Microbiology

Head of Department: Dr. Rohini Wadanamby

Microbiology is the study of microscopic organisms, such as bacteria, viruses, archaea, fungi and protozoa. This discipline includes fundamental research on the biochemistry, physiology, cell biology, ecology, evolution and clinical aspects of microorganisms, including the host response to these agents.

Importance of Microbiology

Clinical Microbiology is arguably the first discipline of personalized medicine. For example, if a patient has the signs and symptoms of a urinary tract infection, including increased urgency, frequency, and pain with urination. A urine sample is collected and cultured quantitatively. Within 24 hours, the clinical microbiology laboratory reports the species and quantity of bacteria found in the urine. 1-2 days later, the laboratory reports the susceptibility of that patient's bacterial isolate to a panel of antibiotics approved to treat urinary tract infections. The patient's clinician can then choose an antibiotic that is predicted to be effective against that patient's infection.

Similarly, microbiology can be utilised to identify a variety of diseases arising from micro-organisms and effective treatment can be determined after doing so.

Why choose LHD for Microbiology tests?

The microbiology department at LHD, offers a large number of tests covering Bacteriology, Infectious Diseases, Serology, Allergy and Autoimmunity.

Bacteriology

Our Bacteriology department is well equipped with the latest technology. Bactec Fx is the latest version of our fully automated blood culture system which is capable of continuously monitoring samples for an effective diagnosis. Our MGIT 960 system offers culture and preliminary antimicrobial susceptibility testing facilities for mycobacteria. Our state-of-the art Vitek-2 system is the very first MIC (minimum inhibitory concentrations) based automated antimicrobial susceptibility testing system, which is a first in Sri Lanka.

Nowadays, MIC is used in antimicrobial susceptibility testing. In laboratories, more often than not, exact pathogens cannot be easily determined by symptoms of the patient. And, even if the pathogen is determined, different traits of pathogens, have differing resistances to antibiotics, so it is hard to prescribe correct antibiotics. The MIC is determined in such cases by growing the pathogen isolate from the patient on plate or broth, which is later used in the assay. So, by knowing the MIC of the pathogen, the physician will have a better idea on which antimicrobial(s) in doses to prescribe. 

Bacteriology tests conducted at LHD can be categorized into 3 main categories, namely:

• Aerobic
• Anaerobic
• Microaerophilic

Aerobic

At our laboratory we utilise conventional incubators, CO2 incubators and incubators with a temperature level up to 25 degrees centigrade to identify aerobic microbes.

Anaerobic

We utilise the latest Vitek 2 system (updated in 2018), which has the ability of identifying micro-organisms up to their species level. The VITEK 2 system has everything our laboratory need for fast, accurate microbial identification, and antibiotic susceptibility testing. The innovative VITEK 2 microbial identification system includes an expanded identification database, the most automated platform available, rapid results, improved confidence, with minimal training time.

The VITEK 2 system next-generation platform provides greater automation while increasing safety and eliminating repetitive manual operations. The rapid response time means results can be provided more quickly than with manual microbial identification techniques.

Microaerophilic

We utilise a highly sensitive and specific Campylobacter culture system in CO2 incubators to identify Microaerophilic organisms. Our CO2 incubators also enable us to cultivate sensitive culture systems for microbes such as pneumococci, haemophili and other volatile pathogens in isolation.

Mycobacteriology culture facility

We utilise this facility to culture microbes such as mycobacterium tuberculosis and other types of mycobacteria (other than mycobacterium tuberculosis) such as actinomycosis and norcardiosis.

Mycology (fungal culture system)

LHD is the only facility which has four types of incubators to perform mycology cultures at temperatures of 25, 37, 42 and 52 degrees centigrade. We have the ability to develop culture systems which are more than 80% sensitive for all possible human invasive fungi.

During instances that clinicians request that we perform a test which correlates human fungal infections to household animals we have the ability to culture relevant animal specimens as well.

Other Culture services

• Sterility checks - We develop environmental cultures from facilities such as theatres, labour rooms, endoscopy units to assess the sterility level of these facilities. We conduct air quality checks for example settle plates and based on instances where certain facilities fail their quality checks, we provide advice and consultations with regards to upholding quality standards.
• Research and Development assistance - Phd research students rely on LHD to perform MICs and and IDs of their isolates or organisms in order to develop their research. We also provide culture and culture media to certain universities for educational purposes.
• Identifying diseases during emigration or immigration - Certain diseases, especially parasitic infections, which are not prevalent in Sri Lanka can be identified during emigration or immigration of tourists.

Parasitology

At LHD we have the ability to identify all types of parasitic ova, eggs, adults and trophozoites, utilising specific stains.

Serology

The serology department is composed of a large number of serology tests performed on automated serology platforms, Architect, ELISA based technology performed on VIDAS, is supported by a large number of rapid, manual card tests. Architect is our newest, fully automated serology platform, capable of performing a large number of infectious disease serology tests, as well as a number of biochemical parameters, with the quickest turnaround time. LHD performs a large number of tests for parasitic infections.

Bacterial Serology

We conduct microbial antigen test and monitor patients’ response to microbes from (anti body tests such as IGM and IGG). Certain clinical bacteria cannot be cultured and are inhibited by various mechanisms by the time patients visits us for tests.  In these instances serology tests helps in providing a conclusive diagnosis.

Bacterial serology tests are also helpful in identifying rare diseases acquired in other countries. Additionally, LHD can also assist in making arrangements to send test samples abroad for testing.

Allergy

Phadia, our newly acquired allergy platform has the capability of testing against 189 allergens, either as a part of a panel of allergies, or individually.

Autoimmune Testing

This department offers a large number of autoimmune serology tests, using immunofluorescence and euroimmune manual card tests.

Advisory Service

We strive to provide a high quality supportive advisory service to the clinicians in areas of microbiology and infectious diseases serology, allergy and autoimmunity.

Together with the microbiology department, the molecular diagnostics department is also actively involved in developing quick molecular tests in areas of clinical microbiology and infection control.