scholarly journals Retrospective analysis on confirmation rates for referred positive rotavirus samples in England, 2016 to 2017: implications for diagnosis and surveillance

2020 ◽  
Vol 25 (43) ◽  
Author(s):  
Cristina C Celma ◽  
Stuart Beard ◽  
Amy Douglas ◽  
Shan Wong ◽  
Nana-Kwame Osafo ◽  
...  
Keyword(s):  
Immunisation Programme ◽  
Information Management System ◽  
Screening Tests ◽  
Detection Methods ◽  
Confirmatory Test ◽  
Reference Laboratory ◽  
National Reference Laboratory ◽  
National Surveillance ◽  
National Reference ◽  
Pcr Test

Background Rapid diagnostic tests are commonly used by hospital laboratories in England to detect rotavirus (RV), and results are used to inform clinical management and support national surveillance of the infant rotavirus immunisation programme since 2013. In 2017, the Public Health England (PHE) national reference laboratory for enteric viruses observed that the presence of RV could not be confirmed by PCR in a proportion of RV-positive samples referred for confirmatory detection. Aim We aimed to compare the positivity rate of detection methods used by hospital laboratories with the PHE confirmatory test rate. Methods Rotavirus specimens testing positive at local hospital laboratories were re-tested at the PHE national reference laboratory using a PCR test. Confirmatory results were compared to original results from the PHE laboratory information management system. Results Hospital laboratories screened 70.1% (2,608/3,721) of RV samples using immunochromatographic assay (IC) or rapid tests, 15.5% (578/3,721) using enzyme immunoassays (EIA) and 14.4% (535/3,721) using PCR. Overall, 1,011/3,721 (27.2%) locally RV-positive samples referred to PHE in 2016 and 2017 failed RV detection using the PHE reference laboratory PCR test. Confirmation rates were 66.9% (1,746/2,608) for the IC tests, 87.4% (505/578) for the EIA and 86.4% (465/535) for the PCR assays. Seasonal confirmation rate discrepancies were also evident for IC tests. Conclusions This report highlights high false positive rates with the most commonly used RV screening tests and emphasises the importance of implementing verified confirmatory tests for RV detections. This has implications for clinical diagnosis and national surveillance.

Implementation of WHO Global Antimicrobial Resistance Surveillance System in Uganda: National Surveillance Report, 2015 to 2020 (Preprint)

2021 ◽  
Author(s):  
Susan Nabadda ◽  
Francis Kakooza ◽  
Reuben Kiggundu ◽  
Richard Walwema ◽  
Joel Bazira ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Action Plan ◽  
Qualitative Description ◽  
Reference Laboratory ◽  
National Reference Laboratory ◽  
National Surveillance ◽  
Health Crisis ◽  
National Reference ◽  
Resource Setting ◽  
Made In

BACKGROUND Antimicrobial resistance is an emerging public health crisis in Uganda. The WHO Global Action Plan recommends that countries develop and implement National Actions Plans for AMR. We describe the establishment of the national AMR program in Uganda and present earlier sensitivity results from the program. OBJECTIVE The objective of the national surveillance programme is the systematic, continuous collection, analysis and interpretation of antimicrobial resistance data. METHODS A systematic qualitative description of the process and progress made in the establishment of the national AMR program is provided, detailing progress made since 2015 to 2020. This is followed with reporting of the findings of the isolates that are collected from the sentinel AMR surveillance sites. The identification and AST of bacterial isolates presented was done using standard methods at both the sentinel sites and the national reference laboratory. RESULTS Progress has been made in establishment of the national AMR program and implementation of the GLASS protocol is ongoing. A national coordinating centre and focal person have been established, a national reference laboratory has been designated, WHO net set up, sentinel AMR surveillance sites have been established with both data and laboratory quality assurance incorporated. Uganda has progressively submitted data to the GLASS reporting system. 19,216 isolates from WHO GLASS priority specimens were collected of which 22.95% (n=4,411) were community acquired infections (CAIs), 9.5% (n=1,818) had hospital acquired infections (HAIs) with 68.57% (n=12,987) being of unknown origin. The highest proportion of the specimens was blood (n=12,398, 64.5%) followed by urine (n=5,278, 27.5%), and then by stool (n=1,266, 6.6%), while, the least proportion were uro-genital swabs (n=274, 1.4%). The mean age was 19.1 (SD=19.8) years while the median was 13 (IQR: 28). Approximately 49.1% of the participants were female and 50.5% were male. Participants with CAIs were older than those with HAIs i.e. Mean: 28.0 (SD=18.6), Median: 26, IQR: 20.5 vs. Mean: 17.3 (SD=20.9) Median 8 IQR: 26. All gram-negative (E. coli, K. pneumoniae, N. gonorhoeae) and gram-positive (S. aureus, Enterococcus sp.) bacteria with AST done showed resistance to each of the tested antibiotics. CONCLUSIONS We demonstrate that systematic capacity building for implementation of the WHO GLASS protocol is feasible in a low resource setting. CLINICALTRIAL NA

scholarly journals Laboratory capacity of Greek hospitals for diagnosis of salmonellosis and surveillance systems’ performance in the years of economic crisis, 2010–2016

2018 ◽  
Vol 147 ◽  
Author(s):  
K. Mellou ◽  
E. Saranti-Papasaranti ◽  
G. Mandilara ◽  
T. Georgakopoulou
Keyword(s):  
Public Hospitals ◽  
Geographical Region ◽  
Reference Laboratory ◽  
Laboratory System ◽  
Surveillance Systems ◽  
National Reference Laboratory ◽  
Notification System ◽  
National Reference ◽  
Laboratory Capacity ◽  
Mandatory Notification

AbstractAusterity might have affected the capacity of public hospitals in Greece to diagnose salmonellosis (laboratory capacity) over the period 2010–2016, as well as the performance of the existing surveillance systems. The scope of this paper is to present data on laboratory capacity over these years, as well as the results of a two-source capture-recapture study (data from Mandatory Notification System and National Reference Laboratory System for Salmonella). The main findings were that: (a) laboratory capacity was high and steady besides the financial crisis, (b) the estimated number of laboratory-confirmed cases (n = 6017, 95% CI 5892–6142) resulted in an incidence rate (7.9 cases/100 000 population) almost twice than that reported by the two systems Mandatory Notification System (MNS); 4.1 and National Reference Laboratory System (NRLS); 4.5 cases/100 000 population, (c) underreporting was high for both systems (MNS; 47.5% and NRLS; 42.8%) and (d) differences by geographical region, size and type of hospital were identified. We suggest that (a) specific interventions are needed to increase completeness of the systems by type of hospital and geographical region, (b) record linkage can help in estimating the disease burden in a more valid way than each system separately and (c) a common electronic database in order to feed one system to the other could significantly increase completeness of both systems.

scholarly journals Evaluation of optimal urine screening and confirmation cut-off values for opiates, at a national reference laboratory

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Çiğdem Karakükcü ◽  
Mehmet Zahid Çıracı ◽  
Derya Kocer ◽  
Mine Yüce Faydalı ◽  
Muhittin Abdulkadir Serdar
Keyword(s):  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
Urine Samples ◽  
Reference Laboratory ◽  
National Reference Laboratory ◽  
Urine Screening ◽  
National Reference ◽  
Positive Rate ◽  
Sensitivity Specificity

Abstract Objectives To obtain optimal immunoassay screening and LC-MS/MS confirmation cut-offs for opiate group tests to reduce false positive (FP) and false negative (FN) rates. Methods A total of 126 urine samples, −50 opiate screening negative, 76 positive according to the threshold of 300 ng/mL by CEDIA method – were confirmed by a full-validated in-house LC-MS/MS method. Sensitivity, specificity, FP, and FN rates were determined at cut-off concentrations of both 300 and 2,000 ng/mL for morphine and codeine, and 10 ng/mL for heroin metabolite 6-mono-acetyl-morphine (6-MAM). Results All CEDIA opiate negative urine samples were negative for morphine, codeine and 6-MAM. Although sensitivity was 100% for each cut-off; specificity was 54.9% at CEDIA cut-off 300 ng/mL vs. LC-MS/MS cut-off 300 ng/mL and, 75% at CEDIA cut-off 2,000 ng/mL vs. LC-MS/MS cut-off 2,000 ng/mL. False positive rate was highest (45.1%) at CEDIA cut-off 300 ng/mL. At CEDIA cut-off 2,000 ng/mL vs. LC-MS/MS cut-off 300 ng/mL, specificity increased to 82.4% and FP rate decreased to 17.6%. All 6-MAM positive samples had CEDIA concentration ≥2,000 ng/mL. Conclusions 2,000 ng/mL for screening and 300 ng/mL for confirmation cut-offs are the most efficient thresholds for the lowest rate of FP opiate results.

scholarly journals Spectral Karyotyping for identification of constitutional chromosomal abnormalities at a national reference laboratory

2012 ◽  
Vol 5 (1) ◽  
pp. 3 ◽  
Author(s):  
Arturo Anguiano ◽  
Boris T Wang ◽  
Shirong R Wang ◽  
Fatih Z Boyar ◽  
Loretta W Mahon ◽  
...  
Keyword(s):  
Chromosomal Abnormalities ◽  
Reference Laboratory ◽  
National Reference Laboratory ◽  
Spectral Karyotyping ◽  
National Reference

Hemoglobin Phenotypes in Nigeria: Data From a National Reference Laboratory

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S115-S116 ◽  
Author(s):  
Ademola Adewoyin ◽  
Olusogo Busari ◽  
Oladapo Aworanti
Keyword(s):  
High Performance ◽  
Health Planning ◽  
Laboratory Data ◽  
Global Scale ◽  
Suboptimal Control ◽  
Reference Laboratory ◽  
National Reference Laboratory ◽  
Cellulose Acetate Electrophoresis ◽  
National Reference ◽  
Hemoglobin Variants

Abstract On a global scale, 5% to 7% of the population carries an abnormal hemoglobin. With a sickle hemoglobin (HbS) carrier prevalence of 25% to 40%, Nigeria bears the greatest burden of sickle cell disorder worldwide. Until recent times, detection of other clinically significant hemoglobin variants associated with HbS has been unavailable, resulting in missed/wrong diagnosis, weak national data, and suboptimal control of hemoglobin disorders. This study aimed to review hemoglobin assays over a 2-year period at a national reference laboratory in Nigeria, in order to describe the prevalent hemoglobin phenotypes for health planning. The study was a retrospective, laboratory data-based survey. Sociodemographics and hemoglobin assay results of 6,851 specimens between January 2016 and December 2017 were analyzed. Study protocol was approved by the Institutional Review Board. Participants aged less than 1 year and who had recent transfusions and a history of hydroxyurea therapy were excluded. At the hemoglobin laboratory, specimens were analyzed using cation exchange high-performance liquid chromatography (CE-HPLC) (Bio Rad D10, California). When indicated, further analysis of suspected abnormal hemoglobins was confirmed using a second method, capillary electrophoresis (SEBIA Capiflex II, France). The distribution of the identified hemoglobin phenotypes was determined as a proportion of the total number of participants. The mean (SD) age of the participants was 31.8 (14.9) years. The most frequent hemoglobin phenotypes were AA (59.4%), AS (23.3%), and SS (13.3%). Hemoglobin phenotypes AC (2.1%), SC (0.9%), AGPhiladelphia (0.2%), and CC (0.2%) were less frequent. Least occurring phenotypes were ADIbadan, AE, AGPhiladelphia, AOArab, DD, and hereditary persistence of fetal hemoglobin (HPFH). In the Nigerian context, accurate diagnosis of hemoglobin variants using quantitative, high-resolution hemoglobin assays, compared to zone (cellulose acetate) electrophoresis at alkaline pH will provide data for health planning, better access to genetic counseling, informed reproductive health choices, and secondary prevention of hemoglobinopathies.

scholarly journals Laboratory Blood-Based Testing for Non-Lyme Disease Tick-Borne Infections at a National Reference Laboratory

2019 ◽  
Vol 153 (1) ◽  
pp. 139-145 ◽  
Author(s):  
Elizabeth Lee-Lewandrowski ◽  
Zhen Chen ◽  
John Branda ◽  
Jason Baron ◽  
Harvey W Kaufman
Keyword(s):  
Lyme Disease ◽  
State Level ◽  
Reference Laboratory ◽  
National Reference Laboratory ◽  
Geographic Concentration ◽  
National Reference ◽  
Public Health Reporting ◽  
The Us ◽  
Control And Prevention ◽  
Tick Borne Disease

Abstract Objectives We evaluated trends in non-Lyme disease tick-borne disease (NLTBI) testing at a national reference laboratory. Methods Testing data performed at Quest Diagnostics during 2010 to 2016 were analyzed nationally and at the state level. Results Testing and positivity for most NLTBIs increased dramatically from 2010 through 2016 based on testing from a large reference laboratory. The number of positive cases, though not as stringent as criteria for public health reporting, generally exceeds that reported by the Centers for Disease Control and Prevention. The frequency of NLTBI in the US is seasonal but testing activity and positive test results are observed throughout all months of the year. Positive results for NLTBI testing mostly originated from a limited number of states, indicating the geographic concentration and distribution of NLTBIs reported in this study. Conclusions This report provides an important complementary source of data to best understand trends in and spread of NLTBI.

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