scholarly journals Clinical Microbiology Is Growing Up: The Total Laboratory Automation Revolution

2019 ◽  
Vol 65 (5) ◽  
pp. 634-643 ◽  
Author(s):  
Adam L Bailey ◽  
Nathan Ledeboer ◽  
Carey-Ann D Burnham
Keyword(s):  
Laboratory Testing ◽  
Clinical Microbiology ◽  
Turnaround Time ◽  
Automation System ◽  
Clinical Microbiology Laboratory ◽  
Laboratory Automation ◽  
Microbiology Laboratory ◽  
Total Laboratory Automation ◽  
The Impact ◽  
Automated Methods

Abstract BACKGROUND Historically, culture-based microbiology laboratory testing has relied on manual methods, and automated methods (such as those that have revolutionized clinical chemistry and hematology over the past several decades) were largely absent from the clinical microbiology laboratory. However, an increased demand for microbiology testing and standardization of sample-collection devices for microbiology culture, as well as a dwindling supply of microbiology technologists, has driven the adoption of automated methods for culture-based laboratory testing in clinical microbiology. CONTENT We describe systems currently enabling total laboratory automation (TLA) for culture-based microbiology testing. We describe the general components of a microbiology automation system and the various functions of these instruments. We then introduce the 2 most widely used systems currently on the market: Becton Dickinson's Kiestra TLA and Copan's WASPLab. We discuss the impact of TLA on metrics such as turnaround time and recovery of microorganisms, providing a review of the current literature and perspectives from laboratory directors, managers, and technical staff. Finally, we provide an outlook for future advances in TLA for microbiology with a focus on artificial intelligence for automated culture interpretation. SUMMARY TLA is playing an increasingly important role in clinical microbiology. Although challenges remain, TLA has great potential to affect laboratory efficiency, turnaround time, and the overall quality of culture-based microbiology testing.

scholarly journals Total Laboratory Automation and Three Shifts Reduce Turnaround Time of Cerebrospinal Fluid Culture Results in the Chinese Clinical Microbiology Laboratory

2021 ◽  
Vol 11 ◽  
Author(s):  
Weili Zhang ◽  
Siying Wu ◽  
Jin Deng ◽  
Quanfeng Liao ◽  
Ya Liu ◽  
...  
Keyword(s):  
Clinical Microbiology ◽  
Laboratory Data ◽  
Turnaround Time ◽  
Klebsiella Pneumonia ◽  
Clinical Microbiology Laboratory ◽  
Laboratory Automation ◽  
Microbiology Laboratory ◽  
Significant Difference ◽  
Total Laboratory Automation ◽  
The Difference

BackgroundTotal laboratory automation (TLA) has the potential to reduce specimen processing time, optimize workflow, and decrease turnaround time (TAT). The purpose of this research is to investigate whether the TAT of our laboratory has changed since the adoption of TLA, as well as to optimize laboratory workflow, improve laboratory testing efficiency, and provide better services of clinical diagnosis and treatment.Materials and MethodsLaboratory data was extracted from our laboratory information system in two 6-month periods: pre-TLA (July to December 2019) and post-TLA (July to December 2020), respectively.ResultsThe median TAT for positive cultures decreased significantly from pre-TLA to post-TLA (65.93 vs 63.53, P<0.001). For different types of cultures, The TAT of CSF changed the most (86.76 vs 64.30, P=0.007), followed by sputum (64.38 vs 61.41, P<0.001), urine (52.10 vs 49,57, P<0.001), blood (68.49 vs 66.60, P<0.001). For Ascites and Pleural fluid, there was no significant difference (P>0.05). Further analysis found that the incidence of broth growth only for pre-TLA was 12.4% (14/133), while for post-TLA, it was 3.4% (4/119). The difference was statistically significant (P=0.01). The common isolates from CSF samples were Cryptococcus neoformans, coagulase-negative Staphylococcus, Acinetobacter baumannii, and Klebsiella pneumonia.ConclusionUsing TLA and setting up three shifts shortened the TAT of our clinical microbiology laboratory, especially for CSF samples.

scholarly journals Decrease in Enteroviral Meningitis - An Unexpected Benefit of COVID-19 Mitigation?

2020 ◽  
Author(s):  
Kami D Kies ◽  
Amber S Thomas ◽  
Matthew J Binnicker ◽  
Kelli L Bashynski ◽  
Robin Patel
Keyword(s):  
Cerebrospinal Fluid ◽  
Laboratory Testing ◽  
Clinical Microbiology ◽  
Late Summer ◽  
Mitigation Strategies ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Testing Data ◽  
Early Fall ◽  
Enteroviral Meningitis

Abstract Enteroviral meningitis is seasonal, typically exhibiting a rise in prevalence in late summer/early fall. Based on clinical microbiology laboratory testing data of cerebrospinal fluid, the expected August/September/October peak in enteroviral meningitis did not occur in 2020, possibly related to COVID-19 mitigation strategies.

scholarly journals Pseudoepidemic of Aspergillus niger Infections Traced to Specimen Contamination in the Microbiology Laboratory

1999 ◽  
Vol 37 (5) ◽  
pp. 1612-1616 ◽  
Author(s):  
Valerie L. Laurel ◽  
Patricia A. Meier ◽  
Alicia Astorga ◽  
Donna Dolan ◽  
Royce Brockett ◽  
...  
Keyword(s):  
Aspergillus Niger ◽  
Patient Care ◽  
False Positive ◽  
Clinical Microbiology ◽  
Building Construction ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Hospital Construction ◽  
Construction Strategies ◽  
The Impact

We report a pseudo-outbreak of Aspergillus niger that followed building construction in our clinical microbiology laboratory. Because outbreaks of invasive aspergillosis have been linked to hospital construction, strategies to minimize dust in patient care areas are common practice. We illustrate that the impact of false-positive cultures on patient care should compel laboratories to prevent specimen contamination during construction.

scholarly journals Impact of Changes in Clinical Microbiology Laboratory Location and Ownership on the Practice of Infectious Diseases

2020 ◽  
Vol 58 (5) ◽  
Author(s):  
Michael Pentella ◽  
Melvin P. Weinstein ◽  
Susan E. Beekmann ◽  
Philip M. Polgreen ◽  
Richard T. Ellison
Keyword(s):  
Infectious Diseases ◽  
Clinical Microbiology ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Emerging Infections ◽  
Clinical Practices ◽  
Sentinel Network ◽  
Effective Implementation ◽  
Serious Infections ◽  
The Impact

ABSTRACT The number of onsite clinical microbiology laboratories in hospitals is decreasing, likely related to the business model for laboratory consolidation and labor shortages, and this impacts a variety of clinical practices, including that of banking isolates for clinical or epidemiologic purposes. To determine the impact of these trends, infectious disease (ID) physicians were surveyed regarding their perceptions of offsite services. Clinical microbiology practices for retention of clinical isolates for future use were also determined. Surveys were sent to members of the Infectious Diseases Society of America’s (IDSA) Emerging Infections Network (EIN). The EIN is a sentinel network of ID physicians who care for adult and/or pediatric patients in North America and who are members of IDSA. The response rate was 763 (45%) of 1,680 potential respondents. Five hundred forty (81%) respondents reported interacting with the clinical microbiology laboratory. Eighty-six percent of respondents thought an onsite laboratory very important for timely diagnostic reporting and ongoing communication with the clinical microbiologist. Thirty-five percent practiced in institutions where the core microbiology laboratory has been moved offsite, and an additional 7% (n = 38) reported that movement of core laboratory functions offsite was being considered. The respondents reported that only 24% of laboratories banked all isolates, with the majority saving isolates for less than 30 days. Based on these results, the trend toward centralized core laboratories negatively impacts the practice of ID physicians, potentially delays effective implementation of prompt and targeted care for patients with serious infections, and similarly adversely impacts infection control epidemiologic investigations.

Prospective evaluation of the VITEK MS for the routine identification of bacteria and yeast in the clinical microbiology laboratory: assessment of accuracy of identification and turnaround time

2014 ◽  
Vol 63 (2) ◽  
pp. 235-241 ◽  
Author(s):  
Angella Charnot-Katsikas ◽  
Vera Tesic ◽  
Sue Boonlayangoor ◽  
Cindy Bethel ◽  
Karen M. Frank
Keyword(s):  
Clinical Microbiology ◽  
Clinical Care ◽  
Turnaround Time ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Laboratory Assessment ◽  
16S Rrna Sequence ◽  
Routine Identification ◽  
Vitek 2 ◽  
Vitek Ms

This study assessed the accuracy of bacterial and yeast identification using the VITEK MS, and the time to reporting of isolates before and after its implementation in routine clinical practice. Three hundred and sixty-two isolates of bacteria and yeast, consisting of a variety of clinical isolates and American Type Culture Collection strains, were tested. Results were compared with reference identifications from the VITEK 2 system and with 16S rRNA sequence analysis. The VITEK MS provided an acceptable identification to species level for 283 (78 %) isolates. Considering organisms for which genus-level identification is acceptable for routine clinical care, 315 isolates (87 %) had an acceptable identification. Six isolates (2 %) were identified incorrectly, five of which were Shigella species. Finally, the time for reporting the identifications was decreased significantly after implementation of the VITEK MS for a total mean reduction in time of 10.52 h (P<0.0001). Overall, accuracy of the VITEK MS was comparable or superior to that from the VITEK 2. The findings were also comparable to other studies examining the accuracy of the VITEK MS, although differences exist, depending on the diversity of species represented as well as on the versions of the databases used. The VITEK MS can be incorporated effectively into routine use in a clinical microbiology laboratory and future expansion of the database should provide improved accuracy for the identification of micro-organisms.

scholarly journals The Role of Total Laboratory Automation in a Consolidated Laboratory Network

2000 ◽  
Vol 46 (5) ◽  
pp. 751-756 ◽  
Author(s):  
Richard S Seaberg ◽  
Robert O Stallone ◽  
Bernard E Statland
Keyword(s):  
Cost Effective ◽  
Turnaround Time ◽  
Automation System ◽  
Laboratory Automation ◽  
Labor Costs ◽  
The Core ◽  
The North ◽  
Laboratory Network ◽  
Automation Systems ◽  
Total Laboratory Automation

Abstract Background: In an effort to reduce overall laboratory costs and improve overall laboratory efficiencies at all of its network hospitals, the North Shore–Long Island Health System recently established a Consolidated Laboratory Network with a Core Laboratory at its center. Methods: We established and implemented a centralized Core Laboratory designed around the Roche/Hitachi CLAS Total Laboratory Automation system to perform the general and esoteric laboratory testing throughout the system in a timely and cost-effective fashion. All remaining STAT testing will be performed within the Rapid Response Laboratories (RRLs) at each of the system’s hospitals. Results: Results for this laboratory consolidation and implementation effort demonstrated a decrease in labor costs and improved turnaround time (TAT) at the core laboratory. Anticipated system savings are ∼$2.7 million. TATs averaged 1.3 h within the Core Laboratory and less than 30 min in the RRLs. Conclusions: When properly implemented, automation systems can reduce overall laboratory expenses, enhance patient services, and address the overall concerns facing the laboratory today: job satisfaction, decreased length of stay, and safety. The financial savings realized are primarily a result of labor reductions.

scholarly journals Competency Assessment in the Clinical Microbiology Laboratory

2004 ◽  
Vol 17 (3) ◽  
pp. 681-694 ◽  
Author(s):  
Susan E. Sharp ◽  
B. Laurel Elder
Keyword(s):  
Laboratory Testing ◽  
Clinical Microbiology ◽  
Low Complexity ◽  
Competency Assessment ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Know How ◽  
Technical Procedure ◽  
Areas Of Concern ◽  
To Receive

SUMMARY The laboratory comprises an invaluable part of the total health care provided to patients. Competency assessment is one method by which we can verify that our employees are competent to perform laboratory testing and report accurate and timely results. To derive the greatest benefit from the inclusion of competency assessment in the laboratory, we must be sure that we are addressing areas where our efforts can be best utilized to optimize patient care. To be competent, an employee must know how to perform a test, must have the ability to perform the test, must be able to perform the test properly without supervision, and know when there is a problem with the test that must be solved. In some cases, competency assessment protocols may demonstrate areas of competence but can fail to disclose incompetence. For example, challenges of low-complexity tasks (such as reading the technical procedure manual) are inferior to challenges that measure understanding and execution of a protocol, and poorly designed competency challenges will probably not detect substandard laboratory performance. Thus, if we are to receive the greatest benefit from our competency assessment programs, which may be time-consuming for the supervisors and the staff as well, we must not only meet the letter of the law but also find a way to make these assessments meaningful, instructive, and able to detect areas of concern. As we address competency assessment in our laboratories, we must understand that when done properly, competency assessment will reward our organizations and assist us in providing the best possible care to our patients.

scholarly journals Practical Guidance for Clinical Microbiology Laboratories: A Comprehensive Update on the Problem of Blood Culture Contamination and a Discussion of Methods for Addressing the Problem

2019 ◽  
Vol 33 (1) ◽  
Author(s):  
Gary V. Doern ◽  
Karen C. Carroll ◽  
Daniel J. Diekema ◽  
Kevin W. Garey ◽  
Mark E. Rupp ◽  
...  
Keyword(s):  
Blood Culture ◽  
Clinical Microbiology ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Practical Guidance ◽  
The Impact ◽  
Comprehensive Discussion

In this review, we present a comprehensive discussion of matters related to the problem of blood culture contamination. Issues addressed include the scope and magnitude of the problem, the bacteria most often recognized as contaminants, the impact of blood culture contamination on clinical microbiology laboratory function, the economic and clinical ramifications of contamination, and, perhaps most importantly, a systematic discussion of solutions to the problem.

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