Bacteriology 123 2008 Surveys & Anatomic Pathology Education Programs www.cap.org Bacteriology Do you perform extensive microbiology procedures including: ■ identification of aerobes and anaerobes ■ isolation from multiple sites antimicrobial susceptibility testing ■ Gram stain ■ antigen detection Do you perform limited Microbiology procedures which may include: ■ throat, urine, blood, and GC cultures ■ antimicrobial susceptibility testing ■ Gram stain ■ antigen detection Do you perform cultures, antigen detec- tion, and Gram stains? Perform Gram stain only. Select Survey D5, Gram Stain Select Survey D6 Rapid Strep Antigen Detection or Survey D9 Rapid Strep Antigen Detection, Waived Do you perform Group A Streptococcus Antigen testing? Do you perform bacteriology antigen detection only? Do you perform Chlamydia Antigen Detection? Select Survey D Comprehensive Bacteriology Select from among Surveys: ■ D1 Throat Culture ■ D2 Urine Culture ■ D3 GC Culture ■ D4 Limited Bacteriology Survey (Throat, Urine, and GC Cultures) ■ D7 Urine and Throat Culture ■ BCS Blood Culture Consider Survey BAS for Bacterial Antigens. This Survey is not designed to meet CLIA requirements Select from: ■ HC1 Chlamydia Antigen (DFA) Detection ■ HC3 Chlamydia EIA ■ HC5 Chlamydia Antigen Detection by DNA Probe ■ HC6 Chlamydia Antigen Detection by Nucleic Acid Amplification Consider enrollment in LPX Laboratory Preparedness Exercise. This Survey is not designed to meet CLIA requirements No No No Yes Yes Yes Yes Yes Yes Yes Yes This flowchart is provided as a guide for ordering the appropriate Bacteriology Surveys for your laboratory’s testing menu. In order to meet CLIA requirements for the subspecialty of bacteriology, five specimens must be reported for each mailing. If you have any questions, please contact the CAP Customer Contact Center at 800-323-4040 option 1. Begin No Do you perform Group B Streptococcus Antigen testing? No Select Survey D8 Group B Rapid Streptococcus Antigen Detection Yes
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Do you perform Group A StreptococcusAntigen testing?
Do you perform bacteriology antigen detection only?
Do you perform Chlamydia Antigen Detection?
Select Survey DComprehensiveBacteriology
Select from among Surveys:■ D1 Throat Culture
■ D2 Urine Culture
■ D3 GC Culture
■ D4 Limited Bacteriology Survey (Throat, Urine, and GCCultures)
■ D7 Urine and Throat Culture
■ BCS Blood Culture
Consider Survey BASfor Bacterial Antigens. This Survey is not designed to meet CLIA requirements
Select from:■ HC1 Chlamydia
Antigen (DFA) Detection
■ HC3 Chlamydia EIA
■ HC5 Chlamydia Antigen Detection by DNA Probe
■ HC6 Chlamydia Antigen Detection by Nucleic Acid Amplification
Consider enrollment in LPX Laboratory Preparedness Exercise. This Survey is not designed to meet CLIA requirements
No
No No
Yes
Yes
Yes
Yes
Yes
Yes Yes
Yes
This flowchart is provided as a guide for ordering the appropriate Bacteriology Surveys for your laboratory’s testing menu. In order to meet CLIA requirements for the subspecialty of bacteriology, five specimens must be reported for each mailing. If you have any questions, please contact the CAP Customer Contact Center at 800-323-4040 option 1.
Begin
No
Do you perform Group B StreptococcusAntigen testing?
No
Select Survey D8Group B Rapid StreptococcusAntigen Detection
Yes
124 Bacteriology
College of American Pathologists
800-323-4040 Option 1 for Customer Contact Center
Handle with Care
Specimens included in the Bacteriology Surveys may contain pathogens and must be handledwith extreme care. These specimens must be dealt with and disposed of only by trained laboratory personnel.
Product InformationSurvey D is designed for laboratories performing extensive microbiology procedures (bacterial identification of aerobes and anaerobes, isolation from multiple sites, antimicrobial susceptibility testing, Gram stain, and antigendetection). Laboratories offering a more limited range of testing should consider enrolling in Bacteriology (Limited)Survey D4 or individual Surveys D1, D2, D3, D5, D6, D7, D8, and D9. Note: Concurrent enrollment in Survey Dwith Surveys D1-D9 is not recommended due to the duplication of some organisms.
Each shipment will include five specimens, in duplicate, and two specimens for antigen detection. Antigen detectionchallenges will be offered in the following shipments:
• A - Clostridium difficile toxin/antigen and Spinal Fluid Meningitis Panel• B - Clostridium difficile toxin/antigen and Group A Streptococcus• C - Group A Streptococcus and Spinal Fluid Meningitis Panel
An education activity is planned that includes reading material found in the Participant Summary/Final Critique andonline learning assessment questions. All laboratory staff can participate individually and earn free CME/CE creditwithout leaving the laboratory.
Procedure D Challenges per ShipmentAntimicrobial susceptibility testing ❚ 1-graded, 1-ungradedBacterial antigen detection ❚ 2Bacterial identification ❚ 5Gram stain ❚ 1
Bacteriology DCategory 1 CME
CE
BacteriologyAnalytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS).
Analytes BCS Challenges per ShipmentBlood culture bacterial identification ❚ 2
Product InformationSurvey BCS is designed for laboratories performing microbiology procedures for the detection and identification oforganisms in blood cultures. Each shipment will contain two challenges for inoculation of blood culture bottles.Note: Since 5 specimens must be reported for each mailing for the subspecialty of bacteriology, participation inthis Survey only will not meet CLIA regulatory requirements.
Blood Culture BCS
Procedure D1 D2 D3 D7 Challenges per ShipmentAntimicrobial susceptibility testing ❚ ❚ 1Bacterial identification ❚ ❚ ❚ ❚ 5Gram stain ❚ ❚ ❚ 1Culture source: Throat Urine Various sources Throat/urineMicrobiologic level: Presence or Pathogens Presence or Combination
absence of and/or absence of of two throatGroup A contaminants Neisseria and three
Streptococcus identified to the gonorrhoeae urine culturedetermination extent of your determination specimens
laboratory’sprotocol
Throat, Urine, GC Cultures D1, D2, D3, D7
Product InformationSurveys D1, D2, D3, and D7 are designed for the laboratory performing a limited menu of microbiology procedures.Each shipment of Surveys D1, D2, D3, and D7 will contain five specimens in duplicate. Survey D7 will contain twothroat and three urine culture specimens.
Throat culture Presence or absence of Group AStreptococcus determined
Urine culture Pathogens and/or contaminantsidentified to the extent
of your laboratory’s protocolGC culture Presence or absence of
Neisseria gonorrhoeae determined
Bacteriology (Limited) D4
Product InformationSurvey D4 is designed for the laboratory performing moderately comprehensive microbiology procedures. Each shipment of Survey D4 will contain five inoculated loop specimens, in duplicate, and one swab specimen for Group A Streptococcus antigen detection.
Procedure D5 Challenges per ShipmentGram stain ❚ 5
Product InformationSurvey D5 includes two purulent smear challenges per shipment. Each shipment will contain five air-dried, methanol-fixed, unstained glass slides.
Procedure D6 Challenges per ShipmentGroup A Streptococcus antigen detection ❚ 5
Product InformationEach shipment will contain five swab specimens.
Rapid Strep Antigen Detection D6
Analyte D8 Challenges per ShipmentGroup B Streptococcus antigen detection ❚ 5
Product InformationEach shipment will contain five swab specimens.
Group B Strep Antigen Detection D8
Analyte ST Challenges per ShipmentShiga toxin ❚ 2
Product InformationEach shipment will include two liquid simulated stool specimens for direct shiga toxin testing.
Shiga Toxin ST
Analyte MRS Challenges per ShipmentMRSA detection ❚ 2
Product InformationSurvey MRS is designed for laboratories performing screening testing for the detection of Methicillin ResistantStaphylococcus aureus from a swab.
Procedure D9 Challenges per ShipmentGroup A Streptococcus antigen detection ❚ 2
Product InformationSurvey D9 is designed for laboratories performing testing for the detection of Group A Streptococcus antigen using awaived method.
Rapid Strep A Antigen Detection, Waived D9
Challenges per ShipmentAnalyte BAS A BLegionella – bronchoalveolar lavage ❚ 1Bordetella pertussis/parapertussis – nasal wash ❚ 1 1Streptococcus pneumoniae – urine ❚ 1
Product InformationSurvey BAS shipments will include lyophilized, liquid, or simulated clinical specimens for bacterial antigen detectionby the methods commonly used for testing (eg, direct fluorescent antibody [DFA], enzyme immunoassay [EIA], latexagglutination, optical immunoassay [OIA]).
Analyte LAS Challenges per ShipmentLegionella pneumophila ❚ 2
Product InformationEach shipment will include two 0.5-mL liquid urine specimens to be used for detection of Legionella pneumophilaantigen by enzyme immunoassay (EIA) or immuno-chromatographic methods.
Analyte VS VS1 Challenges per ShipmentGardnerella vaginalis ❚ 5Candida sp. ❚ 5Trichomonas vaginalis ❚ ❚ 5
Product InformationEach shipment will include five simulated vaginal fluid specimens to be used for identification by DNA probe technology.Survey VS is intended for testing using the BD Affirm VP III antigen detection method.Survey VS1 is intended for testing using the Genzyme OSOM Trichomonas Rapid Test method.
Product Fulfillment Group VS
Vaginitis Screen Antigen Detection VS, VS1
Procedure HPS Challenges per ShipmentHelicobacter pylori antigen detection ❚ 2
Product InformationSurvey HPS is designed for laboratories performing enzyme immunoassay (EIA) testing for Helicobacter pyloriantigen in stool. Each shipment will include two 0.5-mL fecal suspensions.
Helicobacter pylori Antigen, stool HPS
Analyte/Procedure LPX Challenges per ShipmentLive organisms ❚ 5
Product InformationThe Laboratory Preparedness Exercise was developed as a collaborative effort between the College of AmericanPathologists, the Center for Disease Control and Prevention, and the Association of Public Health Laboratories. Theexercise tests the preparedness of laboratories across the United States to handle potential public health emergenciesrelated to bioterrorism agents. Laboratories will be sent live organisms that exhibit characteristics of bioterrorismagents and will be expected to respond following Laboratory Response Network protocols. All agents provided areexcluded from the CDC’s select agent list. These may include strains of Bacillus anthracis, Yersinia pestis,Francisella tularensis, and Brucella abortus that have been modified and are safe for testing in a laboratory thatcontains a certified, properly functioning Class II Biological Safety Cabinet and is capable of handling Category A andB agents.
Laboratory Preparedness Exercise LPX New
130 Mycobacteriology
College of American Pathologists
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Procedure E Challenges per ShipmentAcid-fast smear ❚ 1Antimycobacterial susceptibility testing ❚ 1Mycobacterial identification ❚ 5
Product InformationSurvey E is designed for laboratories performing comprehensive mycobacteriology procedures. Each shipment willinclude five simulated clinical isolates for mycobacterial identification (one of which is to be used for antimycobacterial susceptibility testing), plus one specimen for performing an acid-fast bacillus (AFB) smear.
Mycobacteriology E
MycobacteriologyAnalytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS).
Product InformationSurvey E1 is designed for laboratories performing concentration for acid-fast bacillus (AFB) smears and/or isolatingmycobacteria to be referred to another laboratory for identification. Each shipment will include five simulatedsputum specimens for acid-fast smears and/or for the determination of the presence or absence of AFB by culture.
Procedure F Challenges per ShipmentAntifungal susceptibility testing ❚ 1Cryptococcal antigen detection ❚ 2 per yearMold and yeast identification ❚ 5
Product InformationSurvey F is designed for laboratories performing more extensive mycology procedures, with challenges provided foryeast, dermatophytes, actinomycetes, and other molds. Laboratories offering a more limited range of testing shouldconsider Survey F1. Note: Concurrent enrollment in Survey F and Survey F1 is not recommended due to duplication of some organisms.
Each shipment will include five challenges, in duplicate, along with one antifungal susceptibility challenge. Two simulated cerebrospinal fluid (CSF) specimens will be provided per year for cryptococcal antigen detection.Challenges for cryptococcal antigen detection will be included in the A and B shipments. Note: Those laboratories performing India Ink preparations may now order the CAP’s India Ink Survey IND, found on page 132.
An education activity is planned that includes reading material found in the Participant Summary/Final Critique andonline learning assessment questions. All laboratory staff can participate individually and earn CME/CE credit withoutleaving the laboratory.
Mycology F
MycologyAnalytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS).
Procedure F1 Challenges per ShipmentAntifungal susceptibility testing ❚ 1Cryptococcal antigen detection ❚ 2 per yearYeast identification ❚ 5
Product InformationSurvey F1 is designed for laboratories performing only yeast cultures and/or cryptococcal antigen detection.
Each shipment will include five challenges, in duplicate, along with one antifungal susceptibility challenge. Two simulated cerebrospinal fluid (CSF) specimens will be provided per year for cryptococcal antigen detection.Challenges for cryptococcal antigen detection will be included in the A and B shipments. Note: Those laboratories performing India Ink preparations may now order the CAP’s India Ink Survey IND, found on page 132.
Yeast F1
Category 1 CME
CE
132 Mycology
College of American Pathologists
800-323-4040 Option 1 for Customer Contact Center
Procedure IND Challenges per ShipmentIndia Ink ❚ 2
Product InformationEach shipment will include two specimens to be used for detection of capsule production. Note: Please see MycologySurveys F and F1 described on page 131, which include challenges for cryptococcal antigen detection.
India Ink IND
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Challenges per ShipmentProcedure P P3 P4 P5Fecal suspension (wet mount) 2 5 2Fecal suspension (Giardia and/or 2 1 1 5Cryptosporidium immunoassay and modified acid fast stain)Giemsa-stained blood smear 1Preserved slide (for permanent stain) 2 3
Product InformationParasitology Survey options have been designed to allow laboratories to choose the option that most closely matchestheir test menu and ensure compliance with CLIA requirements. To meet CLIA requirements for the subspecialty ofparasitology, you must test five specimens per mailing.
Each shipment will include:❚ Survey P will include one thin and one thick film for blood or tissue parasite identification, two preserved slides,
two 0.75-mL fecal suspensions for direct wet mount examination, and two 0.75-mL fecal suspensions for Giardiaand/or Cryptosporidium immunoassay testing and modified acid fast stain.
❚ Survey P3 will include five 0.75-mL fecal suspensions for direct wet mount examination and one fecal suspension for Giardia and/or Cryptosporidium immunoassay testing and modified acid fast stain.
❚ Survey P4 will include two 0.75-mL fecal suspensions for direct wet mount examination, three preserved slides for permanent stain, and one 0.75-mL fecal suspension for Giardia and/or Cryptosporidium immunoassay testing and modified acid fast stain.
❚ Survey P5 will include five 0.75-mL fecal suspensions for Giardia and/or Cryptosporidium immunoassay and modified acid fast testing.
Note: Laboratories that perform only Giemsa-stained blood smear should enroll in Survey BP found on page 134.
Note: Modified acid fast stain results do not meet CLIA requirements for Parasite Identification.
Product Fulfillment Group P
Parasitology P, P3, P4, P5
ParasitologyAnalytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS).
Note: The proficiency materials used for Parasitology Survey contain formalin as a preservative. Check your
methodology prior to ordering this Survey.
134 Parasitology
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Procedure BP Challenges per ShipmentThick blood film, Giemsa-stained ❚ 5*Thin blood film, Giemsa-stained ❚ 5
Product InformationSurvey BP meets regulatory requirements for laboratories performing only blood parasite testing. Survey BP willconsist of five thin blood films and five corresponding thick films (*when available) per shipment. The samples willinclude a variety of blood parasites, including Plasmodium, Babesia, Trypanosoma, and a variety of filarial worms.Thick film examination is the gold standard for detection of blood parasites, and this Survey will allow participants tocompare the thick and thin film appearance of a wide variety of blood parasites.
Do you perform molecular testing Chlamydia or GC only
Do youperform nucleic acid amplification other than GC?
Do you performviral load testing only?
Do you perform any of the following Virology testing:■ Virology Culture
■ Virology Antigen Testing
■ Virology Antibody Testing
Select from the following Surveys:
■ HC5Chlamydia/GC DNA Probe or
■ HC6Chlamydia/GC Nucleic AcidAmplification
Select ID, IDVNucleic AcidAmplificationSurvey
Select from the following Surveys:■ HIV,
HV2HIV Viral Load
■ HCVN, HCV2, HBVL Hepatitis Viral Load
■ VLS, CMV, BK,and EBVViral LoadSurvey
Select
VR1
Select
VR2
Select
VR3
Select
VR4
Select
HC2
Select
HC4
For Comprehensive Virology Culture Testing
For Virology Antigen Testing byImmunofluorescence
For Comprehensive VirologyAntibody Testing
For Virology Antigen by EIA or Latex Agglutination
For Herpes Simplex Virus Antigen Detection by DFA
For Herpes Simplex Virus Culture Testing
Yes
Yes Yes Yes
This flowchart is provided as a guide for ordering the appropriate Virology and Molecular Microbiology Surveys for yourlaboratory’s testing menu. In order to meet CLIA requirements for the subspecialty of virology, you must test five specimens per mailing. If you have any questions, please contact the CAP Customer Contact Center at 800-323-4040option 1.
Product InformationSurvey VR1 may include the following viral cultures: adenoviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), cytomegalovirus (CMV), herpes simplex viruses (HSV), enteroviruses, varicella-zoster virus (VZV), and Chlamydia trachomatis. Each shipment will contain five 2.0-mL specimensfor viral isolation and identification, and one 1.0-mL specimen for Chlamydia trachomatis culture.
Product InformationSurvey VR2 is designed for participants using direct immunofluorescence (DFA) methods for viral antigen detection.Challenges are distributed in shipments as indicated above. Each shipment will contain five 5-well slides.
Virology Antigen Detection (DFA) VR2
Handle with CareSpecimens included in the Virology Surveys may contain pathogens and must be handled with extreme care. These specimens must be dealt with and disposed of only by trained laboratory personnel.
Virology Analytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS).
Analyte VR3 VR3M Challenges per ShipmentCytomegalovirus (CMV) – IgG, IgM, and total antibodies ❚ 1Epstein-Barr virus (EBV) – ❚ 1VCA: IgG, IgMEBNA: IgG, IgM, and total antibodiesEA-IgGHelicobacter pylori – IgG, IgA, and total antibodies ❚ 1Herpes simplex virus (HSV) – IgG antibody ❚ 1Mycoplasma pneumoniae – IgG, IgM, and total antibodies ❚ 1Mumps – IgG NEW ❚ 1Rubeola virus – IgG antibody ❚ 1Toxoplasma gondii – IgG, IgM, and total antibodies ❚ 1Varicella-zoster virus – IgG and total antibodies ❚ 1
Product InformationVR3 will contain eight 0.5-mL lyophilized plasma specimens. VR3M will contain one 0.5-mL lyophilized plasma specimen.
Product Fulfillment Group VR3
Virology Antibody Detection VR3, VR3M
Analyte VR4 Challenges per Shipment Adenovirus (Respiratory) antigen ❚ 5Influenza A antigen ❚ 5Influenza B antigen ❚ 5Respiratory syncytial virus (RSV) antigen ❚ 5Rotavirus antigen ❚ 5
Product InformationSurvey VR4 is designed for participants using enzyme immunoassay and/or latex agglutination methods for viral antigen detection. Challenges may be tested for any or all of the listed viruses. Each shipment will contain fivespecimens. Participants are instructed to test for all viruses tested in their laboratories.
Virology Antigen Detection VR4
138 Virology
College of American Pathologists
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Analyte TTD Challenges per ShipmentAntibody to tick-transmitted disease organisms ❚ 5
Tick-Transmitted Diseases TTD
Product InformationSurvey TTD includes educational critiques, as well as challenging sera for the detection of antibodies to Borreliaburgdorferi, Babesia microti, and Anaplasma phagocytophilum. Each shipment will include five 0.25- to 0.50-mLliquid serum specimens.
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Product InformationConcurrent enrollment in Surveys HC2 and HC4 is not recommended. (Laboratories confirming HSV cultures bydirect immunofluorescent methods should enroll in Survey HC4 only.) Survey HC5 cannot be used for nucleic acidamplification (NAA) methods; laboratories using NAA technology for C. trachomatis and N. gonorrhoeae shouldorder Survey HC6. Laboratories using nucleic acid probe (NAP) methods for C. trachomatis and N. gonorrhoeaeshould order Survey HC5.
HC1 C. trachomatis antigen detection (DFA) Five 5-well slides HC2 Herpes simplex virus antigen detection (DFA) Five 5-well slidesHC3 C. trachomatis enzyme immunoassay Five 2.0-mL liquid specimens
(EIA only)HC4 Herpes simplex virus culture Five 2.0-mL viral suspensions HC5 C. trachomatis and N. gonorrhoeae Five swab specimens*
by DNA probeHC6 C. trachomatis and N. gonorrhoeae Three swab specimens* and two simulated
by nucleic acid amplification urine specimens
HC6X C. trachomatis and N. gonorrhoeae Three swab specimens* and two
by nucleic acid amplification simulated urine specimens (each sent in duplicate) for those methods that require additional volume.
* For Surveys HC5 and HC6, each swab is used to perform both C. trachomatis and N. gonorrhoeae testing.
C. trachomatis, Herpes, N. gonorrhoeae HC1-HC6, HC6X
Note: Biohazard warning refers to Surveys HC4, HC5, and HC6
140 Molecular Microbiology
College of American Pathologists
800-323-4040 Option 1 for Customer Contact Center
Analyte/Procedure HIV HV2 Challenges per ShipmentHIV-RNA ❚ ❚ 5HIV genotyping ❚ ❚ 1
Product InformationSurvey HIV is designed for laboratories performing analysis of human immunodeficiency virus (HIV) by nucleic acidamplification and will include quantitative challenges. Survey HV2 is an available option with additional material forusers of methods requiring a testing volume greater than 0.5-mL. Surveys HIV and HV2 are also available for laboratories performing genotyping. Each shipment of Survey HIV will contain five 0.5-mL specimens. Each shipmentof Survey HV2 will contain five 2.5-mL specimens.
Product Fulfillment Group HIV
HIV Viral Load HIV, HV2
Molecular MicrobiologyAnalytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS).
Product InformationSurvey HCVN is designed for laboratories performing analysis of hepatitis virus by nucleic acid amplification and willinclude quantitative challenges. Survey HCV2 is an available option with additional material for users of methodsrequiring a testing volume greater than 0.5-mL. Surveys HCVN and HCV2 may also be used by laboratories performingqualitative analysis and genotyping.
Each shipment of Survey HCVN will contain five 0.5-mL liquid specimens. Each shipment of Survey HCV2 will containfive 1.5-mL liquid simulated plasma specimens.
Survey HBVL allows laboratories to perform quantitative testing for Hepatitis B virus by nucleic acid amplification.Each shipment of HBVL will contain one plasma specimen.
Analyte VLS Challenges per ShipmentCMV viral load ❚ 2EBV viral load ❚ 2BK viral load NEW ❚ 2
CMV and EBV Viral Load VLS
Product InformationSurvey VLS is designed for laboratories performing analysis of viral load by nucleic acid amplification and willinclude quantitative challenges. Each shipment will include six 0.5-mL EDTA plasma specimens.
Product InformationSurveys ID and IDV are intended for advanced clinical microbiology or special-function laboratories performingnucleic acid amplification techniques (ie, PCR, LCR, bDNA, NASBA). These Surveys are not intended to meet requirements for procedures regulated for proficiency testing. Each shipment will contain serum, plasma, or simulated clinical isolate specimens.
Nucleic Acid Amplification ID, IDV
Analyte HPV Challenges per ShipmentHuman papillomavirus ❚ 2
Human Papillomavirus HPV
Product InformationSurvey HPV is for laboratories performing nucleic acid amplification techniques for HPV. Each shipment will includesimulated cervical specimens contained in Digene transport media. Note: This survey is not intended to meetrequirements for procedures regulated for proficiency testing.