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 is assessed by the National Pathology accreditation body United Kingdom Accreditation Service (UKAS) against ISO 15189:2012 standards.
- See UKAS Scope of accreditation
- See Microbiology UKAS Certificate of accreditation
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.
Vancomycin
- 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.
Blood cultures
Adult Blood Cultures: Blood culture specimen collection
2 bottles: 1 green, 1 pink
Paediatric Blood Culture
1 yellow bottle
Blood cultures can be taken at any time during the on-call period.
- Specimens taken at Tunbridge Wells Hospital should be sent to Pathology on level -2 before 08:00hrs in the morning to ensure that they are sent to Microbiology on the first morning transport run.
- Specimens from Maidstone should be available for collection on the first porters run each morning.
Specimens do not require specific incubation temperature and can remain at ‘room temperature’ overnight if needed. There is no requirement to notify Microbiology staff when blood cultures are taken.
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
Chlamydia
Viral Swabs
- Specimen Collection Instruction for Viral investigations
- This includes influenza, swine flu and non-respiratory viral investigations
All other swabs
Body fluids
Urines
Other specimen types
-
- Acanthamoeba instruction
- Conjunctival and Corneal scrape instructions
- microbiology sample collection instructions for dematophyte culture (hair/skin/nails) for fungal culture investigations
- Threadworm
Out of hours service
Authorised results are available via the web browser.
Scientific staff provide an on call service to process urgent samples. Unauthorised results from routine samples are not available.
Microbiology consultant staff provide an on call clinical advisory service.
For details of both of these services and contact details please see Microbiology out of hours service