Comparison of Automated Processing of Flocked Swabs with Manual Processing of Fiber Swabs for Detection of Nasal Carriage of
            <i>Staphylococcus aureus</i>

G, Jones; Matthews, Roger; Cunningham, Richard; Jenks, Peter J.

doi:10.1128/jcm.00504-11

Cited by 23 publications

(15 citation statements)

References 2 publications

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“…This observation is in agreement with a similar study that demonstrated a 13.1% increase in the recovery of Staphylococcus aureus by direct culture and a 10.2% increase in recovery by enrichment culture using ESwab and the WASP compared to specimens collected using traditional fiber wrapped swabs (14). Other clinical evaluations have demonstrated a 6-fold higher total CFU count and recovery of additional microorganisms from wound cultures when using ESwab compared to using traditional swabs (16).…”

supporting

confidence: 91%

“…Advancements in technology and automation in the clinical microbiology lab have made available more efficient methods for specimen collection and processing, which have the potential to improve the sensitivity of screening and recovery of GBS and other pathogens (14)(15)(16)(17)(18). The introduction of ESwab (Copan Diagnostics, Murrieta, CA), when used in combination with the Walk-Away specimen processor (WASP) (Copan Diagnostics), has the potential to improve the efficiency and reproducibility of specimen collection, processing, and pathogen recovery through increased sensitivity, specificity, and reduced turnaround time (14)(15)(16)(17)(18)(19). Traditional fiber wrapped swabs coupled with nonnutritive transport medium, such as Liquid Stuart or Amies Gel, aid in the preservation of microorganisms during transit to the clinical laboratory; however, the inefficient transfer or release of microorganisms from a traditional fiber swab may reduce the overall sensitivity of the diagnostic procedure.…”

mentioning

confidence: 99%

“…In contrast, flocked swabs are constructed with a solid bulbous head that is covered in fibers protruding perpendicularly to the swab shaft. The combination of a liquid-based transport medium along with a flocked swab, such as the ESwab collection device, may more evenly distribute and release microorganisms and has been demonstrated to increase the recovery of bacteria from wound and other sources compared to use with standard fiber wrapped swabs (14)(15)(16)(17)(18). This in turn increases the number of microorganisms inoculated to culture plates and/or other media in a more standardized and reproducible manner, particularly when used with an automated specimen processor, such as the WASP.…”

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Clinical Evaluation of the Walk-Away Specimen Processor and ESwab for Recovery of Streptococcus agalactiae Isolates in Prenatal Screening Specimens

Buchan

Olson

Mackey³

et al. 2014

J Clin Microbiol

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Rectal/vaginal specimens (n ‫؍‬ 97) were collected in parallel using ESwab and Liquid Stuart (LS) rayon fiber wrapped swab collection devices. Each collection device was used to directly inoculate culture medium and LIM broth. Medium inoculation by ESwab was conducted using the Walk-Away specimen processor (WASP). Medium inoculation by the LS device was conducted manually. The sensitivities of ESwab and LS upon direct plating were 93.8% and 87.5%, respectively, and increased to 96.9% and 90.6%, respectively, following broth enrichment.T ransient colonization of the female urogenital tract by Streptococcus agalactiae, or group B Streptococcus (GBS), is a recognized risk factor for the development of neonatal infections acquired during the birthing process. These infections are characterized by onset of sepsis, pneumonia, and meningitis within the first 7 days of life and carry a mortality rate of up to 7% (1, 2). While GBS has been associated with bacteremia, soft tissue infections, pneumonia, and meningitis in adults (3), carriage is typically asymptomatic, with a point prevalence of 10 to 30% in pregnant women (2, 4-6). The identification of GBS during routine prenatal screening aids in decreasing the incidence of invasive GBS disease in newborns through the administration of intrapartum antibiotic prophylaxis in women with a positive GBS test result (7). Further, the screening of pregnant women at 35 to 36 weeks gestation has been recommended by Centers for Disease Control and Prevention (2). Therefore, sensitive methods for detecting GBS in routine prenatal screening specimens are a key component in preventing neonatal disease (2).The use of enrichment broth, selective and chromogenic medium, and molecular diagnostics (6,(8)(9)(10)(11)(12)(13) has increased the sensitivity of GBS detection; however, the initial collection and processing of specimens have largely remained unchanged. Advancements in technology and automation in the clinical microbiology lab have made available more efficient methods for specimen collection and processing, which have the potential to improve the sensitivity of screening and recovery of GBS and other pathogens (14-18). The introduction of ESwab (Copan Diagnostics, Murrieta, CA), when used in combination with the Walk-Away specimen processor (WASP) (Copan Diagnostics), has the potential to improve the efficiency and reproducibility of specimen collection, processing, and pathogen recovery through increased sensitivity, specificity, and reduced turnaround time (14-19). Traditional fiber wrapped swabs coupled with nonnutritive transport medium, such as Liquid Stuart or Amies Gel, aid in the preservation of microorganisms during transit to the clinical laboratory; however, the inefficient transfer or release of microorganisms from a traditional fiber swab may reduce the overall sensitivity of the diagnostic procedure. In contrast, flocked swabs are constructed with a solid bulbous head that is covered in fibers protruding perpendicularly to the swab shaft. The combination of a liquid...

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confidence: 91%

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confidence: 99%

mentioning

confidence: 99%

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Clinical Evaluation of the Walk-Away Specimen Processor and ESwab for Recovery of Streptococcus agalactiae Isolates in Prenatal Screening Specimens

Buchan

Olson

Mackey³

et al. 2014

J Clin Microbiol

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“…However, the true effectiveness of automated inoculation systems needs to be validated by independent routine clinical microbiology laboratories. Compared to manual streaking, a few studies have demonstrated that the InoqulA and Previ Isola automated systems produce more isolated colonies, show better reproducibility, have no cross-contamination, and exhibit a significant decrease in hands-on plating time (2)(3)(4)(5). These studies concluded that such automated systems should improve laboratory workflow and shorten the time to results, but direct laboratory impact assessments remain to be performed to confirm these expectations.…”

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Comparison of Inoculation with the InoqulA and WASP Automated Systems with Manual Inoculation

et al. 2015

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bThe quality of sample inoculation is critical for achieving an optimal yield of discrete colonies in both monomicrobial and polymicrobial samples to perform identification and antibiotic susceptibility testing. Consequently, we compared the performance between the InoqulA (BD Kiestra), the WASP (Copan), and manual inoculation methods. Defined mono-and polymicrobial samples of 4 bacterial species and cloudy urine specimens were inoculated on chromogenic agar by the InoqulA, the WASP, and manual methods. Images taken with ImagA (BD Kiestra) were analyzed with the VisionLab version 3.43 image analysis software to assess the quality of growth and to prevent subjective interpretation of the data. A 3-to 10-fold higher yield of discrete colonies was observed following automated inoculation with both the InoqulA and WASP systems than that with manual inoculation. The difference in performance between automated and manual inoculation was mainly observed at concentrations of >10 6 bacteria/ml. Inoculation with the InoqulA system allowed us to obtain significantly more discrete colonies than the WASP system at concentrations of >10 7 bacteria/ml. However, the level of difference observed was bacterial species dependent. Discrete colonies of bacteria present in 100-to 1,000-fold lower concentrations than the most concentrated populations in defined polymicrobial samples were not reproducibly recovered, even with the automated systems. The analysis of cloudy urine specimens showed that InoqulA inoculation provided a statistically significantly higher number of discrete colonies than that with WASP and manual inoculation. Consequently, the automated InoqulA inoculation greatly decreased the requirement for bacterial subculture and thus resulted in a significant reduction in the time to results, laboratory workload, and laboratory costs.T he emergence of automation in bacteriology has opened a new era in clinical diagnostic laboratories. Automation is impacting laboratory management and workflow but also offers new perspectives for research and development in bacteriology by developing intelligent algorithms and driving innovation. Sample inoculation is a fastidious and repetitive process representing about 25% of a laboratory's workload (1). Thus, automated inoculation systems represent a need in diagnostic laboratories given the reductions in human, material, and financial resources and the increase in sample volumes (1). Moreover, the quality of inoculation is critical for achieving an optimal yield of discrete colonies in both monomicrobial and polymicrobial samples to facilitate rapid identification (ID) and antibiotic susceptibility testing (AST). Several inoculation and streaking instruments are currently available for routine diagnostic laboratories, including the Autoplak (NTE-SENER), the InoqulA (BD Kiestra), the Innova (BD), the PreLUD (i2a), the Previ Isola (bioMérieux), and the WASP (Copan). However, the true effectiveness of automated inoculation systems needs to be validated by independent routine clinical mic...

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“…Lastly, they demonstrated that plating of urine transport tubes by the WASP is highly reproducible (11). Jones et al demonstrated increased detection of Staphylococcus aureus nasal colonization using ESwabs plated with the WASP in comparison to that with manually inoculated wound fiber swabs (12).…”

Section: Microbiology Specimen Processorsmentioning

confidence: 99%

Automation in Clinical Microbiology

Jorgenson¹

2018

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b Historically, the trend toward automation in clinical pathology laboratories has largely bypassed the clinical microbiology laboratory. In this article, we review the historical impediments to automation in the microbiology laboratory and offer insight into the reasons why we believe that we are on the cusp of a dramatic change that will sweep a wave of automation into clinical microbiology laboratories. We review the currently available specimen-processing instruments as well as the total laboratory automation solutions. Lastly, we outline the types of studies that will need to be performed to fully assess the benefits of automation in microbiology laboratories.Editor's Note: In this issue of the Journal of Clinical Microbiology, Paul Bourbeau and Nate Ledeboer provide an informed review of an exciting new concept in clinical microbiology, the use of instrumentation to automate the front-end processing and workup of specimens submitted to a laboratory for analysis. The potential value of such instrumentation includes the possibility of substantial cost savings, standardization of initial specimen processing, more rapid and consistent provision of both identification and antimicrobial susceptibility test results, and a diminished risk for laboratory-acquired infections. However, as with any new diagnostic modality in clinical microbiology, there now exists a pressing need for investigations aimed at elucidating the performance characteristics of this new technology. Going forward, it will be imperative that laboratorians assess this new technology in objective, comparative, and preferably prospective clinical studies. Such studies will be necessary to define the true, rather than perceived or hoped-for, value of front-end and total laboratory automation in clinical microbiology. The Journal of Clinical Microbiology enthusiastically awaits submission of manuscripts that report the results of such investigations. Gary V. Doern, Editor in Chief, Journal of Clinical MicrobiologyI n recent years, while automation has steadily spread throughout the clinical chemistry and clinical hematology areas of diagnostic laboratories, clinical microbiology laboratories have largely been excluded from this trend. Although continuous-monitoring blood culture systems, automated microbial identification, and automated antimicrobial susceptibility testing systems are widely utilized in microbiology laboratories, microbiology specimen processing and culture workup, in particular, remain largely manual tasks, and indeed, few changes to the methods used to perform these tasks have occurred for many years. While we acknowledge that some larger microbiology laboratories utilize urine-plating instrumentation, most microbiology laboratories have littleto-no automation in their specimen-processing areas, with the exception of some laboratories in Western Europe, Australia, and the Middle Eastern nations. Still fewer laboratories have implemented some version of total laboratory automation (TLA).Driven by a variety of factors, we believe th...

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Comparison of Automated Processing of Flocked Swabs with Manual Processing of Fiber Swabs for Detection of Nasal Carriage of Staphylococcus aureus

Cited by 23 publications

References 2 publications

Clinical Evaluation of the Walk-Away Specimen Processor and ESwab for Recovery of Streptococcus agalactiae Isolates in Prenatal Screening Specimens

Clinical Evaluation of the Walk-Away Specimen Processor and ESwab for Recovery of Streptococcus agalactiae Isolates in Prenatal Screening Specimens

Comparison of Inoculation with the InoqulA and WASP Automated Systems with Manual Inoculation

Automation in Clinical Microbiology

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