Laboratory manager

E-TEST QUALITY CONTROL

ATCC 29213 ATCC 25922 ATCC 27853 ATCC 49619*

Penicillin 0.25-2.0 0.25-1*

Ceftriaxone 1.0-8.0 0.03-0.12*

Oxacillin

Ceftazidime 4.0-16.0

Cefotaxime 1.0-4.0

Vancomycin 0.5-2.0

Mupirocin <0.064-0.5

Teicoplanin 0.125-0.5

Linezolid 1-4

Levofloxacin 0.06-0.5

Ertapenem 0.004-0.015

Polymixin B 1-4

Colistin 0.5-4

Pipercillin 1-8

Pipercillin/tazobactam 1/4 – 8/4

Test weekly on the VITEK bench. LIS VITEK QC worklist will generate testing requirement on scheduled day.

1. 
   The QC organism is sub-cultured from the TSB slant (in fridge) to BA the day before setting up the QC.
   
2. 
   Follow procedure described in the Antibiotic Susceptibility section of the lab manual.
   
3. 
   Record results in the LIS E-TEST QC chart.
   

Reference: CLSI M100-S22 document

1. 
   Enter "Result Comment" in the LIS.
   

2. 
   Inform QA or charge technologist of all out-of-range results.
   

3. 
   Corrective action will be instituted as required. See CLSI M100-S22 Table 4G - MIC Troubleshooting Guide for corrective action suggestions.
   

4. 
   The lab will be notified through LIS e-mail if needed.
   

ROSCO Diagnostica Tablets QC

Frequency of Quality control is weekly and on receipt.

Mueller-Hinton agar plates

Rosco Diagnostica KPC + MBL Confirm ID kit tablets

Meropenem (MRP10)

Meropenem+Dipicolonic acid (MR+DP)

Meropenem+Boronic acid (MR+BO)

Meropenem+Cloxacillin (MR+CL)

Klebsiella pneumoniae ATCC 1705 (Class A KPC)

Klebsiella pneumoniae ATCC 1706 (MHT negative)

Escherichia coli N10-505 (MBL)
Procedures:

Using the Vitek colorimeter, prepare a 0.5 McFarland suspension of the test organism in sterile saline

Using a sterile cotton swab, inoculate the organism onto half of a 150 mm (large) MH agar plate. Two isolates maybe tested per plate.

Dispense tablets into a petri dish and use forceps to apply the 4 Rosco KPC tablets (MRP10, MR+DP, MR+BO, MR+CL) onto the agar. Place the tablets at least 30 mm apart from each other.

Incubate plate in O₂ at 35^oC x 18 hours.
Results:

Record the zone size results of all the tablets in LIS.

Compare the zone size of the MRP10 tablet against the zone sizes of MRDP, MRBO and MRCL. If there is >5 mm difference in zone size, there is a potentiation of the drug. If there is <5 mm difference in zone size, there is potentiation of the drug. Expected results are as below.

	K. pneumoniae 1705	K. pneumoniae 1705	E coli N10-505
Meropenem 10	15 – 20mm	28 – 35 mm	11 – 16 mm
Mero10+DP	15 – 20mm	28 – 35 mm	25 – 30mm
Mero10+BO	22 – 28mm	28 – 35 mm	11 – 16 mm
Mero10+CL	15 – 22mm	28 – 33 mm	11 – 16 mm
Differential Characteristic	DP<5, BO>5, CL <5 mm	DP<5, BO<5, CL<5 mm	DP >5, BO<5, CL <5

TREK Sensititre Weekly QC

The weekly quality control of the TREK sensititre instrument is performed using the Streptococcus pneumoniae ATCC 49619.

Sensititer ARIS 2X Automated Reader

Sensititer cation adjusted Meuller-Hinton broth 5 ml

Sensititer cation adjusted Meuller-Hinton broth with lysed horse blood 11 ml

Sensititer Streptococcus pneumonia MIC Susceptibility plates

* New lots must be registered. Refer to the Trek sensititre Manual.doc

HIGH LEVEL AMINOGLYCOSIDE RESISTANCE SCREEN PLATE (QUAD) QC

Streptomycin 2000 mg/L

Vancomycin 6mg/L
ISOLATES FOR TESTING:
Enterococcus faecalis ATCC 49532

Enterococcus faecalis ATCC 49533

Enterococcus gallinarum ATCC 35038
FREQUENCY OF TESTING:
Test all QC isolates weekly on the VITEK bench with new lot, and each day the plate is used.

Test Enterococcus faecalis ATCC 49532 on each plate as they are set up with clinical isolates.

LIS VITEK QC worklist will generate testing requirements as scheduled.
PROCEDURE:
Follow procedure described in the Antibiotic Susceptibility section of the lab manual.
Record results in the LIS QUAD QC chart.
EXPECTED RESULTS:

	Expected results of each quadrant
	Control	Gent.	Strep.	Vanco.
E. faecalis (ATCC 49532) E. faecalis (ATCC 49533) E. gallinarum (ATCC 49573)	+ + +	+ - -	- + -	- - +

OUT-OF-RANGE RESULTS:

1. 
   Enter "Results Comment" in the LIS.
   
2. 
   Inform QA or charge technologist of all out-of-range results.
   
3. 
   Corrective action will be instituted as required.
   
4. 
   The lab will be notified through LIS e-mail if needed.