No abstract

we report the first Belgian outbreak of CA-MRSA USA300 in this article. A strict search and destroy strategy and continued surveillance are required in the management of CA-MRSA USA300.

Total CO₂, or bicarbonate, is a parameter in clinical chemistry often applied to assess the metabolic status of a patient. This article discusses the observations and interventions during an episode of assay instability on an Abbott Architect routine chemistry analyser. The Levey-Jennings plot of QC data showed a circadian pattern, having an overestimation of total CO₂ during periods of high personnel attendance. A qualitative analysis revealed a correlation between atmospheric CO₂ in the lab environment and the acquired total CO₂ value in a quality control sample. Assessment of total CO2 is hence influenced by the equilibrium between atmospheric CO₂, dissolved CO₂ and bicarbonate. The effect is more pronounced on samples containing low concentrations of total CO₂. The bias related to environmental CO₂ is also noticeable on patient samples, patient means between periods with high and low atmospheric CO₂ levels differed by 2 mmol/L. Passive ventilation of the laboratory environment is proven insufficient during weather conditions in which the lab is not exposed to wind. Consistent reduction of atmospheric CO₂ could only be guaranteed with an active ventilation infrastructure. Systematic closure of analyser lids also reduced analyser variance. The lab environment is an important source of parameter variance. Both environmental and infrastructural aspects must be considered when assessing the potential cause of the instability.

No abstract

No abstract