Events during September 2023

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

NHS England established the Genomic Medicine Service (GMS) in 2018 to realise the potential of genomics in healthcare. The NHS GMS built upon the existing NHS infrastructure and used learnings from the 100,000 Genomes Project to embed genomics through a world leading innovative service model from primary and community care through to specialist and tertiary care.

A consolidated national genomic laboratory network was established with seven GMS Alliances working together to support the clinical leadership and embedding of genomic medicine in end-to-end pathways more broadly and the working with other key clinical specialties. Equitable genomic testing is delivered through a single mandated National Genomic Test Directory for improved outcomes in cancer, rare, inherited and common diseases, and in enabling precision medicine and reducing adverse drug reactions.

Working in partnership with Genomics England the delivery of the whole genome sequencing service and ongoing key research initiatives are integral in developing the genomic service. Ongoing evolution of the service through cutting-edge science, research and innovation to ensure that patients can benefit from rapid implementation of advances is critical.

The IBMS Certificates of Achievement are designed as gateway qualifications to reflect the training needs of people working as Assistant Practitioners or Associate Practitioners in laboratory services.

In this ‘show and tell’ session designed for trainees, training officers, training managers or laboratory managers, we will outline the structure of the Certificates of achievement and give some information on the support and guidance that the IBMS currently offer for completing both parts of this qualification. We will interactively explore how the resources available as a result of our recent collaboration with LearnSci can supplement the existing training matter you have in your laboratory, to help you scaffold and deliver engaging, supportive and enjoyable training experiences to those completing this qualification.

We will also canvass the views of everyone present in this talk to better understand the needs of each group and to gain insight into the resources and support that attendees would find useful, to help the IBMS drive the evolution of this qualification by ensuring it remains relevant and useful to practitioners.