CURRENT STATUS

1
Introduction of molecular diagnostic techniques
in the diagnosis of health care associated
infections (MRSA and C.diff) - CONCEPTION AND
INCEPTION Dr. Venkat Sivaprakasam, Consultant
Microbiologist - Hereford Hospitals NHS Trust
BEST PRESENTATION AWARD
CURRENT STATUS Consultant Microbiologist with
additional responsibilities of Head of The
Department and Director of National Leptospirosis
Reference Unit at Hereford Hospitals NHS Trust.
Tool kits the team embraced in planning
strategy Delegation stakeholder
mapping. Empathising Giving and receiving
feedback Setting targets meeting deadlines and
promises. Sharpening the Saw Regular social
meets, The attendance to this year Christmas
party is 100 ( First time ever in the History of
Hereford Microbiology).
Pilot project initiated after creating awareness
and inciting interest clostridium difficile
associated diarrhea uncertainties in testing
algorithms and the role of Toxin gene detection
Objectives To define an optimum testing
algorithm for the laboratory diagnosis of CDAD
with the use of clostridium difficile gene
detection system (PCR assay) by GeneXpert
(Cepheid), with the single objective to achieve
zero tolerance to hospital acquired
CDAD. Methods 261 Stool samples from patients
with loose stools attending Hereford hospitals
NHS trust in UK, were tested for the presence of
Clostridium difficile toxin by VIDAS assay
(Biomerieux) and cell culture cytotoxin assay
(CTA) and the clostridium difficile toxin gene by
PCR assay. Results With reference to CTA as
the gold standard the sensitivity and specificity
of the VIDAS assay was 83.92 and 75.72 and that
of PCR assay was 100 and 77.66
respectively.. Conclusion The superiority of
the GeneXpert gene detection assay over VIDAS in
terms of efficacy is significant. In terms of
efficiency (user comfort, turn around time and no
equivocal results) we feel the PCR assay is far
more superior. The ability to identify the
ribotype 027 strain at the same time is
beneficial to prevent harmful cohorting.
END IN MIND (VISION) A highly motivated and
committed team which includes all the staff in
the Department of Microbiology to facilitate
synergistic work to deliver the highest quality
Microbiology services in the most appropriate
time scale, that would assist and support the
clinicians to deliver a safe, high quality and
evidence based health care package to the
patients, their relatives and people of
Herefordshire that they could be proud of and
enable them to enjoy their cushioned journey
through the health care system as and when one
arises.
MOLECULAR GROUP FORMED
Mile stones set and achieved (MISSION) SWINE FLU
PCR TESTING The team has developed
respiratory PCR assays including swine flu
testing. Routine testing is likely to happen this
winter. (The team is very excited and
enthusiastic by the product of their synergistic
efforts. MRSA TESTING BY PCR Project has
been developed to do MRSA PCR testing for the
high risk patients group as POCT using the same
platform as for C Diff toxin gene
testing. LEPTSPIROSIS TESTING BY PCR
Routine PCR testing is likely to roll out early
next year as part of the reference services to
the whole of UK.. Molecular work shop
Planned for the entire team and for BMS from
neighboring trusts.
INNER CHALLENGE New team and new
environment. Unpolished and untested leadership
qualities. Time management.
OUTER CHALLENGE Team more comfortable with
historical practices. Resistance to change Lack
of awareness to recent advances and
developments. Financial constraints.
THIS PROJECT WAS PRESENTED AT ECCMID IN VIENNA IN
ARPIL 2010
Perceived benefits to the team Increased
awareness and interest leading to
confidence. Awards, recognition and the feeling
of being valued was motivating and inspiring to
the team. No time was lost in spreading the team
dynamics and building the team spirit by
crediting every member of the team for whatever
little contribution made.
MARCH CONTINUES WITH INCREASING VIGOUR AND TEAM
SPIRIT TOWARDS THE SAME END IN EVERY TEAM
MEMBERS MIND
First step Set exceptional standards for myself
by regular training and practising the SEVEN
HABBITS OF LEADERSHIP
Thanks to Merlin and Penny AND all others who
have been instrumental in facilitating this
seemingly MIRACLE.