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

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