Lab Matters Summer 2019 - Page 50

APHL 2019 POSTER ABSTRACTS Exposure to perfluorinated compounds has been found to negatively impact the health of the consumer, which motivated the U.S. EPA to add these compounds to the list of chemicals that are monitored in drinking water. The EPA has outlined a method for extracting and quantifying those analytes from drinking water in Method 537. One of the biggest challenges when tackling this application is in minimizing interferences and opportunities for contamination during sample preparation and analysis. As PFCs are highly stable and non- reactive, they have become commonly used materials for equipment parts and laboratory supplies. This work will demonstrate the use of a cartridge-based extraction system to extract and quantify up to 24 PFC compounds in drinking water to highlight the challenges associated with this application. The work will emphasize a number of potential pitfalls that analysts face — including blank interferences, system interferences and carryover effects — along with tips for troubleshooting those interferences and avoiding them during future analyses. Presenter: Evan Walters, Biotage, Salem, NH J. Stuff, F. Foster and J. Whitecavage, GERSTEL, Inc. Introduction: The Opioid Epidemic continues to increase throughout the United States. According to the CDC, 66% of all drug overdose deaths in 2016 involved an opioid. This calculates to roughly 116 deaths every day from opioid related overdoses. After becoming addicted to prescription opioids, users may unfortunately turn to illicit alternatives such as heroin. To compound the issue further, heroin has increasing been found to be mixed with other synthetic opioids such as fentanyl, which is 100 times more potent than morphine. There is a critical need for forensic, heath care, and law enforcement scientists to be able to quickly assess and monitor which opioid is involved, to effectively respond to this epidemic. Methods: Automating the entire hydrolysis, extraction, and subsequent analysis by LC/MS/MS provides the critical high throughput analysis for opioids in urine. Using the new GERSTEL MPS robotic autosampler, syringe transfer of all liquids involved in the enzymatic hydrolysis procedure, controlled incubation of the samples for a defined period of time, as well as extractions of the subsequent hydrolyzed urine samples using dispersive solid phase extraction were performed. The resulting eluents from the automated extractions were then introduced into the new Agilent Ultivo LC/MS/MS instrument. Preliminary Data: As a result of this study, we were able to show that an automated enzymatic hydrolysis and subsequent cleanup method was shown to be successful using the GERSTEL MPS robotic sampler for a variety of opioid compounds in urine. Using this method, opioid analytes can be rapidly and reproducibly isolated from hydrolyzed urine samples using an automated cleanup procedure coupled to LC/MS/MS analysis using the Agilent Ultivo Triple Quadrupole Mass Spectrometer, allowing their respective limits of detection to be met. Linear calibration curves resulting in R2 values 0.99 or greater were acheived upon the complete automated hydrolysis of glucuronide conjugated analytes. Coupling the solid phase extraction to the LC/MS/MS provides high 48 LAB MATTERS Summer 2019 Novel Aspect: Complete automation of enzymatic hydrolysis procedure coupled with the online extraction and LC/MS/MS analyses of opioid drug compounds in urine. Presenter: John Stuff, GERSEL, Inc., Linthicum, MD New Legionnaires’ Disease Prevention Roles for Environmental and Clinical Public Health Laboratories P. Root 1 , P. Gounder 2 , K. Majeska 1 ; 1 IDEXX, 2 Los Angeles County Public Health As Legionnaires’ disease outbreaks make headlines, clinical and environmental public health laboratories are fielding questions about prevention and the role of microbiological testing in reducing risk. This poster will educate laboratorians on 3 ways to combat this deadly disease: raising awareness, providing environmental testing guidance and encouraging sputum sample collection. It will also incorporate a case study of a 2018 Water Safety Management Plan (WSMP) education effort by a large public health laboratory. Raising Awareness: The CMS memo stating healthcare facilities must reduce their Legionnaires’ disease risk was published in 2017. However, in a recent survey, 65% of the long-term care facility staff expected to be involved in WSMPs (infection control professionals, directors of engineering, etc.) rated their WSMP understanding as “Low”. This poster will prepare public health labs to educate their communities 1) about Legionnaires’ disease prevalence, 2) water features where L. pneumophila can proliferate, 3) new research about “cold” water and cooling towers. Providing Guidance on Routine Monitoring: The abundance of Legionnaires’ disease guidance makes it tough to stay current. The poster will prepare attendees to talk with their stakeholders about 1) the value of routine monitoring to ensure a WSMP is effective 2) the revision of ASHRAE Standard 188’s Annex C guidance to recommend accredited laboratory use and 3) choosing routine testing methods. Encouraging collection of culture samples from Legionnaires’ Disease Patients: Per the CDC, the best way to identify a Legionnaires’ disease source and reduce the risk of more cases is to match a patient’s sputum sample cultured in a clinical laboratory with a water sample culture. With a clinical sample for comparison, further analyses can be performed for a strain and/or sequence match. This poster will cover communicating this message to hospitals and promoting testing services the public health lab may provide. It will also show how clinical culture data, like those from the European Centers for Disease Control and CDC provide insight into the causes of Legionnaires’ disease and for prioritizing monitoring and mitigation efforts. Case Study: In 2018 the Los Angeles County Public Health Department hosted 128 staff from 90 skilled nursing care facilities for a day-long WSMP Seminar. The poster will highlight “before and after” learnings and key success factors for this initiative. Presenter: Patsy Root, IDEXX, Westbrook, ME, PublicHealthLabs @APHL Completely Automated Hydrolysis, Extraction and Analysis of Opioids in Urine Using a New Robotic Autosampler and LC/MS/MS Platform throughput and minimizes matrix interference from these biological samples.