GLOBAL HEALTH
Sierra Leone’s Antimicrobial Resistance
Surveillance Strengthens with Microbiology
and Bacteriology Lab Activations
by Lucy Atieno, PhD, QMS consultant, Global Health
To support the Sierra Leone Ministry
of Health and Sanitation (MoHS) in a
bid to set up a functional microbiology
laboratory and address the priority of
antimicrobial resistance surveillance,
APHL installed a microbiology unit at two
adjacent referral hospitals in May 2017:
the Ola During Children’s Hospital (ODCH)
and Princess Christian Maternity Hospital
(PCMH). The clinical setup of these
facilities ensured that sample availability
would not pose any challenges.
Creating the Laboratories
The project began with clearing, cleaning
and redesigning the provided workspace
to make sure the minimum specifications
for a microbiology and, especially,
bacteriology laboratory were met. APHL
ensured the facility had the key supplies
and equipment to provide necessary
testing services.
A training program was created for
relevant staff that included standard
procedures for optimal lab operability.
When APHL started at this facility, there
were no ongoing culture or quality
management system (QMS) activities;
this was primarily due to lack of relevant
training and/or practical experience of
staff working in bacteriology.
The Microbiology laboratory at ODCH before workstation
set up
Table 1: Current Status of Testing at ODCH/PCMH Microbiology Laboratory (February 2018)
Examination Procedure (s) Current Status
Urinalysis and Urine Culture Urine Microscopy, Biochemistry and Culture tests available and running.
Cultures can be done for Urinary Enterobacteriaceae.
Stool Microscopy and Culture Stool Microscopy and culture tests available and running. Cultures can
be done for all Pathogenic Enterobacteriaceae, Campylobacteriacea and
Vibrionaceae
CSF Culture/Gram Stain,
Cell Counts and India Ink
Preparations Culture, Cell Counts and Gram Stain are currently available. Organisms
that can be isolated include: Group B Streptococci, E. coli and other
coliforms, Haemophilus influenzae, Neisseria meningitidis and
Streptococcus pneumoniae.
Urogenital Swab Cultures/Wet
Preparations and Gram Stain Culture, Wet preparations and Gram Stain is currently available.
Organisms that can be isolated include: Neisseria gonorrhoeae, Beta
Haemolytic Streptococcus Group and Staphylococcus aureus.
Respiratory Samples for Culture
and Gram Stain Culture and Gram Stain is currently available.
Pus Samples for Culture and
Gram Stain Culture and Gram Stain is currently available.
Accomplishments
Over a period of nearly two years, the
ODCH/PCMH microbiology laboratory has
acted as a training hub for both MoHS
staff and medical laboratory science (MLS)
students from the College of Medicine
and Allied Health Sciences (COMAHS). The
training covered theoretical seminars and
QMS activities.
LAB MATTERS Spring 2019
Bacteria that can be isolated include: Group A Streptococcus,
Pseudomonas aeruginosa, Haemophilus influenzae, Streptococcus
pneumoniae and Staphylococcus aureus.
Bacteria that can be isolated include: Staphylococcus aureus,
Serratia marcescens, Enterococcus species, Streptococcus pyogenes,
Streptococcus pneumoniae, Enterobacteriaceae and Pseudomonas
species
Effusions (Synovial Fluids, Pleural Culture, Cell Count, wet preparations and Gram Stain is currently
Fluids, Pericardial Fluids Ascitic
available.
Fluids and Hydrocele Fluids)
Bacteria that can be isolated include: Staphylococcus aureus, Serratia
marcescens, Enterococcus species, Streptococcus pyogenes and
Streptococcus pneumoniae.
Blood Culture
18
The Microbiology lab at ODCH after workstation set up.
Test currently NOT available.
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