Eurofins Clinical Diagnostics Ireland’s microbiology services

Bacteriology examinations start with the collection of samples, which can originate from multiple sites on the human body or from medical equipment (Figure 1). 

Our team perform culture and sensitivity (C&S) tests, which involve growing bacteria in specialised media to allow for their identification and characterisation. Microbial identification is performed both manually using staining, spot tests and analytical profile indexes (API), and using automated methods. 

The Sysmex UF-5000 is a fully automated urine particle analyser that uses fluorescent flow cytometry to analyse urine samples. The Sysmex UF-5000 is leveraged in tandem with our urine culture and microscopy capabilities to provide a complete urinalysis workflow for each patient. 

Antimicrobial susceptibility is assessed according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) standards using both Vitek platforms, MICs, Etests and disc diffusion tests to identify the real-time sensitivity or resistance of bacteria to different antibiotics. Screening for multi-drug-resistant bacteria including MRSA, CPE, VRE, ESBL and AmpC’s is conducted within rapid turnaround timelines.

Urinary tract infections (UTIs)

Urinary tract infections (UTI) result from the presence and multiplication of micro-organisms in one or more structures of the urinary tract. This can give rise to a wide variety of clinical syndromes, including acute and chronic pyelonephritis (kidney and renal pelvis), cystitis (bladder), urethritis (urethra), epididymitis (epididymis) and prostatitis (prostate gland). Infection may spread to surrounding tissues (e.g. perinephric abscess) or to the bloodstream.

E. coli remains the most common cause of complicated UTIs, although other frequent isolates include Klebsiella sp., Enterobacter sp., Proteus sp., Enterococcus sp. and Pseudomonas aeruginosa. Staphylococci and streptococci can also cause uncomplicated infections such as Staphylococcus saprophyticus and Group B Streptococcus.

Helicobacter pylori

Helicobacter pylori (H. pylori) infection is a public health issue. It remains one of the most common infections in adults in Ireland and is associated with significant disease. It is the main cause of chronic gastritis, peptic ulcers, gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma. Antibiotic resistance is one of the main reasons for H. pylori treatment failure. 

Eurofins Clinical Diagnostics Ireland has conducted extensive research in the area and offers a range of analyses for Helicobacter pylori, including:

• Helicobacter pylori stool antigen
• Serology tests for H. pylori antibodies

Clostridium difficile

Clostridium difficile is a leading cause of nosocomial diarrhoea. The production of two toxins A (enterotoxin) and B (cytotoxin) causes the characteristic mucosal damage consisting of plaque-like lesions leading to the formation of a pseudo membrane. Not all strains of C. difficile produce toxin and therefore not all can cause illness.

 
Test Protocol

A GDH screening test is initially performed on a stool sample requesting C. difficile. If this is negative, C. difficile infection is highly unlikely, and no further testing is required.

If the GDH screen is positive, C. difficile toxin testing is performed. If this toxin test is positive, C. difficile infection is highly probable, and the sample is reported as positive.

If the C. difficile toxin testing is negative, we recommend testing samples for confirmatory PCR testing. Clinicians will be contacted before a sample is referred for PCR testing.