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

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.

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Clinical Microbiology Is Growing Up: The Total Laboratory Automation Revolution

Clinical Chemistry ◽

10.1373/clinchem.2017.274522 ◽

2019 ◽

Vol 65 (5) ◽

pp. 634-643 ◽

Cited By ~ 15

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.

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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

Journal of Medical Microbiology ◽

10.1099/jmm.0.063636-0 ◽

2014 ◽

Vol 63 (2) ◽

pp. 235-241 ◽

Cited By ~ 13

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.

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Kesesuaian Pemeriksaan jamur antara pewarnaan periodic acid schiff(PAS) dan KOH pada flour albus ibu hamil di RSUD dr Soetomo Surabaya

Journal of Health Sciences ◽

10.33086/jhs.v13i01.1342 ◽

2020 ◽

Vol 13 (01) ◽

pp. 34-38

Author(s):

Shinta Arya ◽

Arthur pohan Kawilarang

Keyword(s):

Pregnant Women ◽

Clinical Microbiology ◽

Vaginal Discharge ◽

Periodic Acid ◽

Clinical Microbiology Laboratory ◽

Microbiology Laboratory ◽

Childbearing Age ◽

Periodic Acid Schiff ◽

Significant Difference ◽

Pas Staining

Background: Candidiasis vaginalis is a form of vaginal infection by Candida spp, estimated to occur in women of childbearing age in 70-75% of the cases. Clinical history, symptoms and laboratory examinations are very important to diagnose candidiasis vaginalis. Vaginal discharge examination can be done by direct or wet, and culture examination. Microscopic examination can be used to prove the existence of yeast form of Candida. This method is simple, can be applied in clinical microbiology laboratory with limited resources and is considered effective because it is cheap and results are obtained in a short time compared to culture. Detection of fungi by Periodic Acid Schiff (PAS) staining is visually better than KOH. The aim of this study is to analyze the concordance between Periodic Acid Schiff (PAS) staining and KOH method for fungal detection in flour albus from pregnant women. Method: This research is a descriptive observational study to figure out the suitability of Periodic Acid Schiff (PAS) staining and KOH method for fungal detection in flour albus from pregnant women with cross sectional approach. Samples were collected in the form of 30 vaginal discharge specimens taken from pregnant women and sent to the Clinical Microbiology Laboratory Dr. Soetomo Surabaya. The study was conducted in July - August 2019. Result: There was a significant difference in fungal detection between Periodic Acid Schiff (PAS) staining (56.7%, 17 samples) and 20% KOH method (6 samples) out of 30 samples (p=0.017). The concordance between Periodic Acid Schiff (PAS) staining and KOH method for fungal detection in flour albus from pregnant women is low (Kappa=0.321). Conclusion: Periodic Acid Schiff (PAS) staining detects more fungi when compared to KOH, and therefore is considered as a better method. Keywords: Flour albus, pregnancy, Periodic Acid Schiff (PAS), KOH.

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Bigger and Better? Representativeness of the Influenza A Surveillance Using One Consolidated Clinical Microbiology Laboratory Data Set as Compared to the Belgian Sentinel Network of Laboratories

Frontiers in Public Health ◽

10.3389/fpubh.2019.00150 ◽

2019 ◽

Vol 7 ◽

Cited By ~ 1

Author(s):

Sigi Van den Wijngaert ◽

Nathalie Bossuyt ◽

Bridget Ferns ◽

Laurent Busson ◽

Gabriela Serrano ◽

...

Keyword(s):

Influenza A ◽

Clinical Microbiology ◽

Laboratory Data ◽

Clinical Microbiology Laboratory ◽

Microbiology Laboratory ◽

Data Set ◽

Sentinel Network

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Comparison of Three Commercial Systems for Identification of Yeasts Commonly Isolated in the Clinical Microbiology Laboratory

Journal of Clinical Microbiology ◽

10.1128/jcm.37.6.1967-1970.1999 ◽

1999 ◽

Vol 37 (6) ◽

pp. 1967-1970 ◽

Cited By ~ 26

Author(s):

Jill K. Wadlin ◽

Gayle Hanko ◽

Rebecca Stewart ◽

John Pape ◽

Irving Nachamkin

Keyword(s):

Clinical Microbiology ◽

Reference Method ◽

Clinical Microbiology Laboratory ◽

Microbiology Laboratory ◽

Diagnostic Systems ◽

Routine Identification ◽

Significant Difference ◽

Additional Testing ◽

Card System ◽

Better Than

We evaluated three commercial systems (RapID Yeast Plus System; Innovative Diagnostic Systems, Norcross, Ga.; API 20C Aux; bioMerieux-Vitek, Hazelwood, Mo.; and Vitek Yeast Biochemical Card, bioMerieux-Vitek) against an auxinographic and microscopic morphologic reference method for the ability to identify yeasts commonly isolated in our clinical microbiology laboratory. Two-hundred one yeast isolates were compared in the study. The RapID Yeast Plus System was significantly better than either API 20C Aux (193 versus 167 correct identifications; P < 0.0001) or the Vitek Yeast Biochemical Card (193 versus 173 correct identifications;P = 0.003) for obtaining correct identifications to the species level without additional testing. There was no significant difference between results obtained with API 20C Aux and the Vitek Yeast Biochemical Card system (P = 0.39). The API 20C Aux system did not correctly identify any of the Candida krusei isolates (n = 23) without supplemental testing and accounted for the major differences between the API 20C Aux and RapID Yeast Plus systems. Overall, the RapID Yeast Plus System was easy to use and is a good system for the routine identification of clinically relevant yeasts.

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

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1881 ◽

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.

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Implementation and evaluation of a novel real-time multiplex assay for SARS-CoV-2: in-field learnings from a clinical microbiology laboratory

Pathology ◽

10.1016/j.pathol.2020.08.004 ◽

2020 ◽

Vol 52 (7) ◽

pp. 754-759 ◽

Cited By ~ 2

Author(s):

Eloise Williams ◽

Katherine Bond ◽

Brian Chong ◽

Dawn Giltrap ◽

Malcolm Eaton ◽

...

Keyword(s):

Real Time ◽

Clinical Microbiology ◽

Multiplex Assay ◽

Clinical Microbiology Laboratory ◽

Microbiology Laboratory

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Impact of Clinical Practice Guidelines on the Clinical Microbiology Laboratory When Using Automated Blood Culture Systems for Bacterial Contamination Screening of Apheresis Platelet Products

Journal of Clinical Microbiology ◽

10.1128/jcm.42.12.5963-5964.2004 ◽

2004 ◽

Vol 42 (12) ◽

pp. 5963-5964

Author(s):

L. C. Stutzman ◽

N. Sullivan ◽

P. H. Gilligan

Keyword(s):

Clinical Practice ◽

Blood Culture ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Clinical Microbiology ◽

Bacterial Contamination ◽

Clinical Microbiology Laboratory ◽

Microbiology Laboratory ◽

Culture Systems

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One Small Step for the Gram Stain, One Giant Leap for Clinical Microbiology

Journal of Clinical Microbiology ◽

10.1128/jcm.00303-16 ◽

2016 ◽

Vol 54 (6) ◽

pp. 1416-1417 ◽

Cited By ~ 14

Author(s):

Richard B. Thomson

Keyword(s):

Clinical Microbiology ◽

Rapid Test ◽

Error Rates ◽

Clinical Microbiology Laboratory ◽

Microbiology Laboratory ◽

Gram Stain ◽

Small Step ◽

Link Type ◽

Giant Leap

The Gram stain is one of the most commonly performed tests in the clinical microbiology laboratory, yet it is poorly controlled and lacks standardization. It was once the best rapid test in microbiology, but it is no longer trusted by many clinicians. The publication by Samuel et al. (J. Clin. Microbiol. 54:1442–1447, 2016,http://dx.doi.org/10.1128/JCM.03066-15) is a start for those who want to evaluate and improve Gram stain performance. In an age of emerging rapid molecular results, is the Gram stain still relevant? How should clinical microbiologists respond to the call to reduce Gram stain error rates?

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