Events in 2023

Networks – how Greater Manchester is making it work for them

Clostridioides difficile is responsible for the eponymous C. difficile infection (CDI). Faecal microbiota transplant (FMT), a NICE recommended treatment for recurrent CDI, is effective but logistic and safety concerns remain.

With the advent of non-donor derived products, the presentation will outline the principles and evidence related to correcting gut dysbiosis and explore whether there is a need for current or expanded FMT services in the future.

This presentation will provide an update Update to the clinical use of lipids and the laboratory role in lipid disorders.

Vaccinations to Covid 19 virus have been at the forefront of news headlines. One of the issues highlighted was the risk of adverse reactions, both allergic and non-allergic. This caused an influx of queries to Allergy services regarding patients who had suffered potential allergic reactions and posed the question, 'how can they be investigated'?

The laboratory has limited commercial assays to the components and excipients of vaccines. However, tests can potentially be modified or developed in-house to provide evidence of a potential allergy. They could also be utilised to determine if an alternative vaccination can be used. The testing strategy may need to be adapted on a case by case basis.

There is the potential that this could be used to develop a service for allergic reaction investigation for all vaccine types.

To explore the molecular profiles of Acanthamoeba from laboratory-confirmed Acanthamoeba keratitis (AK) cases reported within the United Kingdom (UK) using DNA taken directly from clinical samples.

Acanthamoeba species are free-living organisms responsible for causing a debilitating, sight-threatening disease of the cornea. Of the 24 known Acanthamoeba species, 14 cause AK.

Thirty-five Acanthamoeba DNA-positive corneal samples from the Scottish Microbiology Reference Laboratories (SMiRL), Glasgow collection were selected from cases reported from 2017 - 2019. Following extraction of the DNA directly from each clinical specimen, the DNA was subjected to in-depth molecular typing using a nested PCR / bi-directional sequencing approach.

Molecular profiling was successful for 32 samples which comprised of two genotypes namely T3 and T4. The T4 genotype were further sub-typed; five sub-types existed namely; T4A, T4B, T4C, T4E and T4F.

Using a molecular typing assay applied directly to corneal tissue, this study highlights the T4 genotype and the T4A subtype are the predominant molecular variants of Acanthamoeba to cause ocular disease in the UK. Gaining in-depth information on the molecular profiling of Acanthamoeba is essential to increase our knowledge and understanding of the epidemiology, transmission pathways and potential associations with clinical outcomes for this rare, yet potentially debilitating ocular disease.

Nuisance Antibodies

The Royal College of Pathologists has led an initiative to improve the transparency and standardise the operation of external quality assurance for providers of clinical diagnostic testing in the UK. This project has resulted in the development of the EQA Governance Framework, bringing together the current system of the National Quality Assurance Advisory Panels and the other stakeholders. Most diagnostic service providers are aware of the Panels, to which the EQA providers report performance concerns relating to UK laboratories, but perhaps are less certain on the criteria for reporting and the involvement of other oversight bodies, e.g., the Medicines and Healthcare Regulatory Agency and the Care Quality Commission.

The EQA Governance Framework has been developed through four separate workstreams. Workstreams 1 and 2 cover the governance and description of the process and have developed a portfolio of documents designed to support a standardised approach to the investigation and resolution of performance concerns with individual laboratories and method related problems.

Fundamental to the management of laboratory performance is the definition of unsatisfactory or poor performance, for qualitative and quantitative testing, in terms applicable to all pathology disciplines, and the action points at which the EQA provider will consider the escalation of a performance concerns to the oversight process. A challenging aspect of the work has been the development of procedures to recognise and manage method-related performance concerns, especially when working with global providers of testing platforms.

This long-term project is intended to strengthen the oversight of diagnostic testing, ensure the sharing of learning points and best practice and benefit patient safety.

The dynamic of virological diagnosis has transformed dramatically over the past few years in light of the Covid-19 pandemic, with significant changes to equipment and technology, workforce, workload and expertise. This presentation looks at those changes and focuses on the challenges observed and how these will continue over the coming years for virology departments across the country.

Managing change with compassion

Understanding your laboratories baseline data is the most important first step to identify where to improve services. Data is key to understanding preanalytical processes, simple things such as the location of phlebotomy clinics, the timings of transport collections, the number of paper requests all have an impact on specimen reception workflows and specimen turnaround times.

Many labs still continue to measure a specimen's turnaround time from the moment it arrives at the lab, which is too late.

We will demonstrate how data modelling and innovative transport solutions will improve system workflows, reduce specimen rejections, smooth out specimen arrivals, reduce the output of CO2 and meet the preanalytical quality requirements for your next UKAS inspection.