Laboratory manager

APPENDIX II - Bacteriology QC Bench Workflow

1. 
   Read and document results of Q.C. testing. Document in micqc, Tasks, result entry, F2 to
   

2. 
   Go to walk in fridge and retrieve any media, reagents, kits, or panels that need to be
   

3. 
   Register new media into Softmic QC following SOFT FOR MICQC instructions.
   
4. 
   Prepare labels for new media as per Printing QC Labels Procedure.
   
5. 
   Prepare inoculum as required and set up QCs for all the new materials.
   
6. 
   Perform other daily QC Bench tasks as follows
   

1. 
   Prepare the following labels as per Printing QC Labels Procedure using the “QC Monday
   

appropriate McFarland suspensions as listed below:

For KB and e-test QC	McFarland Standard
P. aeruginosa ATCC 27853	0.5
S. aureus ATCC 29213	0.5 and 2.0
E. coli ATCC 25922	0.5
H. influenzae ATCC 49247	0.5
S. aureus ATCC 25923	0.5
S. pneumoniae ATCC 49619	0.5
S. epidermidis ATCC 12228	0.5
S. saprophyticus ATCC 15305	0.5
C. jejuni ATCC 29428	2.0
C. fetus ATCC 15296	2.0
S.aureus ATCC 700699	2.0
S.aureus ATCC 700698	2.0
K.pneumoniae ATCC 1705	0.5
K.pneumoniae ATCC 1706	0.5
E. coli ATCC N10-505	0.5

2. 
   With the prepared suspensions, set up KB, e-test and ROSCO tablets as follows:
   

3. 
   Set up E-test as follows:
   

E-test
P. aeruginosa ATCC 27853	S. aureus ATCC 29213	S. aureus ATCC 700699	S. aureus ATCC 700698
Polymixin B	Penicillin	Vancomycin	Vancomycin
Colistin	Ceftazidime	Teicoplanin	Teicoplanin
Piperacillin	Cetriaxone
Pipercillin/Tazobactam	Vancomycin *
	Cefotaxime
	Mupirocin.
	Fusidic acid
	Levofloxacin
	Linezolid
	Teicoplanin *
	Synercid (QuinuDalfo)

* Note: Used for susceptibility testing on both Mueller Hinton and BHI casein agars

4. 
   Set up Kirby-Bauer (KB) test with the following antimicrobial discs:
   

KB
E. coli ATCC 25922	H. influenzae ATCC 49247	S. pneumoniae ATCC 49619
Ampicillin	Ampicillin	Levofloxacin
Gentamicin	Ceftriaxone	Clindamycin
Cefazolin		Erythromycin
Ceftriaxone	P. aeruginosa ATCC 27853	Oxacillin
Co-trimoxazole	Amikacin	Vancomycin
Tetracycline	Gentamicin
Nitrofurantoin	Piperacillin/Tazobactam	S. epidermidis ATCC 12228
Tobramycin	Ceftazidime	Novobiocin
Ceftazidime	Piperacillin
Ciprofloxacin	Tobramycin	S. saprophyticus ATCC 15305
Imipenem	S. aureus ATCC 25923	Novobiocin
Amox/Clavulanic acid	Erythromycin
Aztreonam	Oxacillin	C. jejuni ATCC 29428
Cefpodoxime	Clindamycin	Cephalothin
Cefuroxime	Vancomycin	Naladixic acid
Cefoxitin	Gentamicin
Cefepime	Cefazolin	C. fetus ATCC 15296
	Penicillin	Cephalothin
	Co-trimoxazole	Naladixic acid
	Tetracycline
	Rifampin

5. 
   Subculture the suspensions used for susceptibilities to the following to confirm purity:
   

BA	MAC	CHOC
S. aureus ATCC 29213	P. aeruginosa ATCC 27853	H. influenzae ATCC 49247
S. saprophyticus ATCC 15305	E. coli ATCC 25922	H. influenzae ATCC 10211
S. epidermidis ATCC 12228
S. pneumoniae 49619
S. aureus ATCC 25923

Note: The “Quick Reference Bench Guide for KB and Etest Setup” for labelling, salines, plates, and applying discs.

6. 
   Set up Vitek2 cards and sub-culture purity plates. For Vitek QC set up, see Vitek\VT2 Quality Control
   

1. 
   Materials required:
   

Item	Amount
sterile tubes	16
MUG tubes	2
MUG discs	2
Vitek saline	1
MHB	1
Arabinose
Xylose
Tributyrin
BHI plate	1
conical tube	1
BE	1
BA	2
Prolex kit
Ornithine
Optochin
Bacitracin
VP reagents
Kovacs

2. 
   Prepare the following labels as per Printing QC Labels Procedure using the “QC Tuesday Set up” receiving worklist from Softmic:
   

Test	Organism	Media
Arabinose	E. gallinarum ATCC 49573	Saline tube
Arabinose	E. faecalis ATCC 29212	Saline tube
Bacitracin	S. pyogenes ATCC 19615	BA
Bacitracin	S. agalactiae ATCC 12386	BA
Bile Esculin	E. faecalis ATCC 29212	BE
Bile Esculin	S. pyogenes ATCC 19615	BE
MUG	E. coli ATCC 25922	MUG
MUG	P. mirabilis ATCC 12453	MUG
Opt	S. pneumoniae ATCC 6303	BA
Opt	S. sanguis ATCC 10556	BA
Ornithine	S. lugdenensis ATCC 700328	Tube
Ornithine	S. aureus ATCC 25923	Tube
Prolex	S. pyogenes (Group A) ATCC 19615	Tube
Prolex	S. agalactiae (Group B) ATCC 12386	Tube
Prolex	S. equi ssp. equi (Group C) ATCC 9528	Tube
Prolex	Streptococcus Group F ATCC 12392	Tube
Prolex	S. equisimillis (Group G) ATCC 12394	Tube
Prolex	E. faecalis ATCC 29212	Tube
Tributyrin	M. catarrhalis ATCC 8176	Tube
Tributyrin	N. gonorrhoeae ATCC 43069	Tube
VP	Streptococcus Group F ATCC 12392	Tube
VP	S. pyogenes ATCC 19615	Tube
Xylose	E. gallinarum ATCC 49573	Tube
Xylose	E. faecalis ATCC 29212	Tube

Saline Tube

10

Pa. 27853

Sa. 29213

Ec. 25922

Hi. 49247

Sa. 25923

Se. 12228

Ss. 15305

Sp. 49619

Cj. 29428

Cf. 15296

Large MH	Sm. MH	HTM	MHB	BA	MAC	CHOC
6	2	1	1	4	1	1
Etest	KB	KB	Purity	Purity	Purity	Purity
Ps. 27853	Ps. 27853	Hi. 49247	Sp. 49619	Sa. 29213	Ps. 27853	Hi. 10211
Sa. 29213	Se. 12228	Hi. 10211		Sa. 25923	Ec. 25922	Hv. 49247
Sa. 29213	Ss. 15305			Sp. 49619
KB				Se. 12228
Ec. 25922				Ss. 15305
Ec. 25922				Cj. 29428
Sa. 25923				Cf. 15296

Apply discs as follows:

Etest	DISCS	DISCS	DISCS	DISCS
Pa. 27853	Ec. 25922	Hi. 49247	Sa. 25923	Sp. 49619
Polymixin B	Ampicillin	Ampicillin	Erythromycin	Levofloxacin
Colistin	Gentamicin	Ceftriaxone	Oxacillin	Clindamycin
Piperacillin	Cefazolin	Ps. 27853	Clindamycin	Erythromycin
Pip/Taz	Ceftriaxone	Amikacin	Vancomycin	Oxacillin
Meropenem	Co-trimoxazole	Gentamicin	Gentamicin	Vancomycin
	Tetracycline	Pip/Taz	Cefazolin
Sa. 29213	Nitrofurantoin	Ceftazidime	Penicillin	Cj. 29428
Penicillin	Tobramycin	Piperacillin	Co-trimox.	Cephalothin
Ceftazidime	Ceftazidime	Tobramycin	Tetracycline	Naladixic Acid
Ceftriaxone	Ciprofloxacin		Rifampin
Vancomycin	Amox/Clav			Cf. 15296
Cefotaxime	Aztreonam		Se. 12228	Cephalothin
Mupirocin	Cefpodoxime		Novobiocin	Naladixic Acid
Fusidic Acid	Cefuroxime
Levofloxacin	Cefoxitin		Ss. 15305
	Cefepime		Novobiocin