Microbiology

Introduction

Microbiology Unit HQE provides diagnostic and consultative services, training, research and development to support screening, diagnosis and treatment monitoring of infectious diseases caused by bacteria, fungi, parasites and viruses. Services are also provided to support non-infectious diseases such as autoimmune disease.

Services are provided either in house or referred to other facilities within government agencies (such as Hospital Kuala Lumpur, IMR, Hospital Sg Buloh and Makmal Kesihatan Awam).

The Microbiology Unit of Pathology department HQE works in close collaboration with Infection Control Unit, Infectious Disease Physician and Pharmacist for the prevention, control and management of hospital acquired infection and antimicrobial resistance. For activities related to prevention and control of vaccine preventable diseases and other communicable infectious diseases, collaboration is with other relevant departments and units such as the Medical Department, Occupational and Safety Unit and Public Health Unit.

List of Services

Diagnostic microbiological services provided by various laboratories namely bacteriology, mycology, parasitology, general serology, immunology and virology. 

Microbiology Laboratory Diagnostic Services offered are as follows:

• Direct detection of bacteria, viruses and fungi in clinical specimens by microscopic examination of stained or unstained smears.

• Isolation, identification and sensitivity testing of significant isolates of bacteria and fungi.

• Utilisation of immunological methods for antibody or antigen detection.

• Viral genome detection and/or viral load determination using nucleic acid testing such as polymerase chain reaction (PCR).

• Participation in hospital wide infection and antibiotic stewardship activities related to surveillance, control and prevention of healthcare-associated infections.

• Consultative services to clinicians and other health care providers, contribution to development of relevant policy, clinical care guidelines and hospital infection and antibiotic control related documentation or activity.

• Training for post-basic students under KKM.

Laboratory Consultation

In addition to overseeing the diagnostic tests the Medical Microbiologist, Medical Officer and Microbiology Scientific Officer also provide consultative services to clinicians to determine the most appropriate tests, specimens and timing of collection to meet particular diagnostic needs.

The choice of most appropriate test(s) and interpretation of result(s) will require a certain amount of clinical information to be provided on the request form, thus, Clinicians should consider consultation when:

• The laboratory frequently requests either more clinical information or additional specimens or both.

• It is unclear whether routine procedures can provide the information desired. 

• It is not known whether any specific viral infections are associated with an unusual syndrome.

• It is a medico legal case.

Services After Office Hours

1. Blood for Malaria Parasite, Dengue NS-1, Leptospira rapid serology test, CSF microscopy, CSF cryptococcal antigen, COVID Rapid Antigen Test, and Culture for bacteria and fungi.

2. Samples from Transplant cases.

3. Blood sample from needle stick injury (NSI) cases, after consultation with Medical Microbiologist.

   • If only a sample from the health care worker/victim is received, the sample will be processed if the status of the source is known to be positive

   • If the infectivity of the source is not known and only the health care worker/victim sample is received, sample will be processed the next working day. 

4. Sample for rapid molecular COVID-19, after consultation with a Clinical Microbiologist.

* All specimens other than above that are received after office hours and on public holidays will be kept in the refrigerator and will be processed on the next available working day.

The diagnostic microbiological services are provided by various laboratories namely bacteriology, mycology, parasitology, general virology, serology & immunology and molecular.

1. Bacteriology laboratory - Located at ground floor of Kompleks D.  Ext 7118.

2. Mycology laboratory - Located at ground floor of Kompleks D.  Ext 7118.

3. Parasitology - Located at ground floor of Kompleks D.  Ext 7118.

4. Virology, Serology & Immunology - Located at first floor of Kompleks D.  Ext 7137 / 7264.

5. Molecular - Located at ground floor of Kompleks D.  Ext 7260. (For SARS CoV-2) For other molecular tests, done at first floor of Kompleks D.  Ext 7137 / 7264.

Tests that are offered as 24 hours service are

1. Corneal scraping (Gram stain)

2. BFMP ( for new case only)

3. NS-1 Antigen (Dengue)

4. Rapid Leptospiral Test

5. CSF FEME (Cell count, Gram stain, India ink)

6. CSF antigen detection (Cryptococcus)