How Liquid Based Microbiology Can Change the Workflow in the Microbiology Laboratories

Carla Fontana, Marco Favaro, Cartesio Favalli

.
Department of Experimental Medicine and Surgery, “Tor Vergata” University of Rome, Rome, Italy.

DOI: 10.4236/aim.2013.36067                

Abstract

Liquid-based microbiology (LBM) is the future for the technological development of microbiology laboratories. In particular, the Eswab system (by Copan) simplifies and streamlines specimen collection and represents the only liquid system supporting the recovery of all types of bacteria (aerobic, anaerobic, and fastidious bacteria). In addition, LBM offers advantages in the efficiency of microorganism recovery and ease of sampling, transport, and storage. LBM also allows the introduction of true automation in the laboratory: either by using Copan ? (Walk-Away Specimen Processor) or any other commercially available specimen processor that utilizes LBM. In this paper, we illustrate how LBM can positively change laboratory workflow by illustrating several years of our experience with LBM. LBM allows clinical specimen optimization and has several important advantages: cost reduction (due to the smaller number of different devices used), time savings for medical or nursing staff (less confusion in collection device selection and fewer samples being collected), time savings for laboratory staff (fewer samples to access and handle for individual investigations), and patient comfort improvement (multiple sample collection can be avoided). A unique collection device for several investigations also guarantees quality due to the uniformity of the sample and standardization of procedures.

 

Keywords

Workflow; Liquid-Based Microbiology; Specimen Processor; Molecular Assays; Rational Use of Laboratory Resources

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	K. G. Van Horn, C. D. Audette, D. Sebeck and K. A. Tucker, “Comparison of the Copan ESwab System with Two Amies Agar Swab Transport Systems for Maintenance of Microorganism Viability,” Journal of Clinical Microbiology, Vol. 46, Suppl. 5, 2008, pp. 1655-1658. http://dx.doi.org/10.1128/JCM.02047-07
[2]	K. G. Van Horn, C. D. Audette, K. A. Tucker and D. Sebeck, “Comparison of 3 Swab Transport Systems for Direct Release and Recovery of Aerobic and Anaerobic Bacteria,” Diagnostic Microbiology and Infectious Diseases, Vol. 62, No. 4, 2008, pp. 471-473. http://dx.doi.org/10.1016/j.diagmicrobio.2008.08.004
[3]	C. Fontana, M. Favaro, D. Limongi, J. Pivonkova and C. Favalli, “Comparison of the eSwab Collection and Transportation System to an Amies Gel Transystem for Gram Stain of Clinical Specimens,” BMC Research Notes, Vol. 2, No. 1, 2009, p. 244. http://dx.doi.org/10.1186/1756-0500-2-244
[4]	G. Jones, R. Matthews, R. Cunningham and P. Jenks, “Comparison of Automated Processing of Flocked Swabs with Manual Processing of Fiber Swabs for Detection of Nasal Carriage of Staphylococcus aureus,” Journal of Clinical Microbiology, Vol. 49, No. 7, 2011, pp. 2717-2718. http://dx.doi.org/10.1128/JCM.00504-11
[5]	P. P. Bourbeau and B. L. Swartz, “First Evaluation of the WASP, a New Automated Microbiology Plating Instrument,” Journal of Clinical Microbiology, Vol. 47, No. 4, 2009, pp. 1101-1106. http://dx.doi.org/10.1128/JCM.01963-08
[6]	C. Fontana, M. Favaro, S. Minelli, M. C. Bossa, A. Altieri and C. Favalli, “A Novel Culturing System for Fluid Samples,” Medical Science Monitor, Vol. 15, No. 2, 2009, pp BR55-BR60.
[7]	U. Edwards, T. Rogall, H. Blocker M. Emde and E. C. Bottger, “Isolation and Direct Complete Nucleotide Determination of Entire Genes Characterization of a Gene Coding for 16S Ribosomal RNA,” Nucleic Acid Research, Vol. 17, No. 19, 1989, pp. 7843-7853. http://dx.doi.org/10.1093/nar/17.19.7843
[8]	M. Schmohl, S. Beckert, T. O. Joos, A. Konigsrainer, N. Schneiderhan-Marra and M. W. Loffler, “Superficial Wound Swabbing: A Novel Method of Sampling and Processing Wound Fluid for Subsequent Immunoassay Analysis in Diabetic Foot Ulcerations,” Diabetic Care, Vol. 35, No. 11, 2012, pp. 2113-2120. http://dx.doi.org/10.2337/dc11-2547
[9]	C. Matkosky, E. S. Susan and L. K. Deanna, “Evaluation of the Q Score and Q234 System fro Cost Effective and Clinically Relevant Interpretation of Wound Cultures,” Journal of Clinical Microbiology Vol. 44, No. 5, 2006, pp. 1869-1872. http://dx.doi.org/10.1128/JCM.44.5.1869-1872.2006
[10]	O. Kommedal, B. Karlsen and O. Saebo, “Analysis of mixed Sequencing Chromatograms and Its Application in Direct 16S rRNA Gene Sequencing of Polymicrobial Samples,” Journal of Clinical Microbiology, Vol. 46, No. 11, 2008, pp. 3766-3771. http://dx.doi.org/10.1128/JCM.00213-08
[11]	J. S. Heelan, J. Struminsky, P. Lauro and C. J. Sung, “Evaluation of a New Selective Enrichment Broth for Detection of Group B Streptococci in Pregnant Women,” Journal of Clinical Microbiology, Vol. 43, No. 8, 2005, pp. 896-897. http://dx.doi.org/10.1128/JCM.43.2.896-897.2005
[12]	A. Trotman-Grant, T. Raney and J. Dien Bard, “Evaluation of Optimal Storage Temperature, Time, and Transport Medium for Detection of Group B Streptococcus in StrepB Carrot Broth,” Journal of Clinical Microbiology, Vol. 50, No. 7, 2012, pp. 2446-2449. http://dx.doi.org/10.1128/JCM.00238-12
[13]	B. R. Berg, J. L. Houseman, M. A. Garrasi, D. W. Newton and C. L Young, “Culture-Based Method with Performance Comparable to That of PCR-Based Methods for Detection of Group B Streptococcus in Screening Samples from Pregnant Women,” Journal of Clinical Microbiology, Vol. 51, No. 10, 2013, pp. 1253-1255. http://dx.doi.org/10.1128/JCM.02780-12
[14]	A. T. Kerri, W. W. L. Hsiao, A. D. Harris, C. C. Stine, D. A. Rasko and J. K. Johnson, “Patients with Acinetobacter baumannii Bloodstream Infections Are Colonized in the Gastrointestinal Tract with Identical Strains,” American Journal of Infection Control, Vol. 38, No. 9, 2010, pp. 751-753. http://dx.doi.org/10.1016/j.ajic.2010.03.005
[15]	A. Adler, S. Navon-Venezia, J. Moran-Gilad, E. Marcos, D. Schwartz and Y. Carmeli, “Laboratory and Clinical Evaluation of Screening Agar Plates for Detection of Carbapenem-Resistant Enterobacteriaceae from Surveil-lance Rectal Swabs,” Journal of Clinical Microbiology, Vol. 49, No. 6, 2012, pp. 2239-2242. http://dx.doi.org/10.1128/JCM.02566-10
[16]	M. C. Salfa, V. Regine, M. Giuliani, M. Ferri, B. Suligoi e la Rete Nazionale dei Laboratori per le Infezioni Sessualmente Trasmesse, “La Sorveglianza delle Infezioni Sessualmente Trasmesse Basata su una rete di Laboratori: 16 Mesi di Attività,” Notiziario ISS, Vol. 23, No. 10, 2010, pp. 11-15.
[17]	N. A. El Aila, I. Tency, G. Claeys, B. Saerens, P. Cools, H. Verstraelen, M. Temmerman, R. Verhelst and M. Vaneechoutte, “Comparison of Different Sampling Techniques and of Different Culture Methods for Detection of Group B Streptococcus Carriage in Pregnant Women,” BMC Infectious Diseases, Vol. 10, 2010, p. 285. http://dx.doi.org/10.1186/1471-2334-10-285
[18]	C. A. Rivers and J. R. Schwebke, “Viability of Trichomonas vaginalis in Copan Universal Transport Medium and eSwab Transport Medium,” Journal of Clinical Microbiology, Vol. 46, No. 9, 2008, pp. 3134-3135. http://dx.doi.org/10.1128/JCM.00841-08
[19]	C. E. Gyorke, S. Wang, J. L. Leslie, S. H. Cohen, J. V. Solnick and C. R. Polage, “Evaluation of Clostridium difficile Fecal Load and Limit of Detection during a Prospective Comparison of Two Molecular Tests, the Il-lumigene C. difficile and Xpert C. difficile/Epi Tests,” Journal of Clinical Microbiology, Vol. 51, No. 1, 2001, pp. 278-280. http://dx.doi.org/10.1128/JCM.02120-12
[20]	P. P. Bourbeau and N. A. Ledeboer, “Automation in Clinical Microbiology” Journal of Clinical Microbiology, Vol. 51, No. 6, 2013, pp. 1658-1665. http://dx.doi.org/10.1128/JCM.00301-13
[21]	O. Dumitrescu, O. Dauwalder and G. Lina, “Present and Future Automation in Bacteriology,” Clinical Microbiology and Infection, Vol. 17, No. 5, 2011, pp. 649-650. http://dx.doi.org/10.1111/j.1469-0691.2011.03511.x
[22]	G. Greub and G. Prod’hom “Automation in Clinical Bacteriology: What System to Choose?” Clinical Microbiology and Infection, Vol. 17, No. 5, 2011, pp. 655-660. http://dx.doi.org/10.1111/j.1469-0691.2011.03513.x