APHL 2018 Annual Meeting Poster Abstracts
diagram and clarify the algorithm by which specimens are
processed, identified and reported. This process map was used
to identify key gaps in current practices and areas that could be
improved. Key indicators, such as turnaround time data, were
retrospectively queried to identify areas that were not meeting our
benchmark goals.
Results: Four key areas were identified that hold the potential for
improvement: Initial identification of specimens, anti-mycobacterial
susceptibility testing (AST), recording and reporting of results and
media contamination. In order to improve these key areas, between
three and five actionable recommendations were made for each.
Key indicators were assigned to monitor each of these metrics
quantitatively, including monitoring of turnaround time for individual
steps in the process map, overall turnaround times, rates of
reporting error and contamination rates. As individual changes are
implemented on an ongoing basis, continued monitoring of these
indicators will be compared to baseline to see which changes are
useful in improving laboratory processes and efficiency.
Presenter: Dana Woell, MPH, New Jersey Public Health and
Environmental Laboratory, Ewing, NJ, Phone: 609.671.6428,
Email: [email protected]
Laboratory Testing for HIV on OCME Specimens at the New
York City Public Health Laboratory: History and Opportunity
A. DeVito 1 , M. Moy 1 , K. Rabinovitz 1 , V. Streva 1 , E. Westheimer 1 , S. Ly 1 ,
S. Braunstein 1 , J. Rakeman 2 ; 1 New York City Department of Health
and Mental Hygiene, New York, NY, 2 New York City Public Health
Laboratory, New York, NY
At the start of the AIDS epidemic in the 1980s, the New York City
Department of Health and Mental Hygiene (DOHMH) Public Health
Laboratory (PHL) began HIV testing of all cases of suspicious death
brought to the NYC Office of the Chief Medical Examiner (OCME)
for fear of missing AIDS cases. Currently, the Bureau of HIV/AIDS
Prevention and Control (BHIV) maintains NYC’s HIV Registry, a
population-based registry of all diagnosed cases of AIDS and HIV
infection in NYC¹. The goal of this study was to retrospectively
determine the number of cases from OCME that had been
previously diagnosed with HIV and therefore were already present
within the HIV Registry prior to death and use this information
to inform the future direction of HIV testing of these cases at
PHL. Using data retrieved from the PHL laboratory information
system, StarLIMS, all reactive and indeterminate results from
specimens received from the NYC OCME for HIV testing between
October, 2013 and November, 2017 were analyzed. PHL data was
matched against the HIV Registry using a deterministic matching
algorithm. Descriptive statistics were gathered using Microsoft Excel
and PowerPivot. This retrospective analysis included data from
October 15, 2013 (the earliest data available in StarLIMS) through
November 21, 2017. During this period, PHL conducted 30,529
HIV tests on 19,920 unique specimens received from the NYC
OCME. Of these, 1,101 (5.5%) specimens from unique cases were
reactive for HIV. Forty-eight (0.24%) specimens from unique cases
had indeterminate results. After matching against the HIV Registry,
1,060 (92.25%) cases were found to already be known HIV-positive
patients. HIV-positive OCME cases were overwhelmingly male (852
male and 272 female) and had a median age of 53 years at the
time of death. Sixty-nine and 21 patients had no record of date-of-
birth or sex-at-birth, respectively. Fifty-nine (5.13%) patients were
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LAB MATTERS Summer 2018
diagnosed by post-mortem testing performed at PHL (i.e., were not
in the HIV Registry at the time of death). Results for 30 patients
were unable to be matched to the registry. This was due to a
number of reasons including indeterminate status, lag time between
testing and entry into the registry, pediatric exposures, missing lab
results, and missing name and/or DOB in the PHL dataset. Because
so few new HIV cases were found through post-mortem testing,
this data strongly suggests that DOHMH testing, outreach and
surveillance is reaching at-risk populations. Future efforts include
modifying OCME specimen testing algorithms so PHL staff are able
to search the name of the decedent in the HIV Registry prior to
testing, reducing unnecessary testing. Overall, this study provided a
new lens into New York City’s evolving approach to HIV testing and
revealed an opportunity for saving precious laboratory resources.
Presenter: Andrea DeVito, MPH, CPH, New York City Department of
Health and Mental Hygiene, New York, NY, Phone: 212.671.5742,
Email: [email protected]
Arbovirus Molecular Testing at New York City Public Health
Laboratory During the Zika Outbreak
B. Deocharan, J. Fu, R. Gu, M. Rasul, J. Hom, S. Glaesker, D. Liu, J.
Rakeman, New York City Public Health Laboratory, New York, NY
After the first confirme