APHL 2018 Annual Meeting Poster Abstracts
Working closely with IDEPC to match response needs with testing capacity allowed us to focus efforts appropriately and minimize turnaround times during overlapping outbreaks . The ability to adjust quickly to changing testing needs allowed rapid follow-up with clinicians and patients , a more efficient public health response , thereby reducing the spread of outbreaks in the community .
Presenter : Anna Strain , PhD , Minnesota Department of Health , St . Paul , MN , Phone : 651.201.5035 , Email : anna . strain @ state . mn . us
Evaluation of Laboratory Procedures for Detection of Mycobacterium tuberculosis in Gastric Fluid
J . Coffin , E . Tacheny , T . Dickerson , R . Howard and F . A . Hamill , MRIGlobal , Gaithersburg , MD
The global Tuberculosis ( TB ) epidemic is well documented with additional attention being given to the specific challenges of TB diagnosis in children . Culture for Mycobacterium tuberculosis is important to confirm the diagnosis and determine antibiotic response . Because infants and young children do not expectorate sputum , aspiration or lavage of gastric fluid is the usual procedure for obtaining a pediatric specimen to test for M . tuberculosis . Currently , there is no standard laboratory procedure available in the literature for culture of pediatric gastric fluid specimens . In fact , there is conflicting information presented on the value of neutralizing the acidic fluid prior to culture and / or analysis on the Cepheid GeneXpert Mtb / Rif assay , the two primary detection methods in many countries . The primary goal of this study , funded by the NIH NIAID contract number HHSN272201700001C for Mycobacterium tuberculosis ( Mtb ) Quality Assessment Program ( TBQA ), was to determine the effect of sample neutralization on organism detection and recovery under various conditions , in order to determine the best laboratory procedure for processing gastric fluid . Limit of detection in gastric fluid was also evaluated by live culture . Commercially available simulated gastric fluid was inoculated with M . tuberculosis H37Ra at different concentrations . Samples were either neutralized or not with 8 % sodium bicarbonate and processed that day or held under varying environmental conditions before processing following the Association of Public Health Laboratories ( APHL ) sample processing method . Sample sediments were inoculated in duplicate onto Lowenstein Jensen agar slants and incubated for 6 weeks , checking periodically for growth to compare neutralized vs not neutralized samples under the same conditions . Samples were also analyzed on the Cepheid GeneXpert Mtb / Rif assay . Results will be presented to the NIAIDfunded AIDS Clinical Trials group ( ACTG ) and International Maternal Pediatric Adolescent AIDS Clinical Trials Network ( IMPAACT ) who are coordinating a large scale clinical trial on household contacts , particularly children , of patients with multi-drug resistant TB .
Presenter : Jeanette Coffin , MRIGlobal , Gaithersburg , MD , Phone : 240.361.4006 , Email : jcoffin @ mriglobal . org
Building Social Networks for Sustainable Local Outbreak Response Capabilities
D . Dasgupta , G . Olinger and J . Michelotti , MRIGlobal , Inc ., Gaithersburg , MD
Outbreaks of high consequence and emerging pathogens , such as Brucella and MERS , do not stop at national borders and require international cooperation and aid to those countries with limited agricultural and human health resources . For many years such cooperation has facilitated efforts to contain outbreaks that may impact public health and security . We have , in a number of instances , been engaged to implement USG-funded science that includes cooperative biological research , activities in biosafety and security and the development and implementation of multifaceted training strategies in Kazakhstan and West Africa . Such training programs facilitate the ability of host countries to prepare and respond to the next disease outbreak . There are , however , limitations to the existing comprehensive programs . They are not always customized to address the specific circumstances of individual host country laboratories and resource-limited countries are unable to sustain some detection and diagnostic technologies , such as multiplex RT-PCR and next generation sequencing . Our team has developed a Capacity Building Pathway aimed at cost effective training and knowledge acquisition . The system of blended learning , documentation and quality processes that can be co-developed with the host nation culminates in a knowledge transfer process that is adopted , maintained and sustained by the host nation to train future generations . The approach utilizes a web-based platform that will provide a forum for continued communication between the partner country and international contract participants . Ideally , this web-platform will continue to remain active after the ongoing contract period of performance and be monitored and supported by US scientific and project management experts . As capacities grow , the program will work towards supporting a regional network of “ communities of practice ” whereby in-country partner laboratories can effectively share information and coordinate their efforts . The proposed workflow is adaptable to various types of training including : biosafety , biosecurity , sample management , research projects , standard operating procedure development and proficiency testing . Moreover , critical components can be migrated to other users that may need the knowledge generated . As one moves through the Capacity Building Pathway , ownership of the process increases for the host nation until they have the ability to own and manage it .
Presenter : Julia Michelotti , PhD , MRIGlobal , Inc ., Gaithersburg , MD , Phone : 240.361.4001 , Email : jmichelotti @ mriglobal . org
Workflow Analysis of the New Jersey Public Health Mycobacteriology Laboratory
D . Woell and T . Kirn , New Jersey Department of Health Public Health and Environmental Laboratory , Ewing , NJ
Background : For Mycobacterium tuberculosis ( TB ) infections , timely identification and rapid detection of drug resistance is critical to ensure proper treatment and infection control measures . Culture is still required for the gold-standard of TB identification and as a slowgrowing organism cultures need to be monitored for up to six weeks . Additionally , repeated specimens need to be tested over a period of days or weeks for monitoring of disease progression . With multiple specimens needing to be monitored for such a prolonged time , efficient management of laboratory processes to streamline testing is essential for the timely and accurate identification of TB .
Objectives : A workflow analysis of the Mycobacteriology lab in the NJ Public Health and Environmental Laboratory ( PHEL ) was undertaken to increase timeliness of reporting and decrease testing burden on staff .
Methods : A process map of all TB lab workflow was drawn to
Infectious Disease
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Summer 2018 LAB MATTERS 69 |