Lab Matters Winter 2019 | Page 29

MEMBERSHIP San Francisco Public Health Laboratory staff. First row (from l to r:) Lourdes Gonzalez, Ejovwoke Ememu, Jasmine Magallanes, Tiombe Valone and Binh Phan. Second row (from l to r:) Dante Afable, Stephanie Trammell, John Lei, Wilson Qiu and Abiy Tadesse. Third row (from l to r:) Mayreen Padgett, Jane Chu, Laura Cruz, Victoria Olivas, Jonathan Carlson, Godfred Masinde and Kevin Sellers. Photo: SF PHL Testing • Introducing new tests for bacterial and tubercular infectious diseases using the bioMérieux Vitek ® MALDI-TOF mass spectrometry platform, reducing TATs from hours to minutes. In 2017, the laboratory performed over 90,000 tests for chlamydia/gonorrhea, the laboratory’s highest volume service, followed by syphilis and HIV testing. Other notable test areas include rabies and foodborne pathogen clearances. Successes When Masinde joined the laboratory, a chief challenge was to reduce lengthy test turnaround times (TATs) owing to aging equipment, insufficient staff and suboptimal process management. Recent systems improvements include: • Introducing electronic test ordering and results reporting for the San Francisco City Clinic and San Francisco Aids Foundation, which reduced errors and cut TAT from over seven days to two. The laboratory uses the ApolloLIMS laboratory information management system. • Hiring all the staff that had left and were never replaced • Replacing most of the aging equipment. For example, a Hologic Tigris ® system that broke down weekly was replaced by two new Hologic Panthers ® , each with a capacity of 250 tests per load and capability for multiple loads per day. PublicHealthLabs @APHL • Establishing testing for lymphogran- uloma venereum, a chronic bacterial infection of the lymphatic system. Apart from the US Centers for Disease Control and Prevention, the San Francisco Public Health Laboratory is the only US laboratory offering this service. • Introducing Cepheid GeneXpert ® testing for chlamydia and gonorrhea at the San Francisco City Clinic Laboratory. “In March 2019, we will be introducing the same testing at San Francisco Jail Health.” The new system reduces TAT and enables testing and treatment to commence in the same day. • Introducing a Public Health Microbiology internal training program for the new upcoming talented employees from our junior staff without them loosing benefits and salary and not costing the department anything extra. Goals • To complete the move to the new laboratory facility on schedule • To introduce whole genome sequencing for select pathogens by 2019 • To automate QuantiFERON ® -TB Gold Plus testing as well as tests for HIV enzyme immunoassay (EIA), herpes simplex virus 1/2 EIA and Hepatitis C Virus EIA, using only one testing system n • Introducing the new QuantiFERON ® -TB Gold Plus testing, which involves the use of a second TB antigen to aid in predicting which patients with positive latent TB could get active TB. • Designing the planned new laboratory facility—an intense, year-long activity that covered details down to “the height of the door from the ground.” Winter 2019 LAB MATTERS 27