Reporting of Microbiology Results

The following will be reported to the attending physician, charge nurse, or other staff such as a ward clerk who is responsible for taking critical value findings. In accordance with th Joint Commission 2004 National Patient Safety Goals, all critical value results given verbally, including over the phone, will be asked to be "read-back" by the person receiving the test results(s).  After the results have been called, the coded comment "RCRB: must be entered into the Laboratory Information System so that the patient report reflects that the critical result was "read-back".  

BACTERIOLOGY

Gram Stain Results:
1.     Positive Gram Stains of
        A.    Blood *
        B.    CSF  * 
        C.    Organ or tissue specimens. 

2.     Cervical, vaginal and urethral smears containing Gram negative intra-cellular diplococci.

Culture, Toxin, and Direct Antigen Results:

1.     Positive blood cultures  *
2.     Positive CSF cultures  *
3.     Any isolates or direct detection of the following organisms;
        A.    Bordetella pertussis
        B.        Chlamydia trachomatis
        C.        Clostridium difficile toxin
        D.        Clostridium perfringens (in wounds)
        E.        Enteric pathogens (Salmonella, Shigella, Campylobacter, Yersinia, Vibro) 
        F.        Legionella
        G.        Neisseria gonorrhoeae
        H.        Neisseria meningitidis
        I.          Streptococcus agalactive (Beta strep. Group B) from L&D or OB Inpatient.

4.     Any culture result, not listed above but that is considered to be of immediate medical
       significance.
5.     Positive test for direct antigen identification for CSF of; 
        A.        Streptococci pneumoniae (83 types)
        B.        Haemophilus influenzae Type B
        C.        Neisseria meningitidis groups A, B, C, Y, W135
        D.        Streptococcus agalactiae (group B Beta Strep) 
6.     Throat specimens with cultures or direct tests positive for Strep. pyogenes (Beta Strep Grp.A) 
        on outpatients not getting auto faxing and all inpatient and outpatient isolates of Strep.
        Pyogenes from specimens other than throat such as wound or vaginal.
7.    Protocol for MRSA and VRE Notification for St. Joseph's, Crouse and Community-General
       Hospitals
       A.    New Patient Isolates
              1.  The results of all presumptive MRSA and VRE isolates recovered from clinical
                   specimens and/or patient surveillance screening samples will be telephoned
                   promptly to two locations for hospital:
                         a)  Infection Control
                                    AND
                         b)  the hospital floor where the patient is located
                   
                   Note:  Be certain to document the name of the person to whom the report was given as
                   well as the date and time.  Also, if the report is given to a telephone recorder for Infection
                   Control, please indicate the date that the sample was collected in your voice message.

              2.   Final and confirmed results need not be telephoned to these locations.

        B.    Results need not be telephoned for patients who have had previously documented infection
              or colonization with VRE and/or MRSA. 

        C.   Outreach Specimens: Notify the location, e.g., physician's office or nursing home.

Mycobacteriology

All positive AFB smears
All positive AFB cultures

Parasitology

In-patients:        All positive Ova and Parasites
Out-patients:     All positive Ova and Parasites that are Reportable Diseases; Giardia, E. histolytica, 
                        Cryptosporidium, Ehrlichia, Malaria, Trichinosis, or others that are reportable.

Mycology

All positive India Ink preparations
All positive KOH preparations
All positive fungal cultures with the exception of some yeasts commonly found in urines and sputums
All positive cryptococcal antigen tests

Virology

In-patients:        All positive virus cultures and direct antigen tests such as RSV
Out-patients:     All positive virus cultures and all positive direct tests

Other

Any pathogens on the reportable disease list of the N.Y.S. Health Department
not listed above.

Any nosocomial pathogens when deemed necessary by infection control (such as VRE and MRSA)