  • Molecular characterization of Carbapenemase Resistant Enterobacteriacae
  • Serotype prevalence and penicillin and other antipneumococcal susceptibility of Streptococcus pneumonia in Royal hospital

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