The Microbiology service is based at Maidstone hospital, providing a comprehensive clinical service to both hospitals within the Trust, the local Clinical Commissioning Group and the community, for the diagnosis, treatment, management and prevention of infectious diseases. Some specialist investigations are provided through arrangements with specialised laboratories throughout the UK. There is 24 hour support 365 days a year on both sites for urgent patient management. The department holds ISO 15189:2012 accreditation (UKAS 8063).
Antimicrobial Guidelines and Antibiotic Levels
See West Kent Antimicrobial Guidelines for treatment of infectious diseases Gentamicin and Vancomycin levels are now performed by Clinical biochemistry department. Results are available on PAS (if requested via PAS) as soon as authorised. For other antibiotic levels, discuss with Microbiology consultant Gentamicin
- A trough (pre-dose) level is required 18-24 hours after the first dose
- It is not necessary to take a post dose level for once daily dosing. Only take a post dose level on patients on bd or tds gentamicin.
- The trough (pre-dose) level should be less than 1mg/L
- The post dose level (if done) should be 5-10mg/l
- If gentamicin levels are within range and renal function is stable, monitor gentamicin levels every 2 to 3 days.
- A trough (pre-dose) level is required immediately before the third dose.
- Post-dose levels are not required.
- Trough (pre-dose) level should be 15-20mg/L
- If trough (pre-dose) level is outside reference range seek advice from Microbiology. After each dose adjustment re-check level before third dose on the new regimen.
- If levels are within range and renal function is stable, twice weekly monitoring of pre-dose (trough) level is recommended.
Adult Blood Cultures: Blood culture specimen collection
Paediatric Blood Culture
There is no need to inform the On-Call team that blood cultures have been taken. Blood cultures can be taken at any time during the on-call period. Porters, on request, will take the blood cultures to the correct incubator. These will be dealt with the following morning after incubation.
Bacterial and Viral Serology
5-10 ml clotted blood (9ml red top) is normally required for each patient. Send the same day or palce in fridge overnight. Tests are processed in batches for economy. For details of individual tests please see test catalogue.
Types of swab and collection techniques
Other specimen types
- Conjunctival and Corneal scrape instructions
- microbiology sample collection instructions for dematophyte culture (hair/skin/nails) for fungal culture investigations
Out of Hours Service
The On-call Biomedical Scientist (BMS) works from outside the hospital and may be contacted via the hospital switchboard. Urgent clinical advice is available from the Consultant Microbiologist via the hospital switchboard. Authorized results will be available via the web browser. Results generated during on call hours will be available but unauthorized results from routine specimens will not be available outside normal hours. Out of hours we will process
- Urgent urines from children
- CSF’s and other specimens from suspected meningitis patients
- Urgent fluids from sterile sites e.g. joint fluids (from A&E, MAU and AAU)
- Other requests at the discretion of the On -call BMS or Consultant Microbiologist
Blood cultures can be taken at any time during the on-call period. Porters, on request, will take the blood cultures to the correct incubator. These will be dealt with the following morning after incubation.