Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Wisconsin Diagnostic Laboratories, Milwaukee, Wisconsin, USA.
J Clin Microbiol. 2019 Dec 23;58(1). doi: 10.1128/JCM.00540-19.
Urine cultures are among the most common specimens received by clinical laboratories and generate a major share of the laboratory workload. Chromogenic agar can expedite culture results, but technologist review is still needed. In this study, we evaluated the ability of the WASPLab software to interpret urine specimens plated onto chromID CPS Elite (CPSE) agar. Urine specimens submitted for bacterial culture were plated onto CPSE agar with a 1-μl loop using the WASP. Each plate was imaged after 0 and 18 h of incubation, and colonies were enumerated by color using the WASPLab software and a technologist's reading from a high-definition (HD) monitor. The results were reported as negative if <10 colonies/plate were detected. Laboratory information system (LIS) time stamps were used to measure the time to result. A total of 1,581 urine cultures were tested. The sensitivity and specificity of the software were 99.8% and 68.5%, respectively, which included 2 manual-positive/automation-negative (MP/AN) results and 170 manual-negative/automation-positive (MN/AP) results. Of the 170 MN/AP specimens, 116 were caused by microcolonies missed by the technologist. The remaining MN/AP results were caused by either count differences near the 10-colony threshold ( = 43) or count differences of >50 CFU ( = 11). The use of both CPSE agar and the WASPLab software improved the time to result for urine culture, reducing the average time to result by 4 h 42 min for negative specimens and 3 h 28 min for positive specimens compared to that with standard-of-care testing. These data demonstrate that the use of CPSE agar and automated plate reading has the potential to improve turnaround time while maintaining high sensitivity and reducing urine culture workload.
尿液培养是临床实验室最常收到的标本之一,也是实验室工作量的主要来源。显色琼脂可以加速培养结果,但仍需要技术人员进行审核。在这项研究中,我们评估了 WASPLab 软件解读接种在 CPSE 琼脂平板上的尿液标本的能力。使用 WASP 将尿液标本接种在 CPSE 琼脂平板上,每个平板在孵育 0 和 18 小时后进行成像,使用 WASPLab 软件和高清(HD)显示器上的技术人员读数根据颜色对菌落进行计数。如果每个平板上检测到的菌落数 <10,则报告结果为阴性。使用实验室信息系统(LIS)时间戳来衡量报告结果的时间。共检测了 1581 份尿液培养物。软件的灵敏度和特异性分别为 99.8%和 68.5%,包括 2 份手动阳性/自动阴性(MP/AN)结果和 170 份手动阴性/自动阳性(MN/AP)结果。在 170 份 MN/AP 标本中,有 116 份是由于技术人员错过微菌落而导致的。其余的 MN/AP 结果是由于接近 10 菌落阈值( = 43)的计数差异或 >50 CFU( = 11)的计数差异所致。同时使用 CPSE 琼脂和 WASPLab 软件可以改善尿液培养的报告结果时间,与标准护理测试相比,阴性标本的平均报告结果时间缩短了 4 小时 42 分钟,阳性标本的平均报告结果时间缩短了 3 小时 28 分钟。这些数据表明,使用 CPSE 琼脂和自动平板读取有潜力在保持高灵敏度和减少尿液培养工作量的同时提高周转时间。