Choosing Wisely Microbiology during COVID-19

There has been a significant surge in requests for COVID-19 testing over the past week. This has likely been triggered by the recent cases diagnosed in incoming travellers, and the re-establishment of rhinovirus circulation post-lockdown.

As normal work volumes have recently returned to normal, this has put a lot of pressure on our scientific staff. To this end we request that requestors make every effort to apply “choosing wisely” principles before ordering microbiology tests.

The following are a few examples where “choosing wisely” can be applied to general microbiology:

  • Urines should not be sent to the laboratory in cases of uncomplicated cystitis.

  • Superficial wound swabs from the peri-anal area and from chronic ulcers are often colonised with enteric flora and these results rarely change patient management.

  • There are only a limited range of indications for sputum samples from the community setting. Please refer to the clinical details guides for details.

  • Stool samples should be restricted to where the patient is systemically unwell or where there is a public health issue. (Note that stool samples are processed on the same platform as COVID-19 samples which can lead to a testing bottleneck.)

On a similar note, we also ask that requestors remind patients not to contact the laboratory for their COVID-19 results. Please note: all COVID-19 results will be reported to the requesting clinician as soon as they are available. For confidentiality reasons, the laboratory cannot give results directly to patients, with these calls also interrupting / slowing workflow within the laboratory.

Many thanks for providing good clinical details on all microbiology request forms - it is much appreciated. We now receive these in the vast majority of patients and it leads to improved quality of processing and reporting.