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Wirral University Hospital NHS Foundation Trust

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Bacteriology

The Microbiology service examines swabs, pus, body fluids, sputum, faeces and urine for the presence of infection and disease causing bacteria. 

Through association with other laboratories it is able to offer a comprehensive service.

Antimicrobial Therapy and Clinical Consultation

When a conclusive microbiological diagnosis has been reached, optimum therapeutic regimens are reported when necessary. They will be reported as:

Sensitive (S): Implies that the micro-organism is inhibited by the usually achievable concentrations of the antimicrobial agent when the recommended dosage is used for the site of infection.

Intermediate (I): Implies clinical efficacy in body sites where the drugs are physiologically concentrated (e.g. quinolones and b -lactams in urine) or when a higher than normal dosage of a drug can be used (e.g. b -lactams). This will include micro-organisms with antimicrobial agent Minimum Inhibitory Concentrations (MICs) that approach usually attainable blood and tissue levels and for which response rates may be lower than for susceptible micro-organisms.

Resistant (R): Implies that micro-organisms are not inhibited by the usually achievable concentrations of the antimicrobial agent with normal dosage schedules.

Performance Standards for Antimicrobial Susceptibility Testing; 19th Informational Supplement January 2009: Clinical Laboratory Standards Institute (CLSI)

The serum concentration of relatively toxic antimicrobials and those used in critical infections are monitored.

The following empirical (blind / provisional) prescribing regimens can be found in the

Wirral Prescribers’ Guide and The Chester Joint Formulary

(a)     for patients with severe sepsis and

(b)     when the microbiological diagnosis is inconclusive