Events on 26 September 2023

Complement testing

Complement genetic testing

Following on from a talk given last year on the Precision AMR Project, this presentation will look at the incorporation of WGS and genotypic methods vs phenotypic methods and how they can impact on diagnostic laboratory practices, antibiotic reporting and prescribing.

This presentation follows on from the research on the Precision AMR project and discusses how this can be translated into routine practice. Also looking at potential new workflows that may be incorporated into laboratory's to support clinicians and infection control.

AMR/CSO Diagnostic pathway change – Biomedical Scientist Perspective

Antimicrobial resistance is a major concern with mortality rates growing exponentially. Current ASTs used clinically can take 24-48hrs to report results, ensuing in initial treatment with broad spectrum antibiotics. The novel iFAST method can report results within 2 hours of exposure to an antibiotic. The main objective of this study was to measure the impedance signal of resistant and sensitive isolates of Staphylococcus aureus that had been exposed to cefoxitin. Sequentially collected bacterial isolates were accessed from the clinical microbiology laboratory to determine susceptibility.

50 methicillin resistant/sensitive isolates of S. aureus were taken from the middle of the clinical workflow and tested on the iFAST. The isolates were streaked onto blood plates and incubated at 37 degrees for 2 hours. The bacteria were then exposed to cefoxitin for 2 hours at the EUCAST breakpoint concentration of 8mg/L. Following exposure, the samples were measured on the iFAST.

The impedance cytometer measures the electrical signal of bacterial cells as they individually flow through a microfluidic channel, via electrodes driven by an AC current of multiple frequencies. This is interpreted as a read-out of cell volume and opacity. Exposure to antibiotics can change the electrical characteristics of the bacterial cell in size and opacity compared to the control sample. The number of exposed cells within the contour defined by the control sample can measure how the cells have altered in opacity and size following exposure.

iFAST results showed 100% concordance with disk diffusion sensitivity testing carried out by the clinical laboratory. The data showed different electrical impedance changes for both resistant and sensitive strains of S. aureus. Sensitive strains showed a decrease in cell size and resistant strains showed an increase in cell size following exposure to cefoxitin.

The bacterial impedance cytometer was able to rapidly differentiate between MRSA and MSSA isolates in concordance with current susceptibility testing in the clinical setting. The results help to show how the iFAST could reduce the time taken to provide critical and accurate antibiotic treatment to patients.

Bench to Bedside: Clinical Cases from an HSST

Albert Norman Keynote Opening Address

Highlighting the value of diagnostics, promoting the diagnostic workforce and improving diagnostic services

Health inequalities are unfair and avoidable differences in health across the population, and between different groups within society. Health inequalities arise because of the conditions in which we are born, grow, live, work and age. These conditions influence our opportunities for good health, and how we think, feel and act, and this shapes our mental health, physical health, and wellbeing. The COVID-19 shone harsh light on the pre-existing health inequalities which persist in our society. It has become increasingly clear that COVID-19 has had a disproportionate impact on many who already face disadvantage and discrimination. The impact of the virus has been particularly detrimental on people living in areas of high socio-economic deprivation, on people from Black, Asian and minority ethnic minority communities and those with a learning disability.

In England, there is a 19-year gap in healthy life expectancy (whether we experience health conditions or diseases that impact how long we live in good health) between the most and least affluent areas of the country, with people in the most deprived neighbourhoods, certain ethnic minority and inclusion health groups getting multiple long-term health conditions 10 to 15 years earlier than the least deprived communities, spending more years in ill health and dying sooner.

The Biomedical Sciences have a significant and pivotal role to play in narrowing the health inequalities gap through Research, Innovation and Life Sciences and its extensive reach across clinical practice within the NHS.

Defining biomedical scientists in the NHS Long Term Workforce Plan - the IBMS plan