LabPLUS is part of Auckland District Health Board
and provides medical laboratory testing
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MICROBIOLOGY |
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| The consultant microbiologists provide clinical support for the department. The service is a 7day per week 24hour for advice about interpretation of Microbiology results, treatment of infections and infection control issues. They also work in close liaison with the infectious disease clinicians and the Infection Control service at ADHB. |
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| The Clinical
Microbiology Laboratory at LabPlus provides the following services:
Microbiology, Anaerobic microbiology, Mycobacteriology, Mycology,
Parasitology, Antimicrobial Susceptibility Testing, Sexual Transmitted
Infections, leptospira serology and culture, leprosy testing by skin
smears, and molecular diagnostics. The Heart Valve bank provides human heart valves for use as allografts. The laboratory is the national reference centre for Mycology, Anaerobes, and molecular typing of Mycobacteria The Microbiology Laboratory performs approximately 186,000 tests each year and is IANZ accredited. The laboratory participates in a number of Quality Assurance programmes including the RCPA, AGSP (Australian Gonococcal / Meningococcal Surveillance Programme) WHO Pacific Rim Susceptibility Programme for Mycobacterium, CDC Performance Evaluation Programme for drug susceptibility of Mycobacterium tuberculosis. |
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General Microbiology Section | ||||||||||||||||||||||||
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| The General Microbiology section performs routine as well as specialised testing. High volume tests include blood cultures, urine cultures, lower respiratory tract cultures, wound cultures and enteric specimens. Specialised tests include culturing for fastidious organisms (eg Bartonella spp., Legionella spp., and Bordetella spp.) and screening clinical specimens for multi-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and extended spectrum beta lactamase producing Enterobacteriaceae (ESBL). Identification of aerobic isolates is performed using automated, commercial and manual phenotypic tests. |
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Anaerobic | ||||||||||||||||||||||||
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The Anaerobic section is the National Reference Centre and receives anaerobes from hospital and community laboratories throughout New Zealand. Anaerobic cultures are performed using freshly prepared pre-reduced media incubated in an anaerobic chamber, and then isolates are identified using a combination of phenotypic tests, commercial systems and 16SrRNA-sequence analysis. There is a focus on rapid turnaround and the 16SrRNA-sequence analysis is performed on site so delay is minimal. |
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Mycobacteriology | ||||||||||||||||||||||||
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The Mycobacteriology section processes approximately 4500 specimens annually and receives 300 referred cultures. Rapid DNA probes are available for Mycobacterium. tuberculosis, M.avium-complex and M.gordonae. Susceptibility testing is performed using the BACTEC MGIT and BACTEC 460 technologies. An extensive range of second line anti-TB drugs is available. E-test susceptibilities and micro-broth MIC using NCCLS methodology can be performed on rapid-growing Mycobacteria. The laboratory is contracted to ESR to provide DNA fingerprinting (RFLP testing) for all strains of M. tuberculosis identified in New Zealand. |
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Mycology | ||||||||||||||||||||||||
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The Mycology section processes approximately 6000 specimens each year. On request a service is provided for the collection of skin, hair and nail samples. Fungal serology includes cryptococcal latex antigen and aspergillus precipitins. Indirect fluorescent antibody staining for Pneumocystis carinii is offered 7 days a week. Leishmania spp. and Acanthomoeba spp. are cultured for and regularly isolated. Since 1997 the laboratory has provided a National Reference service for identification of fungi and aerobic actinomyctes. Antimicrobial susceptibility testing is provided when considered clinically appropriate. This service is funded by ESR and is provided free of charge to hospital and community laboratories. An extensive culture collection is maintained and fungal cultures can be provided for teaching purposes. |
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Enteric Pathology and Parasitology | ||||||||||||||||||||||||
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Faecal specimens are routinely cultured for Campylobacter spp., Salmonella spp., Shigella spp, Yersinia spp. routinely with Aeromonas spp., Vibrio spp., Pleisomonas spp., E. coli O157 and other enterohaemorrhagic E.coli (EHEC) serotypes investigated where clinically indicated. Testing for rotavirus, and Clostridium difficile toxin A and B is also available. The parasitology section processes approximately 2500 specimens annually. Routine parasite examination includes cysts, oocysts, helminth ova and worms. The Microbiology Lab is contracted to screen new immigrants for faecal parasites. The diversity of parasites gives the laboratory the ability to provide teaching in this area. Examination for Microsporidia spp. is offered on request. |
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Antimicrobial Susceptibility | ||||||||||||||||||||||||
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The Antimicrobial Susceptibility testing section performs a wide range of susceptibility testing. Routine susceptibility methods include breakpoint agar dilution and Kirby-Bauer disk diffusion. These are supplemented by MIC testing (E-test or alternatively broth/agar dilution) The laboratory follows the protocols of NCCLS disc diffusion protocols. Screening of E.coli and Klebsiella spp. as well as other Enterobacteriaceae for ESBL production is routine and confirmation is by recommended NCCLS disc confirmation. Other specialised procedures offered are serum bactericidal titres (SBT), biological assays, NCCLS Microbroth MIC for Nocardia spp. and rapid-growing Mycobacterium spp. Detection of the mecA gene in Staphylococcus spp is performed in the Molecular Diagnostic section. Assays for aminoglycoside and gycopeptide levels are performed in Clinical Chemistry. Local susceptibility patterns are reported annually. This report is
currently being reviewed and will be available soon. |
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Sexually Transmitted Infections | ||||||||||||||||||||||||
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The Sexually Transmitted Infections section is a specialist reference laboratory providing a local and regional service. Chlamydia and gonorrhoea detection from clinical specimens is performed by nucleic acid amplification. This is done using the BD Viper XTR DNA assay using strand displacement amplification (SDA) technology. Cell culture techniques are used for Chlamydia trachomatis and Chlamydia pneumoniae. The service also provides Trichomonas and Neisseria gonorrohoeae MIC testing, routine testing for chlamydia, trichomonas and yeast for Auckland Sexual Health Clinics (ASHC), clinic sited laboratory microscopy and blood collection at the ASHC, forensic microbiology testing on sexual abuse/assault cases, collating susceptibility results of Neisseria gonorrhoeae for the global WHO antibiotic programme and specialised testing for Haemophilus ducreyi and cytolytic vaginosis. |
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Leprosy | ||||||||||||||||||||||||
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Slit skin smears (on leprosy patients) are performed on request. Samples are taken from the earlobes, elbows and a representative lesion and stained by the Auramine M fluorescent procedure. Information on the Bacterial Index (number of bacilli present in the lesion) and Morphological Index (percentage of organisms viable) are provided. |
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Molecular Diagnostic | ||||||||||||||||||||||||
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| The Molecular Diagnostic section testing spans all areas of clinical microbiology. In house PCR tests have been established for the detection of Bartonella spp and Rickettsia spp. From clinical specimens. 16S rRNA sequence analysis of bacteria, 18SrRNA-sequence analysis of fungi and heat-shock protein 65 sequence and analysis for mycobacteria is available. All M. tuberculosis isolates cultured in New Zealand are DNA fingerprinted (RFLP) and entered into a national database. The detection of the mecA gene in staphylococcal isolates is performed on request. Further molecular- based tests are currently under development. |
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Heart Valve | ||||||||||||||||||||||||
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| The Heart Valve Laboratory situated in the Basement of the Starship Building provides and maintains a bank of cryopreserved human heart valves for use as allografts by the Cardiothoracic Surgical Unit and private hospitals performing valve implantation. |
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