Department of Microbiology and Infectious Diseases, NSW Health Pathology Nepean, Penrith, New South Wales, Australia.
Department of Microbiology and Infectious Diseases, NSW Health Pathology Nepean, Penrith, New South Wales, Australia; Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Kingswood, New South Wales, Australia.
Diagn Microbiol Infect Dis. 2021 May;100(1):115309. doi: 10.1016/j.diagmicrobio.2021.115309. Epub 2021 Jan 16.
Diagnostic microbiology services form a critical component of the response to infectious disease outbreaks. Like previous respiratory virus pandemics, the COVID-19 pandemic has placed significant strains on the standing capacity of laboratories around the world. In this case study, we describe the surge response required by our laboratory to meet the fluctuating demand for SARS-CoV-2 in our regional pathology service in Western Sydney, Australia between March and May 2020. While the overall number of SARS-CoV-2 PCR positive cases was relatively low compared to other Australian local health districts, testing numbers were highly unpredictable and changed on a weekly basis as local outbreaks were detected. As with other laboratories, numerous other challenges were also faced during this period, including the requirement to introduce a new and unaccredited diagnostic PCR assay for SARS-CoV-2, local and global shortages of reagents for sampling and sample processing, and a significant institutional SARS-CoV-2 outbreak in our laboratory catchment area. A successful service delivery during this period could only be maintained by a dynamic whole-of-laboratory and organizational response including (1) operational changes to the hours of service and the expansion of diagnostic testing at our laboratory site and other sites within our organization (2) careful management of specialist staff and re-training and recruitment of additional staff (3) changes to laboratory workflows to improve SARS-CoV-2 PCR test turnaround time and to accommodate limits to precious laboratory reagents; (4) clear communication within our laboratory and the NSW Health Pathology organization; and (5) collaborative co-ordination and support by NSW Health Pathology.
诊断微生物学服务是应对传染病爆发的关键组成部分。与之前的呼吸道病毒大流行一样，COVID-19 大流行对全球实验室的现有能力造成了巨大压力。在本案例研究中，我们描述了我们实验室在 2020 年 3 月至 5 月期间应对澳大利亚西悉尼地区病理学服务中 SARS-CoV-2 波动需求所需的激增应对措施。虽然与其他澳大利亚地方卫生区相比，我们实验室的 SARS-CoV-2 PCR 阳性病例总数相对较低，但检测数量极不可预测，每周都会因当地爆发而变化。与其他实验室一样，在此期间我们还面临着许多其他挑战，包括需要为 SARS-CoV-2 引入新的未经认证的诊断 PCR 检测，采样和样品处理试剂在当地和全球短缺，以及我们实验室集水区发生的重大机构 SARS-CoV-2 爆发。只有通过整个实验室和组织的动态应对，包括 (1) 服务时间的运营变更以及我们实验室和组织内其他站点的诊断检测扩展，(2) 对专业人员的谨慎管理以及对额外人员的再培训和招聘，(3) 对实验室工作流程的更改以提高 SARS-CoV-2 PCR 检测周转时间并适应宝贵实验室试剂的限制；(4) 在我们的实验室和新南威尔士州健康病理学组织内进行清晰的沟通；以及 (5) 新南威尔士州健康病理学的协作协调和支持，才能在这段时间内维持服务的成功交付。
