APHL 2024 POSTER ABSTRACTS methods ( e . g ., fungal culture ), the analysis time per sample is considerably reduced .
Presenter : Chris Mazzochi , chris . mazzochi @ euroimmun . us laboratory capacity for other TB diagnostic and surveillance activities .
Presenter : Blake Bertrand , uqn7 @ cdc . gov
Optimization of Specimen Submission for Patients with Known Tuberculosis in the State of Georgia
B . Bertrand 1 , E . Nansi 2 , T . Glover 2 , R . Turner 2 , E . Reilly 2 , K . Pasley 2 , B . Yarn 2 , L . Burns 2 , T . Parrott 2 , N . Balakrishnan 2 , Centers for Disease Control and Prevention 1 , Georgia Public Health Laboratory 2
Tuberculosis ( TB ) is caused by Mycobacterium tuberculosis ( MTB ) and remains a significant public health concern in the state of Georgia . According to the Centers for Disease Control and Prevention , Georgia had the seventh highest number of new TB cases and the 11th highest TB incidence rate in the United States in 2022 . Timely submission of clinical specimens for TB testing is crucial for early diagnosis and therapeutic decisions . Testing of specimens from known MTB-positive patients with acid-fast bacilli ( AFB ) smear and culture is necessary to monitor therapeutic efficacy and are key indicators used to release patients from airborne isolation . The Georgia Public Health Laboratory ( GPHL ) Mycobacteriology Unit receives clinical specimens for AFB smear , culture , identification and first-line growth-based drug susceptibility testing from primary health care facilities and county health departments in Georgia . Per the Georgia TB Program guidelines , it talkes three consecutive positive sputum specimens to establish a likely TB diagnosis . Once diagnosed , one sputum specimen per week is collected from known TB patients until culture conversion to negative . We evaluated current specimen submission criteria for MTB culture in Georgia , seeking to improve testing efficiency and reduce burden of sputum specimen collection from patients . Additionally , we measured direct and indirect costs of testing to evaluate effective use of state and federal TB budgets . The retrospective data analysis was conducted by reviewing GPHL ’ s Laboratory Information Management System for clinical specimens submitted for MTB culture during January 1 , 2022 – September 30 , 2023 . MTB culture-positive specimens were classified as either initial diagnostic specimens or positive cultures from patients with known MTB . To distinguish reinfection from current infection , we examined the number of repeat positive cultures ≤60 days of initial diagnostic specimen . A cost analysis was performed by measuring direct labor and consumables for each classification . A total of 7,240 specimens were submitted to GPHL for MTB culture and 1,017 ( 14 %) were culture-positive . Of the culture-positive specimens , only 248 ( 24 %) were initial diagnostic specimens and 769 ( 76 %) were from patients with known MTB . The number of specimens submitted for each patient with known MTB was 4.8 positive cultures per patient and ranged as high as 17 MTB-positive cultures ≤60 days of initial diagnostic MTB culture for one patient . A total of $ 50,140 was spent on initial diagnostic specimens and $ 123,556 was spent on repeat testing . Although repeat testing of patients with known TB is a crucial for monitoring patients ’ disease state , repeat tests outside of state guidelines represent a financial burden on the Georgia TB budget . GPHL will closely work with the state TB Program to strengthen outreach to facilities that collect and submit specimens , such as developing fact sheets for initial diagnostic and known TB patient specimen submission . Optimizing repeat tests might improve budget allocation for increased
Pennsylvania Department of Health Bureau of Laboratories Implementation of Candida auris PCR using High Throughput Roche cobas ® 8800
L . Dettinger , J . Brooks , D . Glatts , D . Xia , Pennsylvania Department of Health Bureau of Laboratories ( PA DOH BOL )
Abstract Text : Candida auris , discovered in 2009 , is a multi-drugresistant yeast that easily spreads in healthcare facilities causing serious infections and death in sick and hospitalized patients . This yeast is capable of surviving on surfaces for weeks and requires special cleaning . Identification of colonized patients is necessary to implement isolation precautions and cleaning processes . Currently , there are no PCR test kits approved by the US Food and Drug Administration ( FDA ). C . auris has quickly become a significant public health concern . Public health partners and laboratorians are working together to stop the spread of C . auris in healthcare settings . To address this significant public health concern , PA DOH BOL needed to determine which laboratory-developed test would be best implemented at our laboratory facility for C . auris colonization screening . Drawing inspiration from the presentation “ Strategies for Using Your Omni Utility Channel ” presented at the APHL 2022 conference and recognizing the need to develop flexibility in equipment operation while simultaneously taking the initiative to build future preparedness , we decided to build capability and capacity for detecting C . auris using our existing polymerase chain reaction ( PCR ) equipment , cobas ® 8800 . As with any laboratorydeveloped test of interest , BOL staff had combed through available information identifying suitable primers and probes . We formulated our “ test package ” and proceeded to use the optimization parameters provided by Roche on the cobas ® omni Utility Channel cassette . BOL obtained isolates of C . auris to move forward with validation . The Candida auris CAU panel available through CDC & FDA Antibiotic Resistance Isolate Bank was procured . Additionally , clinical specimens were shared with BOL from the Wisconsin State Laboratory of Hygiene ( WSLH ). The various C . auris ( and other yeasts ) were evaluated for accuracy , precision ( reproducibility ) and analytical sensitivity ( limit of detection ). Validation proved to be successful with very good performance metrics and implementation for C . auris colonization screening was realized in November 2023 .
Presenter : Lisa Dettinger , ldettinger @ pa . gov
Performance Evaluation of the Streck ARM-D ® TEM / SHV / GES Kit
J . Ilutsik 1 , B . Yoo 2 , M . Machado 2 , M . Karlsson 3 , J . Rasheed 2 , Goldbelt C 61 , Centers for Disease Control and Prevention 2 , Goldbelt C 6 / Centers for Disease Control and Prevention 3
Background : Resistance to β-lactam antibiotics is a rising problem and the production of different β-lactamases is the main cause of β-lactam resistance , especially among Gram-negative bacteria . Currently , there is a growing demand for , but limited availability of , commercial molecular assays for the accurate detection of β-lactamase-encoding genes . The Streck ARM-D ® TEM / SHV / GES
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Fall 2024 LAB MATTERS 75 |