1 / 1

Form M: Strain shipment data sheet (enhanced protocol)

Form M: Strain shipment data sheet (enhanced protocol). ( one for each strain ). Network- Id :. *. Hospital code :. *. Surveillance period : From ( dd /mm/ yyy ):. *. Surveillance period : To ( dd /mm/ yyy ):. *. Patient counter :. yes. yes. positive. positive. no. no.

sally
Download Presentation

Form M: Strain shipment data sheet (enhanced protocol)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Form M: Strain shipment data sheet (enhanced protocol) (oneforeachstrain) Network-Id: * Hospital code: * Surveillanceperiod: From (dd/mm/yyy): * Surveillanceperiod: To (dd/mm/yyy): * Patient counter: yes yes positive positive no no negative negative Age in years: * If < 2 yearsold, age in months: * Laboratory code: Microbiological results: * Performed by the national reference laboratory: * PCR ribotypeofC. difficileisolate: * Productionoftoxins A and/or B: * Presence ofbinarytoxin genes: * Performed by the national reference laboratory: * by: MIC determination to metronidazole: mg/l: * by: MIC determination to vancomycin: mg/l: * by: MIC determination to moxifloxacin: mg/l: Form Version 0.3

More Related