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Franklin Lakes, NJ, United States

Simundic A.-M.,University of Zagreb | Cornes M.,Royal Wolverhampton | Grankvist K.,Umea University | Lippi G.,Clinical Chemistry and Hematology Laboratory | And 5 more authors.
Clinical Chemistry and Laboratory Medicine

Background: European questionnaire survey was conducted by the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for the Preanalytical Phase (EFLM WG-PA) to assess how phlebotomy is performed in EFLM countries, including differences in personnel, level of education and skills, and to investigate the presence and compliance of national phlebotomy guidelines on this matter. Methods: A questionnaire was constructed containing questions elucidating different aspects of the organization behind the phlebotomy praxis on a national basis, including questions on the staff performing phlebotomy, the education of these staff members, and the existence of and adherence to national guidelines. All 39 EFLM member countries were invited to participate. Results: In total 28/39 (72%) EFLM member countries responded. Seven out of the 28 (25%) have national phlebotomy guidelines and five have implemented other guidelines. The estimated compliance with phlebotomy guidance for the laboratories in the countries that have national guidelines available is poor, regardless to whether the phlebotomy was under the laboratory control or not. Most countries were interested in EFLM guidelines and to participate in a pilot EFLM preanalytical phase external quality assessment (EQA) scheme. In the responding EFLM member countries, the majority of phlebotomy is performed by nurses and laboratory technicians. Their basic education is generally 4-5 years of high school, followed by 2-5 years of colleague or university studies. Only a third (10/28; 36%) of the participating member countries has any specific training available as a continuous educational resource. A specific training for phlebotomy is not part of the education required to become qualified in 6/28 (21%) and 9/28 (32%) of countries for nurses and laboratory technicians, respectively. In countries and professions where training is required, most require more than 5 h of training. Conclusions: Based on the results of this survey we conclude the following: 1) There is a need to assess the quality of current practices, compliance to the CLSI H3-A6 guidelines and to identify some most critical steps which occur during phlebotomy, in different healthcare settings, across Europe; 2) Existing CLSI H3-A6 phlebotomy guidelines should be adapted and used locally in all European countries which do not have their own guidelines; 3) National EFLM societies need to be engaged in basic training program development and continuous education of healthcare phlebotomy staff (implementing the certification of competence). © 2013 by Walter de Gruyter Berlin Boston 2013. Source

Cuellar-Rodriguez J.,National Institute of Allergy and Infectious Diseases | Connor D.,University of Pittsburgh | Murray P.,BD Diagnostics | Gea-Banacloche J.,U.S. National Cancer Institute
European Journal of Clinical Microbiology and Infectious Diseases

It is unclear whether blood culture samples should be obtained through one or multiple catheter lumens. We measured how frequently drawing blood cultures from all the lumens from a multilumen catheter resulted in discordant results and how often these caused medical interventions. We performed a retrospective review of the microbiology database of the National Institutes of Health (NIH) Clinical Center. Most patients were immunocompromised. All blood cultures obtained from May 1, 2007 to April 30, 2009 were reviewed. We analyzed all positive blood cultures (i.e., positivity of any of the blood cultures drawn through the catheter lumens) when simultaneous samples from different lumens were obtained, and reviewed the medical charts of those in which blood cultures from different lumens had discordant results (i.e., not all lumens revealed the same organism). We also analyzed how often the discordant results lead to a medical intervention, defined as a change of antimicrobials and/or removal of the catheter. There were 405 episodes of positive blood cultures, in which simultaneous samples of different lumens of a multilumen catheter were obtained. Eighty-five episodes (21 %) were considered to be contaminants and excluded. We analyzed 320 episodes of positive blood cultures in 153 patients; 173 episodes (54.1 %) had discordant results. In 77 % of the 173 episodes, the discordant isolate led to a medical intervention. In immunocompromised patients, sampling all the lumens of a multilumen catheter results in more positive blood cultures, and many of these result in medical interventions. When evaluating bloodstream infection in patients with multilumen catheters, sampling all lumens should be strongly considered. © 2013 Springer-Verlag. Source

Islinger M.,University of Heidelberg | Eckerskorn C.,BD Diagnostics | Volkl A.,University of Heidelberg

Since its introduction five decades ago, free-flow electrophoresis (FFE) has been mainly employed for the isolation and fractionation of cells, cell organelles and protein mixtures. In the meantime, the growing interest in the proteome of these bio-particles and biopolymers has shed light on two further facets in the potential of FFE, namely its applicability as an analytical tool and sensor. This review is intended to outline recent innovations, FFE has gained in the proteomic era, and to point out the valuable contributions it has made to the analysis of the proteome of cells, sub-cellular organelles and functional protein networks. © 2010 Wiley-VCH Verlag GmbH & Co. KGaA. Source

Patel P.A.,NorthShore University HealthSystem | Ledeboer N.A.,Medical College of Wisconsin | Ginocchio C.C.,NorthShore Long Island J Health System Laboratories | Condon S.,NorthShore Long Island J Health System Laboratories | And 4 more authors.
Journal of Clinical Microbiology

We evaluated the BD GeneOhm MRSA achromopeptidase (ACP) assay, which incorporates a new specimen preparation approach. A total of 1,216 leftover nasal samples were tested; using culture as the gold standard, the sensitivity and specificity were 92% and 94.6%, respectively. The new lysis method provides good sensitivity and simplifies specimen preparation. Copyright © 2011, American Society for Microbiology. All Rights Reserved. Source

Strauss S.,Reading Hospital | Bourbeau P.P.,BD Diagnostics
Journal of Clinical Microbiology

This study compared results from plating urine specimens with the BD InoqulA instrument using a 10-μl inoculum with results from cultures plated manually with a 1-μl loop for comparable 2-month periods. The positivity rates, turnaround times for positive cultures, and BD Phoenix identification and antimicrobial susceptibility test results were comparable for both time periods. We experienced no problems with culture interpretation as the result of moving to the 10-μl inoculum. Copyright © 2015, American Society for Microbiology. All Rights Reserved. Source

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