LAUSR

Introduction and Objective: Tuberculosis is a global disease and detection of acid fast bacilli in sputum smears remains the most widely used rapid diagnostic test.NICE guideline recommended collection of multiple respiratory samples(3 deep cough sputa)for laboratory diagnosis of respiratory TB. We explored compliance against the guideline locally regarding submission of specimen for diagnosis. Method: A retrospective review of all sputum specimens for culture received by microbiology laboratory over 6 months(1/4/2016 to 30/09/2016) was done and broncho-alveolar lavage samples submitted in the same period were excluded as single BAL will suffice as per the guidance. Results: Receiving samples(n=526) from 245patients, overall compliance with guideline is only 43% with further 10% submitting 2 specimens. Each area of high demand, respiratory department and GP, achieved only 58.4% and 38.6% and the worst outcome is revealed in acute clinical care and non-respiratory specialities. Percentage of positive results increased from 0.88%(1 out of 113)with one sample to 6.6%(7 out of 106)in three samples. Compliance with guideline for sample request by departments Conclusion: The project addressed the requirement to submit optimal number of sample request for good quality of diagnosis and it has led hospital IT system to automatically include 3 sputum sample requests for investigation of respiratory TB including access from GP.