3.Results of the assessment of the laboratory system
Enkhjargal Ts ; Khadkhuu V ; Naran G ; Regzedmaa D ; Dulamjav J
Health Laboratory 2013;2(2):21-25
Rationale:
Effective healthcare starts with an accurate diagnosis, and laboratory plays an important role in this. All health laboratories, be it clinical, animal health, food safety, or environmental health laboratory, contribute to health care and public health security. Therefore, many public health programs are conducting laboratory assessments. The assessment findings can be used for identification of areas in which efforts should be directed in order to strengthen the national laboratory system and health laboratories.
Goal:
The goal of the project was to assess the national laboratory system and health laboratories of Mongolia.
Methods and materials:
Laboratory assessment tool (LAT) developed by WHO was used for the assessment of two areas: 1. strategic organization at the national level, and 2. specific technical capacities at the laboratories level. The national laboratory system was assessed using LAT System questionnaire with the participation of MOH officers, and the assessment of laboratories was conducted using LAT Facility questionnaire with the involvement of laboratories representing public and private sectors, all three levels of urban and rural health care organizations, and clinical and public health areas of laboratory services.
Results:
The strongest areas of the national laboratory system at the policy and regulatory level were “Coordination and management” and “Laboratory information system”. The weaker (below 75%) areas were “Structure and organizations”, “Regulations”, “Infrastructure” and “Human resources”. The insufficient infrastructure score was due to the lack of financing. The main problems detected in the area of Human resources were insufficient financial and organizational support of continuous education of laboratory workers, shortage of trained personnel and incomplete national registration system of laboratory professionals.
The results of the laboratory capacities showed that the assessed laboratories were strong in “Data and information management”, “Specimen collection and handling” and “Consumables and reagents”. The testing performance of most laboratories was excellent but the external quality assurance was not available in some test disciplines. The weaker areas of the laboratories were “Facilities”, “Public health functions” and “Biorisk management”. The module “Organization and management” showed lower score mainly due to insufficient budget. The same was with “Facilities”. Although the general safety management of laboratories was very good, the biosafety component was not incorporated in it.
Conclusions and recommendations:
1.A national regulatory body needs to be established for the registration of all laboratories and laboratory professional staff.
2.Each laboratory should formally designate an appropriately trained Quality manager,
3.Set-up a formal professional development/ continuous education system for laboratory professionals.
4.Develop biosafety policy and implementation plan.
5.Establish a comprehensive national laboratory information management system (LIMS).
4. Results of the assessment of the laboratory system
Enkhjargal TS ; Khadkhuu V ; Naran G ; Regzedmaa D ; Dulamjav J
Health Laboratory 2013;2(2):21-25
Rationale: Effective healthcare starts with an accurate diagnosis, and laboratory plays an important role in this. All health laboratories, be it clinical, animal health, food safety, or environmental health laboratory, contribute to health care and public health security. Therefore, many public health programs are conducting laboratory assessments. The assessment findings can be used for identification of areas in which efforts should be directed in order to strengthen the national laboratory system and health laboratories.Goal:The goal of the project was to assess the national laboratory system and health laboratories of Mongolia.Methods and materials:Laboratory assessment tool (LAT) developed by WHO was used for the assessment of two areas: 1. strategic organization at the national level, and 2. specific technical capacities at the laboratories level. The national laboratory system was assessed using LAT System questionnaire with the participation of MOH officers, and the assessment of laboratories was conducted using LAT Facility questionnaire with the involvement of laboratories representing public and private sectors, all three levels of urban and rural health care organizations, and clinical and public health areas of laboratory services. Results: The strongest areas of the national laboratory system at the policy and regulatory level were “Coordination and management” and “Laboratory information system”. The weaker (below 75%) areas were “Structure and organizations”, “Regulations”, “Infrastructure” and “Human resources”. The insufficient infrastructure score was due to the lack of financing. The main problems detected in the area of Human resources were insufficient financial and organizational support of continuous education of laboratory workers, shortage of trained personnel and incomplete national registration system of laboratory professionals.The results of the laboratory capacities showed that the assessed laboratories were strong in “Data and information management”, “Specimen collection and handling” and “Consumables and reagents”. The testing performance of most laboratories was excellent but the external quality assurance was not available in some test disciplines. The weaker areas of the laboratories were “Facilities”, “Public health functions” and “Biorisk management”. The module “Organization and management” showed lower score mainly due to insufficient budget. The same was with “Facilities”. Although the general safety management of laboratories was very good, the biosafety component was not incorporated in it.Conclusions and recommendations:1.A national regulatory body needs to be established for the registration of all laboratories and laboratory professional staff.2.Each laboratory should formally designate an appropriately trained Quality manager, 3.Set-up a formal professional development/ continuous education system for laboratory professionals. 4.Develop biosafety policy and implementation plan.5.Establish a comprehensive national laboratory information management system (LIMS).
5.Prevalence of asymptomatic bacteriuria in hospitalized patients
Tegshjargal T ; Altantsetseg T ; Regzedmaa D ; Oyunchimeg D
Health Laboratory 2021;13(1):5-11
Description:
Asymptomatic bacteriuria is defined as the presence of 1x105 or more bacteria per milliliter of urine, although there are no signs of UTI [1]. Asymptomatic bacteriuria is quite common and occurs in 1-5% of healthy women before menopause. The incidence of asymptomatic bacteriuria increases in the elderly (men and women) to 4-19%. Asymptomatic bacteriuria is observed in 0.7% -27% of patients with diabetes mellitus, in 2-10% of pregnant women and in 23-89% of patients with spinal cord injury. Asymptomatic bacteriuria is rarely observed in young men and always requires differential diagnosis with chronic bacterial prostatitis[2].
Among the elderly, those in institutionalized settings such as long-term care facilities and hospitals have a higher prevalence of asymptomatic bacteriuria than those living in the community. Therefore, interest in asymptomatic bacteriuria has shifted from the general population to these groups of individuals. The prevalence varies from 2% to 10% in pregnancy and from 15% to 50% in the elderly in long-term care facilities.[3,4]
This study was undertaken to determine the prevalence of people asymptomatic bacteriuria in among hospitalized people.
Purpose:
Investigate cases of asymptomatic bacteriuria among hospitalized individuals and determine antibiotic susceptibility by type of pathogen detected in urine.
Materials and methods:
This cross-sectional study in the “I” Hospital of UB city, Mongolia. We conducted into the study 133 patients. After obtaining informed consent, a midstream clean-catch urine sample was collected in the same 24 hour time window and was evaluated for urinalysis using a dipstick test and routine culture. A positive urine culture was defined as a single urine sample with microbal growth of >105 colony- forming units of a single organism. We use 5-10% Blood agar, UTI agar, Mackkong agar and Chroma agar for a bacterial growth. Then we did antibiotic susceptibility of the determined pathogen.
Result:
The average age of the respondents was 55.9±14.6, the youngest was 17 years old and the oldest was 91 years old (CI 95% 53.4-58.5). By age group, 4.5% (n = 6) of people aged 20-30, 21.1% (n = 28) of people aged 31-45, 37.5% (n = 50) of people aged 46-60, and people over 61 years of age 36.8% (n = 49) respectively.Of the respondents, more than 56 or 54.9% (n = 73) were elderly, of which 63.9% (n = 85) were women and 36.1% (n = 48) were men.
A total of 36 (27.1%) leukocytes were detected, and 25 (34.2%) more (P-0.05) were detected in people over 56 years of age. The protein detected in 24 (18.0%) people, all over 56 years of age and more defined in men (P-0.01).
80.5% (n = 107) of those surveyed were diagnosed with the pathogens, and 54.9% were elderly (P-0.031). 82.4% of women and 77.1% of men were diagnosed with urinary pathogens.
Streptococcus 26%, E.coli 19%, Saprophyticus 13%, Enterococcus 11% and Staphylococcus 11% were detected in the analysis, and Streptococcus and E.coli (19%) accounted for a slightly higher rate of infection.
A total of 13 types of pathogens were identified, of which 53.4% were susceptible, 21.7% were moderately sensitive, and 24.9% were non-susceptible.
Discussion:
According to a study conducted by researchers at the University of Taiwan, the prevalence of asymptomatic UTI-s in the general population is 57.8%. E.Coli was also the most common bacterium in the urine [6].
In our study, there are many cases of E. coli.
Study in the United States found that the prevalence of asymptomatic bacteriuria among inpatients was 8.5%, all of them women. The most common pathogens in this study are Enterococcus bacteria. This study found that 1 in 10 people admitted to the hospital may have asymptomatic bacteriuria. [1]
Conclusion
1. Asymptomatic bacteriuria in 80.5% of those surveyed 54.9% were detected in people over 56 years of age.
2. Antibiotic susceptibility of the tested pathogens was determined as 53.4% sensitive, 21.7% moderately sensitive and 24.9% insensitive.