Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Division of Clinical Microbiology, Indiana University Health, Indianapolis, Indiana, USA.
J Clin Microbiol. 2024 Jun 12;62(6):e0015824. doi: 10.1128/jcm.00158-24. Epub 2024 May 1.
UNLABELLED: is a multidrug-resistant opportunistic fungal pathogen capable of causing serious infections and healthcare-associated outbreaks. Screening for colonization with has become routine and is recommended in many hospitals and healthcare facilities as an infection control and prevention strategy. Subsequently, and since there are currently no FDA-approved tests for this purpose, clinical microbiology laboratories have become responsible for developing protocols to detect using axial and inguinal screening swabs. In a College of American Pathologists-accredited large academic healthcare center setting, we implemented a laboratory-developed nucleic-acid amplification test for the detection of DNA. Our test validation evaluated the performance of the DiaSorin primer set used in a real-time qualitative PCR assay on the LIAISON MDX thermocycler with the Simplexa Universal Disc. The assay was highly sensitive and specific, with a limit of detection of 1-2 CFU/reaction, with no observed cross-reactivity with other spp., bacterial skin commensal organisms or commonly encountered viruses. When run in parallel with a culture-based detection method, the PCR assay was 100% sensitive and specific. The assay was precise, with low variability between replicates within and between runs. Lastly, pre-analytical factors, including swab storage time, temperature, and transport media, were assessed and found to have no significant effect on the detection of at variable concentrations. Taken together, this study expands the available options for nucleic acid detection of and characterizes pre-analytical factors for implementation in both high- and low-volume laboratory settings. IMPORTANCE: This study overviews the validation and implementation of a molecular screening tool for the detection of in a College of American Pathologist-accredited clinical laboratory. This molecular laboratory-developed test is both highly sensitive and specific and has significant health-system cost-savings associated with significantly reduced turn-around-time compared to traditional standard-of-care culture-based work up. This method and workflow is of interest to support clinical microbiology diagnostics and to help aid in hospital inpatient, and infection prevention control screening.
未加说明:是一种具有多重耐药性的机会性真菌病原体,能够导致严重感染和与医疗保健相关的暴发。筛查 的定植已成为常规操作,许多医院和医疗保健机构都推荐将其作为感染控制和预防策略。因此,由于目前尚无经美国食品和药物管理局批准的此类检测方法,临床微生物学实验室已负责制定使用轴向和腹股沟筛查拭子检测 的方案。在一个经过美国病理学家学院认证的大型学术医疗中心环境中,我们实施了一种用于检测 DNA 的实验室开发的核酸扩增检测。我们的测试验证评估了在 LIAISON MDX 热循环仪上使用 DiaSorin 引物对进行实时定性 PCR 检测的性能 Simplexa Universal Disc。该检测方法具有高度的敏感性和特异性,检测限为 1-2 CFU/反应,与其他 spp.、细菌皮肤共生体或常见病毒无交叉反应。当与基于培养的检测方法平行运行时,PCR 检测方法的敏感性和特异性均为 100%。该检测方法具有精确性,在重复运行和运行之间的重复性方面具有低变异性。最后,评估了预分析因素,包括拭子储存时间、温度和运输介质,发现它们对检测不同浓度的 没有显著影响。综上所述,本研究扩展了用于检测 的核酸检测方法,并描述了在高容量和低容量实验室环境中实施的预分析因素。
重要性:本研究概述了在经过美国病理学家学院认证的临床实验室中检测 的分子筛选工具的验证和实施。与传统的基于培养的标准护理工作流程相比,这种分子实验室开发的检测方法具有高度的敏感性和特异性,并且与显著缩短周转时间相关联,具有显著的卫生系统成本节约。这种方法和工作流程对支持临床微生物学诊断学具有重要意义,并有助于帮助医院住院患者和感染预防控制筛查。
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