scholarly journals Optimization of Turnaround Time for Group A Streptococcus PCR

2019 ◽  
Vol 57 (9) ◽  
Author(s):  
Thomas J. S. Durant ◽  
Jacob Merwede ◽  
Jesse Reynolds ◽  
David R. Peaper
Keyword(s):  
Tertiary Care ◽  
Night Shift ◽  
Diagnostic Testing ◽  
Final Analysis ◽  
Turnaround Time ◽  
Nucleic Acid Amplification ◽  
Microbiology Laboratory ◽  
Workflow Optimization ◽  
Group A

ABSTRACT The use of some nucleic acid amplification tests (NAATs) for the diagnosis of group A Streptococcus (GAS) pharyngitis allows laboratories to adopt single-tiered testing without reflex culture. However, centralization may delay the delivery of actionable information to the bedside, particularly in the outpatient setting. We describe two novel workflows at our institution and their effect on in-lab turnaround time (TAT) at a tertiary care microbiology lab. Laboratory records were extracted, and relevant data were analyzed after the implementation of qualitative in vitro diagnostic testing for GAS with the Xpert Xpress Strep A assay, performed using the GeneXpert Infinity-48s. Workflow optimization steps studied included: (i) direct specimen submission to the microbiology laboratory via the pneumatic tube system and (ii) autoverification of GAS NAAT results in the laboratory information system. Between April 2018 and October 2018, 2,595 unique specimens were tested for GAS by PCR. Of these, 2,523 were included in the final analysis. Linear regression established that the total in-lab TAT was significantly reduced by direct specimen submission to the microbiology laboratory, autoverification, and processing during the night shift. We describe two workflow optimization methods that reduced the in-lab TAT for GAS NAAT. Although microbiology labs historically use manual processes, the advent of total laboratory automation and the adoption of on-demand NAATs will allow for more streamlined processing of microbiology specimens. It may be beneficial to consider instrument interfacing and specimen processing optimization during the early phases of implementation planning for NAATs in the microbiology laboratory.

scholarly journals The Panther Fusion System with Open Access Functionality for Laboratory-Developed Tests for Influenza A Virus Subtyping

2020 ◽  
Vol 58 (6) ◽  
Author(s):  
Kathleen A. Stellrecht ◽  
Jesse L. Cimino ◽  
Vincente P. Maceira
Keyword(s):  
Open Access ◽  
Influenza A ◽  
Limit Of Detection ◽  
Turnaround Time ◽  
Nucleic Acid Amplification ◽  
Influenza B ◽  
Fusion System ◽  
Valuable Complement ◽  
Syncytial Virus

ABSTRACT Nucleic acid amplification tests, such as PCR, are the method of choice for respiratory virus testing, due to their superior diagnostic accuracy and fast turnaround time. The Panther Fusion (Fusion; Hologic) system has an array of highly sensitive in vitro diagnostic (IVD) real-time PCR assays for respiratory viruses, including an assay for influenza A (FluA) virus, influenza B (FluB) virus, and respiratory syncytial virus (RSV) (FFABR assay). The Fusion system has Open Access functionality to perform laboratory-developed tests (LDTs) alongside IVD assays. We developed two LDTs for FluA virus strain typing on the Panther Fusion instrument, enabling side-by-side testing with the FFABR assay. The LDT-FAST assay uses proprietary primers and probes designed by Hologic for the Prodesse ProFAST+ (PFAST) assay. The exWHO-FAST assay is an expanded redesign of the WHO-recommended reverse transcriptase PCRs (RT-PCRs). To evaluate the performance of these two LDTs, 110 FluA virus-positive samples were tested. Of these, 104 had been subtyped previously; 54 were H3, 46 were 09H1, and 4 were fsH1. All were appropriately subtyped by both LDTs. Of the untyped FluA virus samples, three were subtyped as H3 by both LDTs and two were subtyped as H3 by the LDT-FAST assay only. The sample not subtyped by either LDT was retested with the FFABR assay and was now negative. Limit-of-detection (LOD) analyses were performed with five FluA virus strains. The LDT-FAST LODs were similar to the FFABR assay LODs, while the exWHO-FAST LODs were higher for two H3N2 strains, findings that were explained by analysis of primer/probe homology. In conclusion, either FluA virus typing assay would be a valuable complement to the Panther Fusion respiratory menu given the performance of these LDTs, the system’s full automation, and the ability to split eluates for both IVD and LDT testing.

scholarly journals Effectiveness of CBNAAT in the diagnosis of extrapulmonary tuberculosis

2018 ◽  
Vol 6 (12) ◽  
pp. 3925
Author(s):  
Shivprasad Kasat ◽  
Mahendra Biradar ◽  
Ashish Deshmukh ◽  
Sunil Jadhav ◽  
Hafiz Deshmukh
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Gastric Lavage ◽  
Clinical Problem ◽  
Turnaround Time ◽  
Nucleic Acid Amplification ◽  
Tertiary Care Centre ◽  
Cystic Fluid ◽  
Major Health Problem ◽  
Tuberculosis Patients

Background: Tuberculosis is still a major health problem worldwide. It is estimated that about one-third of the world's population is infected with mycobacterium tuberculosis. Whilepulmonary tuberculosis is most common presentation; extrapulmonary tuberculosis is also an important clinical problem. CBNAAT is cartridge based nucleic acid amplification test with a well-established role in the diagnosis of pulmonary tuberculosis (PTB). We determined the effectiveness of CBNAAT in the diagnosis of extrapulmonary tuberculosis (EPTB) cases in comparison to AFB smear.Methods: Retrospective study of suspected extrapulmonary tuberculosis patients in a tertiary care centre of the study area was conducted. The study period was from January 2017 to July 2018. Data of 166 consecutive suspected extrapulmonary tuberculosis patients was retrieved. Effectiveness of CBNAAT in the diagnosis of EPTB was assessed as compared to that of AFB smear.Results: Samples collected from 166 suspected EPTB patients were subjected to AFB smear and CBNAAT. Samples collected included lymph node, pus, pleural fluid, tissue, CSF, gastric lavage, cystic fluid, peritoneal fluid, ascitic fluid, colonic fluid, synovial fluid, urine. In AFB smear results, 17 cases were positive for TB bacilli and 149 were negative for the same. In CBNAAT results, 25 cases were positive for TB bacilli and 141 cases were negative. In comparative analysis, 8 cases were AFB smear negative but CBNAAT positive.Conclusions: CBNAAT is a useful tool in the diagnosis of EPTB cases because of its simplicity and rapid turnaround time. CBNAAT is more effective as compared to AFB smear in the diagnosis of EPTB cases.

scholarly journals 659. Evaluation of Four Chromogenic Agars for Urine Culture Including Time and Cost Savings Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S386-S386
Author(s):  
Eve Capistran ◽  
Simon Lévesque ◽  
Philippe Martin ◽  
Diane Girard ◽  
Marie-Eve Papirakis ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Susceptibility Testing ◽  
Urine Culture ◽  
Tertiary Care ◽  
Cost Savings ◽  
Turnaround Time ◽  
Microbiology Laboratory ◽  
University Center ◽  
And Performance ◽  
Time Required

Abstract Background With a volume of approximately 5000 urine culture specimens per month in our tertiary-care university center hospital’s microbiology laboratory, we wanted to evaluate methods aiming to improve workflow and performance while reducing turnaround time and potentially overall cost. Methods 310 urine culture specimens as well as selected less frequent pathogens (A. urinae - 26 strains, C. urealyticum - 4 strains) were plated on four chromogenic agars in parallel with standard protocol MacConkey (MAC) and blood agar (BA). Chromogenic agars evaluated were: UriSelectTM 4 (Bio-Rad), CHROMID® CPS® Elite (bioMérieux), BrillanceTM UTI ClarityTM agar Biplate (Oxoid) and BDTM CHROMagarTM Orientation (BD). Primary outcome was overall growth performance for frequent pathogens and for gram positives, where chromogenic agars were previously reported to underperform.The number of additional tests needed and the appreciation of different media by laboratory personnel were also assessed. A sub-analysis measured the total time required to plate and to read 50 consecutive specimens comparatively for the 4 chromogenic agars and for MAC/BA. Results Global performance was 90% for Uriselect, 88% for ChromID, 89% for Chromagar and 81% for Brillance compared to 84% for standard method. ChromID and Brillance supported the growth of more A. urinae and C. urealyticum than the other 2 chromogenic agars. All monoplate chromogenic agars were appreciated equally by technologists. In addition, for all chromogenic agars, working time was reduced by half as compared to MAC/BA. We estimated a time economy of approximately 80 hours per month in our laboratory, translating in a net annual economy. Conclusion All 4 chromogenic medias evaluated in our study had an acceptable performance, with specific strengths and weaknesses for each one. The choice of ChromID CPS Elite (bioMérieux) for our center was based on pre-established criteria including performance for more fastidious gram positives, best time and cost economy, and compatibility with current identification method and susceptibility testing platform. However, since the 4 chromogenic agars have been adequately verified in our laboratory, we consider that they could be interchangeable if needed. Disclosures All Authors: No reported disclosures

scholarly journals The role of EML Consulting Services (QLD): a consulting food microbiology laboratory

2004 ◽  
Vol 25 (3) ◽  
pp. 41
Keyword(s):  
Food Safety ◽  
Turnaround Time ◽  
Food Microbiology ◽  
Microbiology Laboratory ◽  
Safety Testing ◽  
Consulting Services ◽  
Food Quality And Safety ◽  
Group A ◽  
The Relationship

The relationship between the consulting microbiology laboratory and the food industry remains one of the most critical linkages within the framework of food quality and safety in the commercial setting. EML Consulting Services has cultivated such linkages for over 30 years. EML Consulting Services QLD is the Brisbane Laboratory of the Australian owned EML Group, a network of consulting microbiologists, chemists and allergenists incorporating five laboratories in three States. EML offers high quality food safety testing with minimal turnaround time, and expert consultancy which can evaluate facility and production processes for areas contributing to food safety and quality issues.

Factor II Related Antigen and Antithrombin III Levels as Indicators of Liver Failure in Consumption Coagulopathy

1982 ◽  
Vol 47 (03) ◽  
pp. 218-220 ◽  
Author(s):  
P Sié ◽  
E Letrenne ◽  
C Caranobe ◽  
M Genestal ◽  
B Cathala ◽  
...  
Keyword(s):  
Liver Failure ◽  
Antithrombin Iii ◽  
Coagulation Factors ◽  
Consumption Coagulopathy ◽  
Blood Coagulation Factors ◽  
Factor Ii ◽  
At Iii ◽  
Group A ◽  
Group B

SummaryIn order to detect impaired synthesis of blood coagulation factors associated to consumption coagulopathy, a simultaneous evaluation of factor II-related antigen (II rAg) and of antithrombin III (AT III) was carried out in 16 patients affected with severe defibrination. An in vitro preliminary study on plasma and serum demonstrated that the levels of II rAg and of AT III, assessed by the Laurell technique with Behring antisera, were not reduced by the coagulation process. The patients were, a posteriori, classified into two groups according to the absence (group A) or the presence (group B) of factors predisposing to liver failure such as metastasis, cirrhosis, and prolonged shock. II rAg and AT III levels are significantly correlated; they are in the normal range in group A but reduced in group B. Thus II rAg or AT III level determinations are useful markers in the detection of liver failure associated to the consumption phenomenon. These results also suggest that part of the decreased AT III levels reported in severe cases of disseminated intravascular coagulation may be the consequence of an associated liver failure.

COMPARISON OF EFFECTIVENESS OF MOBILIZATION AND SELF-EXERCISES IN ADHESIVE CAPSULITIS OF SHOULDER

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad
Keyword(s):  
Pain Intensity ◽  
Adhesive Capsulitis ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
T Test ◽  
P Value ◽  
Group A ◽  
Group B

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.

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