1 Preanalytic Errors in the Clinical Microbiology Laboratory

OVERVIEW

Clinical microbiologists are well aware of the adage fi rst coined by computer programmers, garbage in, garbage out, but for their profession have renamed it quality in, quality out. Their adage refers to the fact that the quality of the clinical specimen received by the clinical microbiology laboratory is a key factor in the optimal use of clinical microbiology. For serological test-ing, the timing of the serum collection may be an equally critical factor for optimal use. Unfortunately, the clinicians often do not have the tools, interest, training, access to data, or time to deter-mine optimal use of the clinical microbiology laboratory for their patients.

The clinical case reports in this chapter are selected from the medical literature and the personal experiences of the author. They illustrate common preanalytic medical errors in the clinical microbiology laboratory.

Overview 1

Failure to Consider Infection 2

Failure to Consider Uncommon Infections 13

Failure to Appreciate the Proper Timing for Serology Tests 28

Failure to Appreciate the Sensitivity or Speci city of Microbiology Tests 37

Failure to Submit Suitable Microbiology Specimen 45

Failure to Properly Identify Patient, Specimen, or Test Order 57