Microbiology

Microbiology is concerned with the detection, isolation and identification of microbes in clinical samples.

Further information on our service can be found at: Microbiology | Edinburgh and Lothians Laboratory Medicine.

To contact the laboratory

To discuss with the microbiology laboratory team, including results,

Mon-Fri 09:00-17:00 Sat-Sun 09:00-16:00:

RIE laboratory – for all sites except SJH in hours – 0131 242 6021 (26021)
SJH laboratory – 01506 523080 (53080).

To contact for clinical advice

For clinical microbiology advice, please use the GP advice email:

loth.gpmicroadvice@nhs.scot
This is monitored Monday – Friday, 9am – 5pm. If an email is received before 3pm on a normal working day we will aim to respond by 5pm that day.
Emails are NOT monitored during weekends or public holidays.

URGENT clinical microbiology advice is available via telephone:

0131 536 3373 (63373) and choose option 4 for medical microbiology.
During out-of-hours/weekends/public holidays URGENT medical microbiology advice is available via NHSL switchboard 0131 536 1000.

Note for virological queries there is an email inbox: loth.virologyadvice@nhs.scot.

Guidance is available for:

Infection Prevention Control advice – Infection Prevention and Control

Virology contact information and advice – Virology – RefHelp.

Specific guidance:

Antimicrobial prescribing advice – community
Antimicrobial guidance – more detailed / specialist / acute
Diagnostic tests including how to request, turnaround time, specimen requirements
Infectious Diseases including OPAT referrals.

Please see useful guidelines about common infections under the speciality sections:

NICE CKS:

Contains advice on many common infections in primary care and can cover unusual presentations e.g. threadworms in pregnancy.
Infections and infestations | Specialities | CKS | NICE.

FAQs:

1.How should chronic ulcers/wounds be assessed for signs of infection?

a.The ERF has a series of resources, including the Ropper ladder, on managing suspected infection in chronic wounds here: East Region Formulary – Wound Management

2. Mixed growth urines in symptomatic patients

a.If the patient has symptoms consistent with a UTI, treat empirically as per formulary guidance

b.“Mixed growth” usually indicates contamination with vaginal, skin or bowel organisms. Suggest repeat sample if clinically indicated e.g. in pregnancy. Samples in boric acid containers (red top) are preferred to reduce overgrowth of contaminants before the samples arrive in the laboratory.

c.If the patient does not have symptoms or signs of a UTI then treatment is not recommended, regardless of the amount of growth, unless the patient is a pregnant woman.

3.Can I use oral flucloxacillin for a mixture of flucloxacillin sensitive Staph aureus and Beta haemolytic streps in a swab?

a.Oral flucloxacillin alone is expected to be effective for mild infections caused by Streptococcus pyogenes (Group A Streptococcus) and Streptococcus dysgalactiae (Groups C and G Streptococcus).

b.However, Streptococcus agalactiae (Group B Strep) often is less susceptible to flucloxacillin. Amoxicillin would be a better choice for Streptococcus agalactiae. Amoxicillin can be added to flucloxacillin in cases of mixed infections of Streptococcus agalactiae and Staphylococcus aureus.

4.How should I manage a patient with H. pylori whose symptoms have not responded to first- and second-line therapy, or in whom there are contraindications to usual care?

a.Gastroenterology leads on providing advice for Helicobacter infection.

b.Please see Helicobacter Pylori – RefHelp

c.The formulary has prescribing information here: East Region Formulary – H. pylori

If your H Pylori query is not answered by the above, then please contact Gastroenterology by email for advice.