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1 Central Laboratory and Bacteriology Laboratory 1. Pus, CSF, Sputum, Body fluids, Tissue Gram s stain 2. Pus, CSF, Sputum, Body fluids, Tissue 3. Pus, CSF, Sputum, Blood, Body fluids, Tissue, Urine, Feces, Organ swab/wash Modified acid-fast stain Aerobic bacteria: 1. Gram-positive cocci 2. Gram-positive bacilli: non spore forming 3. Gram-positive bacilli: spore forming 4. Gram-negative cocci 5. Fermentative gram negative bacilli 6. Fastidious gram negative bacilli 7. Non-fermentative gram negative bacilli - Microscopic Examination - Gram s Staining (Staining with Crystal Violet, Gram Iodine and Safranin) - Microscopic Examination - Modified Acid-Fast Staining (Modified Kinyoun s Technique) 1. Microscopic Examination - Gram s Staining (Staining with Crystal Violet, Gram Iodine and Safranin) - Modified Acid- Fast Staining (Modified Kinyoun s Technique) Except Urine and Feces 2. Culture 3. Identification - Biochemical Tests - API Analyzer - Vitek 2 Analyzer - Molecular Technique (PCR, Sequencing, Hybridization) 4. Antimicrobial Susceptibility Test - Disk Diffusion Bureau of Laboratory Quality Standards Page 1 of 21
2 4. Pus, Body fluids, Blood, Tissue, Feces (Clostridium difficile) 5. Pus, Body fluids, Blood, Tissue, Feces Anaerobic bacteria: 1. Gram-positive cocci 2. Gram-positive bacilli: non spore forming 3. Gram-positive bacilli: spore forming 4. Gram-negative bacilli: spore forming 5. Clostridium difficile Microaerophilic bacteria: Gram-negative curved bacilli (seagull-wing) 6. CSF Haemophilus influenzae type b antigen - E-Test Reagent Kit - Vitek 2 Analyzer 1. Microscopic Examination - Gram s staining and spore staining 2. Culture 3. Identification - Biochemical tests - Vitek 2 Analyzer - Molecular technique (PCR, Sequencing, Hybridization) 1. Microscopic Examination - Gram s staining (Staining with Crystal Violet, Gram Iodine and Safranin) 2. Culture 3. Identification - Biochemical tests - Vitek 2 Analyzer - Molecular technique (PCR, Sequencing, Hybridization) Antigen detection: Latex agglutination test (Pastorex meningitis) Bureau of Laboratory Quality Standards Page 2 of 21
3 7. CSF Neisseria meningitidis antigen 8. CSF Streptococcus agalactiae antigen 9. CSF Streptococcus pneumoniae antigen Antigen detection: Latex agglutination test (Pastorex meningitis) Antigen detection: Latex agglutination test (Pastorex meningitis) Antigen detection: Latex agglutination test (Pastorex meningitis) 10. CSF Escherichia coli antigen Antigen detection: Latex agglutination test (Pastorex meningitis) 11. Feces Clostridium difficile toxins gene Toxin gene detection: Real-time PCR Mycobacteriology and Mycology Laboratory 12. Pus, CSF, Sputum, Body fluids, Tissue, Skin scraping, Hair, Nail 13. Pus, CSF, Sputum, Body fluids, Feces, Tissue, Urine Fungal Microscopic Detection Mycobacterial Microscopic Detection: (Acid-fast stain) Microscopic Examination: - KOH preparation - Gram s staining - India ink preparation Microscopic Examination: - Acid-fast staining: - Kinyoun s technique - Fluorescent technique Bureau of Laboratory Quality Standards Page 3 of 21
4 14. Pus, CSF, Sputum, Body fluids, Blood, Urine, Feces, Tissue, Organ swab/wash 15. Pus, CSF, Sputum, Body fluids, Blood, Urine, Feces, Tissue, Organ swab/wash Mycobacterial Direct DNA Detection Mycobacterial Detection (Microscopic Examination, Culture, Identification and Antimicrobial Susceptibility Testing) Direct DNA detection: - Real-time PCR - Reverse hybridization assay 1.Microscopic Examination : - Acid-fast staining - Kinyoun s technique - Fluorescent technique 2. Culture - (MGIT ) system Analyzer for non hemoculture - Solid media culture (LJ/Agar) - (BACTEC FX ) system Analyzer for hemoculture 3. Identification -Real-time PCR -Reverse hybridization assay 4. Antimicrobial susceptibility test Proportion method using - (MGIT ) system Analyzer - Conventional methods on Solid / liquid medium - Broth microdilution Bureau of Laboratory Quality Standards Page 4 of 21
5 16. Pus, CSF, Sputum, Body fluids, Blood, Urine, Feces, Tissue, Organ swab/wash, Skin scraping, Hair, Nail 16.(ต อ) Pus, CSF, Sputum, Body fluids, Blood, Urine, Feces, Tissue, Organ swab/wash, Skin scraping, Hair, Nail Fungal Culture and Identification Yeast: Candida spp. Yeast: Cryptococcus spp. Mold: -non-septate hyaline mold: Rhizopus spp., Mucor spp., Absidia spp., Cunninghammella spp., Syncephalastrum spp., Basidiobolous spp., Conidiobolus spp. and Others -Septate hyaline mold: 1. Culture - Conventional method - (BACTEC FX ) system Analyzer for hemoculture - Biochemical test (Chomogenic candida agar, RapID yeast plus system) 3. Identification - Biochemical test, agar (Caffeic acid agar, Urea agar, RapID yeast plus system, CGB agar) - Identification Colony morphology, - Microscopic Examination - Identification Bureau of Laboratory Quality Standards Page 5 of 21
6 Aspergillus flavus, Aspergillus niger, Aspergillus fumigatus, Acremonium spp., Fusarium spp., Penicillium spp., Paecilomyces spp., Scopulariopsis spp. and Others -Dermatophytes mold: Epidermophyton floccosum, Microsporum spp., Trichophyton spp., and Others -Non-sporulate septate hyphae mold -Dematiaceous mold: Alternaria spp., Cladophialophora spp., Curvularia spp., Exophiala spp., Fonseceae spp., Phaeoannellomyces spp., Colony morphology, - Microscopic Examination - Identification Colony morphology, - Microscopic Examination - Identification Colony morphology, - Microscopic Examination Bureau of Laboratory Quality Standards Page 6 of 21
7 16.(ต อ) Pus, CSF, Sputum, Body fluids, Blood, Urine, Stool, Tissue, Organ swab/wash Phialophora spp., Scedosporium spp., and Others - Dimorphic mold: Penicillium marneffei, Histoplasma capsulatum, Sporothrix schenckii and Others Fungal Antimicrobial Susceptibility test 17. Serum, BAL Aspergillus galactomannan antigen 18. CSF, Serum Cryptococcus antigen & titer 19. Sterile Sample Fungal direct DNA detection - Identification Colony morphology, - Microscopic Examination, yeast formation Antimicrobial susceptibility test - YeastOne (broth microdilution) - E-test Antigen detection - Enzyme immunoassay (Platelia Aspergillus EIA Reagent kit) Antigen detection - Latex agglutination test (IMMY Reagent kit) Direct DNA detection - PCR (Sequencing) 20. Blood, CSF Identification DNA detection - PCR (Sequencing) Bureau of Laboratory Quality Standards Page 7 of 21
8 Molecular Microbiology Laboratory 21. Nasopharyngeal aspirate/wash/swab, Lavage, Sputum, Suction 22. Endocervical swab, Urethral swab, Urine 23. EDTA blood, plasma, serum, Urine, Vitreous fluid, CSF, Eye scrape, Tissue, Lavage Avian influenza virus RNA detection Chlamydia trachomatis DNA detection Cytomegalovirus (CMV) DNA detection 24. EDTA blood/ plasma Cytomegalovirus (CMV) viral load 25. EDTA blood, plasma, Clotted blood, serum Tissue, CSF 26. CSF, EDTA blood/ plasma, Feces, Throat swab, Sputum, Nasopharyngeal wash/aspirate Dengue virus RNA detection Direct RNA detection: (Avian Influenza virus Real time RT-PCR, Zj biotech) Direct DNA detection : (Primerdesign TM genesig) Direct DNA detection : (CMV R-gene TM ) Viral load (DNA genome quantitation): (COBAS Ampliprep/COBAS Taqman CMV test) Direct RNA detection : (Sacace TM Dengue Real-TM Genotype) Enterovirus RNA detection Direct RNA detection : (Enterovirus R-gene TM ) Bureau of Laboratory Quality Standards Page 8 of 21
9 27. CSF, EDTA blood/ plasma, Tissue, Feces, 28. EDTA blood/ plasma, Tissue, CSF, Vitreous fluid, Lavage, Body fluid Enterovirus 71 RNA detection Epstein-Barr virus (EBV) DNA detection Direct RNA detection : (Sacace TM Enterovirus 71-type Real-TM) Direct DNA detection : (EBV R-gene TM ) 29. CSF, Vesicular fluid/ scrape, Vitreous fluid, Body fluid Herpes simplex virus (HSV) DNA detection 30. EDTA blood Human immunodeficiency virus 1 (HIV-1) DNA detection 31. EDTA blood/ plasma Human immunodeficiency virus 1 (HIV-1) viral load 32. EDTA blood / plasma Human immunodeficiency virus 1 (HIV-1) drug resistant genotying Direct DNA detection : (HSV1 HSV2 VZV R-gene TM ) Direct DNA detection : (COBAS ampliprep/ COBAS Taqman Qual test) Viral load (RNA genome quantitation (COBAS Ampliprep/ COBAS Taqman HIV-1 Test) (Abbott Realtime HIV-1) Drug resistant genotype : - RT-PCR and nucleotide sequencing (ViroSeq TM HIV-1 genotyping system) Bureau of Laboratory Quality Standards Page 9 of 21
10 33. Cervical swab Human papilloma virus (HPV) DNA detection 34. Nasopharyngeal aspirate/wash/swab, sputum, suction, Throat swab, Lavage, Tissue 35. Nasopharyngeal aspirate/wash/swab, sputum, suction, Throat swab, Lavage, Tissue 36. Endocervical swab, Urethral swab, Urine 37. Vesicular fluid, Vesicular scrape, CSF, Vitreous fluid Influenza A virus RNA detection (H1, H3, influenza A 2009) Influenza B virus RNA detection Neisseria gonorrhoeae DNA detection Varicella zoster virus (VZV) DNA detection Direct DNA detection : (Anyplex TM II HPV HR detection) Direct RNA detection : (Allplex TM Respiratory panel 1) Direct RNA detection : (Allplex TM Respiratory panel 1) Direct DNA detection : (Primerdesign TM genesig) Direct DNA detection : (HSV1, HSV2, VZV, R-gene TM ) 38. Plasma, Urine, CSF JC/BK virus DNA detection Direct DNA detection : - Real-time PCR (Bosphore JC BK Reagent kit) 39. Plasma, Serum, CSF Chikungunya virus RNA detection Direct RNA detection : - Realtime PCR (Chikungunya virus Real time RT-PCR, Zj biotech) Bureau of Laboratory Quality Standards Page 10 of 21
11 40. CSF, Vesicular fluid, eye scrape, Vitreous fluid Plasma, Urine 41. Plasma Human Parvovirus B19 DNA detection 42. EDTA blood, urine, CSF, tissue biopsy Serology Laboratory 43. Clotted blood/ Serum Hepatitis B virus HBe antigen 44. Clotted blood/ Serum Hepatitis B virus HBs antigen 45. Clotted blood/ Serum Human immuno-deficiency virus 1 p24 antigen Adenovirus DNA detection Direct DNA detection : (Adenovirus R-gene ) Direct DNA detection : (Parvovirus B19 Real time PCR, Zj biotech) Zika virus RNA detection Direct RNA detection : (Zika virus Primerdesign TM genesig) Antigen detection: (Architect Analyzer) Antigen detection: (Elecsys, Architect Analyzer) Antigen detection: (Elecsys Analyzer) 46. Clotted blood/ Serum Cytomegalovirus IgG (Architect Analyzer) Bureau of Laboratory Quality Standards Page 11 of 21
12 47. Clotted blood/ Serum Cytomegalovirus IgM (Architect Analyzer) 48. Clotted blood/ Serum Dengue virus: NS1 antigen Antigen detection: Immunochromatography, (PanBio Reagent kit) 49. Clotted blood/ Serum Dengue virus antibody IgG & IgM Immunochromatography, (PanBio Reagent kit) 50. Clotted blood/ Serum Epstein-Barr virus IgM (Semi-Automation VIDAS Analyzer) 51. Clotted blood/ Serum Hepatitis A virus IgG (Architect Analyzer) 52. Clotted blood/ Serum Hepatitis A virus IgM (Architect Analyzer) 53. Clotted blood / Serum Hepatitis B virus antibody (anti-hbs) 54. Clotted blood / Serum Hepatitis B virus antibody (anti-hbc) (Elecsys Analyzer) Bureau of Laboratory Quality Standards Page 12 of 21
13 55. Clotted blood / Serum Hepatitis B virus IgM antibody (anti-hbc IgM) 56. Clotted blood / Serum Hepatitis B virus antibody (anti-hbe) 57. Clotted blood / Serum Hepatitis C virus antibody (anti-hcv) (Elecsys Analyzer) (Architect Analyzer) (Architect Analyzer) (Architect, Elecsys Analyzer) 58. Clotted blood / Serum Hepatitis D virus IgG (DIA.PRO Reagent kit) 59. Clotted blood / Serum Herpes simplex virus IgG (Euroimmun Reagent kit) 60. Clotted blood / Serum Herpes simplex virus IgM (Euroimmun Reagent kit) 61. Clotted blood / Serum Human immuno-deficiency virus 1 (anti-hiv) 62. Clotted blood / Serum Human immuno-deficiency virus 1 (anti-hiv) Immunochromatography, (rapid test)(determine ) Enzyme immunoassay: Bureau of Laboratory Quality Standards Page 13 of 21
14 63. Clotted blood / Serum Human immuno-deficiency virus 1 (anti-hiv) - (Elecsys Analyzer) - (Architect Analyzer) - Semi-Automation (VIDAS Analyzer) Western blot assay, (MP Diagnostic HIV blot 2.2 Reagent kit) 64. Clotted blood / Serum Measles virus IgG Enzyme immunoassay (SERION Reagent kit) 65. Clotted blood / Serum Measles virus IgM Enzyme immunoassay (SERION Reagent kit) 66. Clotted blood / Serum Mumps virus IgG Semi-Automation (VIDAS Analyzer) 67. Clotted blood / Serum Mumps virus IgM Enzyme immunoassay (SERION Reagent kit) 68. Clotted blood / Serum Mycoplasma pneumoniae antibody Agglutination test (Serodia Myco II A Reagent kit) Bureau of Laboratory Quality Standards Page 14 of 21
15 69. Clotted blood / Serum Rubella virus IgG (Architect Analyzer) 70. Clotted blood / Serum Rubella virus IgM (Architect analyzer) 71. Clotted blood / Serum Toxoplasma IgG (Architect analyzer) 72. Clotted blood / Serum Toxoplasma IgM (Architect analyzer) 73. Clotted blood / Serum Varicella zoster virus IgG Enzyme immunoassay Semi-Automation : (VIDAS analyzer) 74. Clotted blood / Serum Varicella zoster virus IgM Enzyme immunoassay (SERION analyzer) 75. Clotted blood / Serum Zika virus: antibody IgG Enzyme immunoassay (Euroimmun Reagent kit) 76. Clotted blood / Serum Zika virus: antibody IgM Enzyme immunoassay Bureau of Laboratory Quality Standards Page 15 of 21
16 77. Clotted blood / Serum Hepatitis E virus (HEV): anti-hev antibody IgG 78. Clotted blood / Serum Hepatitis E virus (HEV): anti-hev antibody IgM (Euroimmun Reagent kit) Enzyme immunoassay (Euroimmun Reagent kit) Enzyme immunoassay (Euroimmun Reagent kit) ห องปฏ บ ต การไวร ส (Virology Laboratory) 79. Feces Adenovirus antigen Antigen detection : Immunochromatography RIDA QUICK Rotavirus/ Adenovirus combi (N1003) 80. Nasopharyngeal/ aspirate/ wash, Bronchoalveolar lavage, Tracheal suction, Urine, Sputum suction 81. Nasopharyngeal/aspirate/ wash, Bronchoalveolar lavage, Tracheal suction, Throat swab, Eye swab, Urine, Feces 82. Throat swab, CSF, Pericardial effusion, Pleural effusion, Feces, Nasopharyngeal Adenovirus antigen Antigen detection : Adenovirus isolation Coxsackie B virus Isolation 1. Isolation Culture using A549/ HEp-2 cells 1. Isolation Culture using Vero/ HEp-2 /LLC- MK2 cells Bureau of Laboratory Quality Standards Page 16 of 21
17 aspirate/ wash 83. Eye swab, genital swab, nasopharyngeal aspirate/wash, Urine (First void) 84. Bronchoalveolar lavage, Nasopharyngeal aspirate/ wash, Urine, Tracheal suction 85. Bronchoalveolar lavage, Nasopharyngeal aspirate/ wash, Urine, Tracheal suction, Tissue, CSF Chlamydia trachomatis Isolation 1. Isolation Culture using McCoy cell Direct immunofluorescence assay (Diagnostic Hybrids) Cytomegalovirus Antigen detection : (Abcam) Cytomegalovirus 1.Isolation Culture using HEL cell 2.Identification - Direct immunofluorescence assay (Diagnostic Hybrids) - (Abcam) 86. Clotted blood / serum Epstein-Barr virus IgA Antibody detection : (Dako Reagent kit) 87. Clotted blood / serum Epstein-Barr virus IgG Antibody detection : (Dako Reagent kit) Bureau of Laboratory Quality Standards Page 17 of 21
18 88. Nasopharyngeal aspirate/wash, Throat swab, CSF, Feces, Rectal swab, Eye swab Enterovirus isolation 89. Nasopharyngeal aspirate/wash Enterovirus Antigen 90. Nasopharyngeal aspirate/wash, Throat swab, CSF, Feces, Rectal swab Enterovirus 71 Isolation 1. Isolation Culture using Vero/ HEp-2 /LLC- MK2 cells 2.Identification Antigen detection : 1. Isolation Culture using Vero/ HEp-2 /LLC- MK2 cells 91. Nasopharyngeal aspirate/wash Enterovirus 71 Antigen Antigen detection : 92. Vesicle scrape, Eye scrape, Lesion scrape, Nasopharyngeal aspirate/wash, Genitalia scrape, Skin, Bronchoalveolar lavage Herpes simplex virus Antigen Antigen detection : (Bio-rad) Bureau of Laboratory Quality Standards Page 18 of 21
19 93. Vesicle fluid/swab/scrape, Lesion swab/scrape, Organ swab, Bronchoalveolar lavage, CSF, Nasopharyngeal aspirate/wash, Tissue, Genital swab 94. Nasopharyngeal aspirate/wash, Tracheal suction, Bronchoalveolar lavage, Sputum 95. Nasopharyngeal aspirate/ wash, Nasal swab, Throat swab, Tracheal suction, Bronchoalveolar lavage 96. Nasopharyngeal aspirate/ wash, Tracheal suction, Bronchoalveolar lavage, Sputum 97. Nasopharyngeal aspirate/wash, Nasal swab, Throat swab, Tracheal suction, Bronchoalveolar lavage Herpes simplex virus Isolation Influenza A virus Antigen Influenza A virus Isolation Influenza B virus Antigen Influenza B virus Isolation 1. Isolation Culture using Vero cell (Bio-rad) Antigen detection : 1. Isolation: Culture using MDCK cells : Antigen detection: 1. Isolation Culture using MDCK cells Bureau of Laboratory Quality Standards Page 19 of 21
20 98. Nasopharyngeal aspirate/wash, Tracheal suction, Bronchoalveolar lavage, Sputum 99. Nasopharyngeal aspirate/wash, Nasal swab, Throat swab, Tracheal suction, Bronchoalveolar lavage 100. Nasopharyngeal aspirate/wash, Tracheal suction, Bronchoalveolar lavage, Sputum 101. Nasopharyngeal aspirate/wash, Nasal swab, Throat swab, Tracheal suction, Bronchoalveolar lavage Parainfluenza 1 virus Antigen Parainfluenza 1 virus Isolation Parainfluenza 2 virus Antigen Parainfluenza 2 virus Isolation 102. Nasopharyngeal aspirate/ wash, Tracheal suction, Bronchoalveolar lavage, Sputum Parainfluenza 3 virus Antigen 103. Nasopharyngeal aspirate/wash, Parainfluenza 3 virus 1. Isolation Antigen detection : 1. Isolation Culture using LLC-MK2 cells Antigen detection : 1. Isolation Culture using LLC-MK2 cells Bureau of Laboratory Quality Standards Page 20 of 21
21 Nasal swab, Throat swab, Tracheal suction, Bronchoalveolar lavage 104. Nasopharyngeal aspirate/wash, Tracheal suction, Bronchoalveolar lavage, Sputum 105. Nasopharyngeal aspirate/wash, Nasal swab, Throat swab, Tracheal suction, Bronchoalveolar lavage Isolation Respiratory syncytial virus Antigen Respiratory syncytial virus Isolation 106. Vesicle fluid/ scrape Varicella zoster virus Antigen 107. Nasal aspirate/wash/swab Nasopharyngeal aspirate/wash/swab Tracheal sputum suction/ aspirate, Throat swab Influenza virus A and B Antigen Culture using LLC-MK2 cells Antigen detection: 1. Isolation Culture using HEp-2 cell Antigen detection: Antigen detection : Immunochromatography (QuickNavi-Flu Reagent kit) Bureau of Laboratory Quality Standards Page 21 of 21
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