Lab Matters Summer 2018 | Page 75

APHL 2018 Annual Meeting Poster Abstracts

surrounding states, to better understand RABV circulation and emergence of new RABV variants. Understanding how these events occur can lead to better rabies control and prevention of human exposure.

Presenter: Adam Aragon, Scientific Laboratory Division, New Mexico Department of Health, Albuquerque, NM, Phone: 505.383.9124, Email: adam. aragon @ state. nm. us

Using Process Mapping to Actively Improve Laboratory Processing in TB Contact Investigations

M. Davis and R. Dixon, South Carolina Public Health Laboratory, Columbia, SC

The South Carolina Public Health Laboratory( PHL) validated and implemented the quanitFERON-TB Gold( QFT) test to be utilized in TB contact investigations in place of the TB skin test in July of 2015. The QFT test offers advantages over the TB skin test including removing the need for a return visit to have the test results read, reducing the patient contact time and removes the risk of losing a patient to follow-up for the reading of the TB skin test. The performance of QFT test requires three tubes of blood to be drawn in specialized tubes with strict requirements for sample volume. The three tubes need to be grouped and sample volumes checked before testing can be performed. Patient identifiers need to be placed correctly on the tubes to not block the fill line. In a large contact investigation this can be time consuming and the need to recollect due to incorrect sample volume can potentially lead to delayed results. In the spring of 2017 a large school contact investigation was being planned and the PHL wanted to ensure rapid sample turnaround time. To do this the PHL process mapped the steps involved in the testing of a large amount of samples in order to identify steps in the process that could lead to more streamlined testing. The PHL identified three areas that if improved would save time and allow for streamlined processing of samples. They were: ensuring samples arrived at the laboratory drawn correctly, sample labeling and matching of the three tubes for each patient. In order to manage all three of these processes the PHL sent a laboratory technologist into the field to monitor collection volumes, organize samples and perform sample accessioning as samples were drawn. This poster will highlight the benefits of this approach to handling TB contact investigations and next steps to continuous process improvement.

Presenter: Megan Davis, MS, South Carolina Public Health Laboratory, Columbia, SC, Phone: 803.896.0870, Email: davismm @ dhec. sc. gov

Method Validation for Testing of Trichomonas from Urine Samples

H-Y. Kan, S. Stevens, B. Hastle, M. Davis and R. Dixon, South Carolina Public Health Laboratory, Columbia, SC

Introduction: South Carolina regional public health laboratories use wet mount microscopy, which is simple, rapid and inexpensive. However, this technique is less sensitive than the Nucleic Acid Amplification Testing( NAAT) technique. South Carolina Department of Health and Environmental Control( DHEC) Public Health Laboratory intends to include the Trichomonas vaginalis assay by sharing urine specimens with GC / CT testing. This abstract highlights our validation study using the Aptima Trichomonas vaginalis( ATV) assay data for the detection of Trichomonas vaginalis( TV) in multiple specimen types including male urines in compliance with CLIA regulations.

Method: A total of eighty male urine samples were used in conducting studies for determining precision, specificity and accuracy using two different GEN-PROBE Tigris instruments. Additional study samples included Aptima panels and previously tested samples, provided by the Alabama Public Health Laboratory. The clinical specificity, sensitivity and accuracy was evaluated using those eighty male urine samples. Interfering substances may influence the detection of TV from the ATV assay. To verify this, a total of seven interfering substances, including acetaminophen, ibuprofen, spermicide, Astroglide, Vagisil, KY liquid and Lotrimin were used in this validation according to manufacturer guidance. The interfering substance( s) was spiked into unique sample( s) and panels to ensure robust assay performance for patient testing.

Result: Reproducibility and Intra-run reproducibility were 100 %. The invalid rate was 0.625 % which was calculated by the total number of invalid results divided by the total number of results. The acceptance criteria for the invalid results were less than 5 %. Clinical specificity and sensitivity from the Tigris 1942 was 92.5 % and 100 % and from the Tigris 1944 are 90.0 % and 100 %, respectively. The positive agreement between the Tigris 1942 and the Tigris 1944 was 100 %. The correlation between the two instruments was 97.5 %. The results of the interference study resulted in no observed effect of spiking 5 % of an interfering substance into the control sample( s) and negative urine specimens. All sixteen controls A and B achieved the expected result and no false positive for TV was identified from the archived negative urine samples. It was demonstrated that spiking 5 %( V / V) of interfering substance did not result in changing the result of ATV assay. The interference effect was calculated by the number of discrepant results from the control samples divided by the total number of control samples.

Novel Aspect: South Carolina DHEC PHL has validated and will offer an expanded test menu for NAAT-based sexually transmitted infections consisting of Chlamydia, Gonorrhea and Trichomonas, including male urine samples.

Presenter: Horng-Yuan Kan, PhD, South Carolina Public Health Laboratory, Columbia, SC, Phone: 803.896.9725, Email: kanh @ dhec. sc. gov

Genomic Similarity of Legionella pneumophila Isolated from Routine Monitoring of Hospital Premise Plumbing Systems

L. DesJardin 1, W. Hottel 2, V. Reeb 1, N. Hall 1; 1 State Hygienic Laboratory at the University of Iowa, Coralville, IA, 2 University of Iowa College of Public Health, Iowa City, IA

Whole genome sequencing( WGS) was performed on Legionella pneumophilia( Lp) strains isolated from routine monitoring of hospital premise plumbing systems in order to better understand strain diversity over time. 46 Lp isolates from various locations in two facilities were analyzed; Facility A predominately isolated Lp serogroup( sg) 1( sampled 2012-2016) and Facility B had predominately Lp sg 4( sampled 2013-2016). The selection of Lp isolates to sequence represented different collection dates to determine if a dominant lineage was observed over time and location. wgMLST analysis of Illumina MiSeq Next Generation Sequence data showed that there were two commonly found sequence type( ST) populations in Facility A. Cluster ST36 is known

Infectious Disease