Bacteriological Examination

• Bacteriological examination of water samples for potability.
• Stool/Rectal Swabs/Vomit Samples Examination For Bacterio – logical Culture–For Cholera And Other Agents Of Diarrhoea, Dysentry, Gastroenteritis.
• Blood Samples For Enteric Fever Cultures & Food Poisoning Agents.
• Antimicrobial Susceptibility Testing of isolated bacterial cultures.
• Microbiological – Samples received under Prevention of Food Adulteration Act 1954.
• Suspected/leftover food, water and related samples to detect causative agent in food poisoning outbreak investigation.
• Food served to VIP and VVIP is tested for bacteriological examination.

Training And Health Education

• In service training to the technical staff.
• Interstate training to the technical staff.
• International training to the WHO fellows.
• Training to the Med. DPH candidates.
• Interstate training for members of consumer forum.
• Health education through demonstration and exhibition.
• To medical students.
• To Local Self Govt. people
• To collage students, catering diploma students.
• To Nursing staff.
• To sanitary & food inspectors.
• To the public

Sample collection methods (Bacteriological Examination)
For effective bacteriological examination of water it is important that the water sampling should fulfill the following requirements.

• Sampling should be properly planned.
• Sampling points should be representative of water source.
• Sampling points should be located in proportion to population served.
• Samples should be collected, stored, dispatched in suitable sterilized glass bottles with properly fitting stoppers or caps.
• At least 250 ml of sample should be collected.
• Send the samples to the nearest district Public Health Laboratory at least within 24 hrs from the time of collection.
• Samples should be sent in a cold chain.

Transportation
The shorter the time that elapses between collection of sample and its analysis the more reliable will be the analytical results. Therefore send the sample at destination at an earliest.

Concerned Laboratories
Samples should be sent to or to The District Public Health Laboratory at an earliest.
(Annexure I)

Collection of Stool Sample
Reliability of results obtained will depend largely on the care taken in collecting samples. Stool samples are collected for various different tests as follows.

• Microscopic examination of parasites i.e. eggs or larvae of Parasitic worms.
• To detect bacteriological pathogens like Vibrio, Salmonella and Shigella.

1) For Microscopic examination to detect the presence of eggs or larvae of parasitic worms.

• Obtain sufficient quantity of stool samples approximately 4–5 Gms or 4 ml of stool sample depending on whether it is in solid or liquid in consistency.
• Liquid stools containing mucus and blood must be examined first, which may contain motile amoeba that may die quickly on exposure to air.
• Specimen should be collected in a waxed cardboard box or in a wide mouth plastic box with a lid.
• Examine stools while fresh i.e. within 1 hr of collection.

2) To detect bacteriological pathogens like Vibrio, Salmonella and Shigella.

• Collect stool samples before the patient receives an antibiotic.
• Use clean cotton sterile tipped swab and introduce well into rectum. When this is done the swab becomes faecally stained and moist.
• Alternately collect freshly passed liquid stools in a bottle or a cotton tipped swab.
• Send the sample to the laboratory in a tightly sealed screw capped sterile bottle. In case of samples of suspected Bacillary dysentery the fresh stool sample is preferred but if it is impossible send the sample in Cary Blair transport medium having pH 7.2 to 7.4.
• If it will take more than 2 hrs to reach laboratory send the sample in a Cary Blair transport medium.
• For suspected Salmonella spp collect the sample in Cary Blair transport medium having pH 7.2 to 7.4.

Storage
Store the samples at 04 degrees C. Each sample should be properly & appropriately labeled. Detail information should be sent for each sample as below:

1. Name of Patient.
2. Name of Mother and Father.
3. Address of Patient.
4. Sex.
5. Date of Onset of Symptoms.
6. Provisional Diagnosis.
7. Clinical Outcome.
8. Antibiotic received prior to collection of sample – Yes / No / Not known.

Transportation
Transport the specimens preferably in cold chain. If not possible send them at ambient temperature at earliest.

Concerned Laboratories
Samples should be sent to or to The District Public Health Laboratory at an earliest.
(Annexure I).

Collection of Blood Sample for detection of pathogens causing Enteric fever

• For detection of Salmonella typhi, Salmonella Para–typhi A and B collect blood sample in 5% bile broth medium. (Bile broth will be made available at District Public Health Laboratory).
• Collect blood sample in the first week of illness.
• Collect sample before antibiotics are administered to the patient.
• If bile broth is unavailable, collect blood sample in sterile plain bulb and send to District Public Health Laboratory at an earliest.

Collection of food Sample for Food poisoning outbreaks
Food borne diseases include food poisoning due to toxins produced by microorganisms (e.g. Staphylococcus aureus). In fact, all the waterborne infections (Viral, bacteriological and parasitic) can be transmitted through contamination of food. Food borne outbreaks are very common in our country.

• Collect sample in a clean, dry, sterile, leak proof container such as glass or plastic jar. If unavailable collect in a disposable new unused plastic bag. Do not add any preservative.
• Collect minimum 250 gms/ml of sample depending upon whether it is solid or liquid.
• If product is in big container representative sample should be collected in sterile container under aseptic conditions.
• Sample should be labeled immediately after collection.
• Collect patient’s stool/vomit sample and water sample, which is used for drinking and food preparation purpose. simultaneously, label properly and sent along with food sample.
• Samples should be sent immediately along with as per standard proforma.
• Samples should accompany relevant information as per Annexure B.
• Samples should be sent in a cold chain so as to minimize the chances of deterioration of prepared food.
• Sample should be sent to State or Regional Public Health Laboratory, which is at nearest distance. Addresses of these labs are given in Annexure I.

Collection of swabs for “Sterilization testing” of Operation theatre swabs

• Collect swabs in Robertson’s cooked meat medium.
• Collect samples from following points.
• Operation table surface.
• Instrument trolley.
• Overhead lamp.
• Boyle’s apparatus.
• Floor near table.
• Alternately walls of the theatre.

Storage
Store the collected swab at ambient temperature and not at freezing temperature.

Transportation
Transport swab to the laboratory at an earliest preferably within 24 hrs of collection.

Concerned Laboratories
Send operation theatre swabs to State Public Health Laboratory Pune–411001.