APHL 2019 POSTER ABSTRACTS
mediated colistin resistance genes. The data demonstrate a very
specific assay, with no observed cross-reactivity with previously
characterized clinical isolates from Gram-negative organisms.
Future studies will evaluate the clinical sensitivity of the assay.
The results demonstrate this assay can serve as a screening tool
for surveillance of this mcr-mediated colistin resistance, thereby
improving antimicrobial stewardship practices to minimize mcr gene
dissemination into the community.
Presenter: Esther Alao, Streck, La Vista, NE,
[email protected]
CDC is currently supporting ETOR expansion efforts, and this
initiative needs to be more widely understood and normalized in
order to be adopted by public health at large.
Presenter: Rachel Shepherd, Association of Public Health
Laboratories, Silver Spring, MD, [email protected]
Informatics
that can benefit from ETOR. This poster will also explore the issues
that laboratories need to consider before developing ETOR capacity,
especially around the sometimes neglected but critical area of
partner engagement and will examine how to broker conversations
with submitters around issues like: Submitter access, Message
standard, Defined vocabulary, Security requirements, Billing
coordination.
Electronic Laboratory Reporting for Animal Rabies Newborn Screening
K. Higginbotham 1 , D. Sanderson 2 , R. Merrick 2 ; 1 Alabama
Department of Public Health, 2 Association of Public Health
Laboratories Evaluation of Free Carnitine (C0) Cutoffs in Newborn
Screening
Currently, most public health laboratories are either not reporting or
sporadically reporting data for animal rabies in a variety of manual
ways, in a manner that hasn’t changed in decades. Calls back and
forth between laboratories and providers, the mailing and filing
of paper results, as well as the logging of those results, often in
multiple spreadsheets or databases, all take a toll on laboratory
productivity. Electronic laboratory reporting (ELR) can be an
invaluable tool in reducing time hours and time delays throughout
the notification process, which is especially critical when dealing
with time-sensitive information. In this poster, we will examine the
benefits of ELR, using Animal Rabies reporting as a case study and
looking at Alabama State Public Health Laboratory’s transition.
Over the last two years, APHL has been providing technical
assistance to laboratories to allow them to electronically report, in
real-time or near real-time, Animal Rabies data using a standardized
vocabulary and message format. This reporting works alongside
laboratories’ existing mechanism for reporting to the state
epidemiologists. APHL has assisted several labs in electronically
reporting to CDC, including Kansas State University, Alabama
State Public Health Laboratory, and Kentucky State Public Health
Laboratory. PHL, and is currently working with Georgia, Montana,
South Carolina, Virginia, and West Virginia. This poster will also
showcase how other laboratories can take advantage of this
free technical assistance to electronically report Animal Rabies
messages.
Presenter: Rachel Shepherd, Association of Public Health
Laboratories, Silver Spring, MD, [email protected]
Making the Most of ETOR
K. Higginbotham1, S. Johnson2, I. Duduk3, M. Wedig4, B. Matthis5,
N. Sankrithi6; 1Alabama Department of Public Health, 2Missouri
State Public Health Laboratory, 3Texas Department of State Health
Services, 4Wisconsin State Laboratory of Hygiene, 5Philadelphia
Department of Public Health, 6Massachusetts Department of Public
Health
This poster will demonstrate the necessary steps and minimum
requirements of a laboratory to utilize Electronic Test Orders and
Results, as well as showcase the range of scenarios in a laboratory
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O. Adair, S. Hall, T. Washington and R.B. Dixon, South Carolina
Department of Health & Environmental Control
Introduction: Newborn screening (NBS) laboratories are involved
in high-throughput and high-impact testing. To serve the needs of
this critical patient population, it is necessary to have accurate
testing and effective cutoffs. Developing cutoffs is challenging
due to diverse populations, gestational age and other factors.
Nonetheless, it is essential for appropriate test interpretation.
Methods: This poster abstract will focus on the evaluation of an
analyte which serves as a screening biomarker in the newborn
screening laboratory. Tools such as Collaborative Laboratory
Integrated Reports (CLIR) available at https://clir.mayo.edu/ provide
an additional multivariate algorithm to evaluate screening test
results. The information from CLIR allows laboratories, NBS Follow
Up staff and medical specialists to evaluate the results in context
of additional screening analytes and factors such as birth weight.
The unique feature of free carnitine (C0) is that it has both an upper
and lower cutoff. Due to this characteristic, both scenarios must
be evaluated. In order to perform this evaluation, data from over
3 months was studied at the upper cutoff and lower cutoff. In this
poster, we will outline the key parameters evaluated and a summary
of the results.
Preliminary data: The intent of our study is to provide accurate
screening in a way that reduces false positives while minimizing
false negatives. The Newborn Screening conditions considered in
the study as indicated by the free carnitine (C0)0 biomarker include
carnitine palmitoyltransferase 1 (CPT-1) deficiency and carnitine
uptake defect (CUD). We applied CLIR to the results in the study to
evaluate the threshold for lower and upper cutoffs. Second tier DNA
analysis results were included for screen positive results to confirm
or rule-out disease.
The information derived from the initial study obviated that both
confirmed negatives and confirmed positive samples are needed
to effectively modify laboratory cutoffs. While this is unsurprising,
it remains a significant challenge for NBS programs due to the
rare nature of particular disorders. Our next steps will be to obtain
feedback from clinical specialists regarding the information from
this study. Ongoing efforts will be made to compile observations to
better support cutoff evaluation and adjustment.
Summer 2019 LAB MATTERS
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