Lab Matters Fall 2019 | Page 25

FOOD SAFETY and Tampa. Next generation sequencing for bacterial organisms is performed in Jacksonville, which can create challenges with coordination. Florida has overcome this [challenge] through training and outreach. Our current protocol is for all three laboratories to receive isolates and for Miami and Tampa to confirm identifications and make DNA. The DNA is then shipped to Jacksonville for sequencing. The major limitation for Florida is funding to support sequencing of all PulseNet isolates that are received, despite the laboratory having the capability and capacity (staffing, equipment, skills) to sequence all isolates. Remaining challenges include attracting and retaining skilled staff. Florida has worked closely with academic institutions to recruit laboratory scientists.” What are some accomplishments Florida would like to highlight from the past year? Florida has successfully filled two key positions in the last few months. One is dedicated to bringing on an NGS method for genotyping and determination of drug resistance in HIV, and the other will serve as the regional bioinformatics resource lead. Both positions will assist Florida in increasing sequencing capabilities in many areas of the laboratory for diagnostics as well as surveillance. To date in 2019, Florida has sequenced 3,535 bacterial isolates. To build on this momentum, in 2020, we hope to increase this number and bring on sequencing more routinely for tuberculosis, HIV, Legionella and other outbreak or multi- drug resistant organisms. New York Department of Health- Wadsworth Center State Hygienic Laboratory at the University of Iowa William (Bill) Wolfgang, PhD, research scientist Michael A. Pentella, PhD, D(ABMM), laboratory director Deborah J. Baker, research scientist Ryan T. Jepson, M(ASCP), microbiology supervisor What are some challenges that laboratories in the northeast face with WGS implementation? All laboratories in the northeast are in various stages of implementing WGS but have encountered challenges, which are likely not unique to the region. We sent around a survey in May and gathered the following information related to these challenges: Funding: No labs received enough funding to sequence all of their isolates. A few labs think they will be able to make up the difference with other funds. As an Area Lab, we did not receive requested funds to host another small local meeting, which we found very beneficial this year. Prioritization: Almost every lab is thinking about or implementing prioritization schemes in the expectation of not being able to sequence all isolates.  Calculation engine: All labs have had various difficulties with the CDC calculation engine. Improving efficiency: Labs are looking at ways to improve efficiency as a means of stretching funding. Frustration: There is definitely some frustration with implementation among the labs.  Issues range from reorganization of workflow, database challenges and struggles to maintain turnaround time. What are some accomplishments the northeast area laboratories would like to highlight from the past year? All laboratories within the region have FastQ certified personnel and all but one are analysis certified. PublicHealthLabs @APHL APHL.org Gina Kline, clinical laboratory technical specialist What are some challenges that Iowa faces with WGS implementation? In general, the State Hygienic Laboratory (SHL) is pleased with the conversion process. The gaps and challenges that we continue to encounter involve electronic communications, especially uploading files and error messages. Troubleshooting problems is very time consuming and issues may take days to resolve. The time it takes to upload files is a significant concern; when uploads fail, it is difficult to pinpoint the source of the error. Recent one-on-one Skype meetings between SHL and PulseNet staff have been very helpful. Increased validation of the electronic communication processes before implementation would have benefitted us. What are some accomplishments Iowa would like to highlight from the past year? SHL has successfully performed WGS of all Salmonella, E. coli and Listeria in real-time since 2016. In February 2018, the Iowa Foodborne Rapid Response Team quickly identified chicken salad as the source of a multistate Salmonella Typhimurium outbreak. For the first time, SHL relied on WGS results to match the Salmonella isolated from the patient to the Salmonella recovered from the chicken salad. This outbreak proved to SHL and its public health partners that whole- genome sequencing could provide a faster turnaround time than PFGE. n Fall 2019 LAB MATTERS 23