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Laboratory operations impact on the final information produced by the laboratory, which in turn impacts on patient treatment and care, surveillance and epidemiological data, public health, research and health systems planning. Therefore, the information produced needs to be reliable and accurate.

There was a focus on microbiology because it was recognized that there are relatively few automated systems, therefore no interfacing of equipment in bacteriology, Therefore there is a greater reliance on manual processes and quality control, and subjective interpretation of clinical data and results, leading to an increased number of sources of error.

The overall objectives of the microbiology component were to:

  • Improve operations of regional and national microbiology operations to provide high quality laboratory information leading to improved patient management and treatment.
  • Ensure that microbiology methods will be harmonized throughout the region, reflecting both best practice and the level of service required from each laboratory, to be cost-effective, and to give a high quality, accurate and appropriate service, and commensurate with the skill level of the staff.
  • Provide guidelines to countries to assist in the determination of the level of service required by the region, and the specific countries within the region.

The Major Achievements of the Microbiology Project Component are:

  1. 34 technical staff, 3 facilitators and 3 administrative staff from a total of 18 countries participated in the standard method drafting group meetings, to produce 27 regional standard microbiology technical methods and  5 standard microbiology support methods, including quality assurance. At least 22 participating laboratories, both public and private, have so far agreed in principle to adopt the regional microbiology standard methods
  2. Microbiology plans developed by each participating country visited, including actions to update technical procedures and to implement ISO 15189
  3. One operational research study. ‘The Effect of Staff Attitudes on Quality in Microbiology Laboratories’ completed. This study examines the extent to which job satisfaction and organizational climate affects the quality of the microbiology service.
  4. An individual EQA tracking tool was developed and distributed to each participating microbiology laboratory in order to monitor their EQA performance. In addition, instructions for updating the tracking tool were also supplied.
  5. Microbiology technical and technical documentation training performed.
  6. Microbiology Technical Network formed.
  7. Development of guidelines for provision of microbiology services via managed networks
  8. Harmonized curriculum/distance education and web-based education





The 'Strengthening of Medical Laboratory Services in the Caribbean' (SMLS) Project, would like to thank The Health Protection Agency, England, for the knowledge and expertise of their staff and working groups in the UK, who develop National Standard Methods, on which the Caribbean Regional Microbiology Standard Operating Procedures are based.

Many thanks also to the facilitators of the Standard Methods meetings, the method editors, administrative support and to the participants from the participating countries for researching and writing the Microbiology Standard Methods, and for supporting this initiative.


  • CRM SOP No. 1 – Sputum Microscopy to Detect AAFB's
  • CRM SOP No. 2  - Intravenous CannulaeTips & Assoc. Swabs
  • CRM SOP No. 3  - CSF Examination
  • CRM SOP No. 4 – Enteric Specimens for Bacterial Pathogens
  • CRM SOP No. 5 – ESBL Detection
  • CRM SOP No. 6 – Genital Tract Specimens
  • CRM SOP No. 7 – Gram Stain
  • CRM SOP No. 8 - Group B Streptococcal Isolation & Identif.
  • CRM SOP No. 9 - Haemophilus Influenzae, Isolation & Identif.
  • CRM SOP No. 10 – MRSA Isolation and Identification
  • CRM SOP No. 11 – Faecal Parasitology
  • CRM SOP No. 12 - SOP for an SOP
  • CRM SOP No. 13 – Sputum Culture for Bacterial Pathogens...
  • CRM SOP No. 14 – Throat Swab
  • CRM SOP No. 15 - Urine Culture
  • CRM SOP No. 16 - Urine Microscopy
  • CRM SOP No. 17 –Vancomycin Resistant Enterococci (VRE)
  • CRM SOP No. 18 Media Preparation and Control
  • CRM SOP No. 19 - Propagation and Maintenance of Quality Control Organisms
  • CRM SOP No. 20 - Safety Guidelines for the Microbiology Laboratory
  • CRM SOP No. 21 - Quality Control of Reagents and Tests
  • CRM SOP No. 22 - Innoculation of Culture Media
  • CRM SOP No. 23 – Eye Swabs and Canalicular Pus
  • CRM SOP No. 24 – Nasal Swabs
  • CRM SOP No. 25 – Investigation of  Skin, Superficial and Non-Surgical Swabs
  • CRM SOP No. 26 – Mouth Swabs
  • CRM SOP No. 27 – Ear Swabs
  • CRM SOP No. 28 – Investigation of Fluids from Sterile Sites
  • CRM SOP No. 29 – Abscesses and Deep Seated Wound Infections
  • CRM SOP No. 30 – Mycology Specimen Investigations
  • CRM SOP No. 31 - Blood Culture Investigations
  • CRM SOP No. 32 – Meningococcal Screening
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    CMLF News Issue #7
    27th January 2016