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A-257 Revolutionizing Fungal Infection Diagnosis: A Sensitive, Cost-Effective, and Time-Efficient Solution A-257 真菌感染诊断的革命性变革:灵敏、经济、省时的解决方案
IF 9.3 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-02 DOI: 10.1093/clinchem/hvae106.254
K Ramakrishnan, M Maung, V Ezike, P Poudel, R Senthilvelan, C Cui, J Mccabe, S Sackeyfio, A Senejani, E Kirkor, S Sinha
Background Fungal infection detection is essential for optimizing therapeutic strategies, preventing complications, enhancing overall health, and alleviating the financial burden, and preventing transmission. According to the CDC, fungal illness resulted in 75,000 hospital admissions and 9 million outpatient visits annually, with 7,199 deaths predicted in the United States in 2021. The rising prevalence of fungal infections, influenced by factors such as population expansion and evolving treatment strategies poses a growing challenge to achieving an early and accurate diagnosis. There is the crucial need for improved detection methods to promptly identify various fungal infections, including Candida species, spanning from skin issues to potentially fatal systemic diseases, ultimately reducing associated morbidity and mortality. Severe and profound infections with life-threatening potential are common in individuals with compromised immune systems and those who are hospitalized. This risk is notably elevated among patients with organ transplants, immunosuppressive treatments, diabetes, recent broad-spectrum antibiotic usage, catheter utilization, and extended hospitalization periods. Our advancement seeks to introduce innovative methods leveraging carbon-based nanomaterials for the detection of fungal infections, offering distinct advantages including cost-effectiveness, ease of operation, and time efficiency compared to conventional techniques. Methods Our technology utilizes carbon-based nano materials, a promising advancement in nanotechnology to detect fungal infections, especially Candida manifestations. The samples are brought into contact with pre-probed carbon-based nano materials sensors maintained at a specific annealing temperature, facilitating nucleic acid hybridization. Subsequently, alterations in the carbon nanotube's electrical signal are observed, indicating a change in conductivity. This change can allow for the measurement of a voltage difference across a continuous flow of electricity, correlating with the concentration of targets present in the sample, thereby enabling the detection of specific microorganisms. No change was noticed in electrical properties of carbon-based nano material when negative experiments were conducted. Results The initial findings showed the presence of specific microorganisms within the sample in less than 15 minutes with carbon-based nano materials sensors. Comparative analysis of the electrical signal magnitude values obtained from carbon nanotube measurements against the corresponding CT values from quantitative PCR (qPCR) provides insights into the correlation between the electrical readouts and molecular quantification, offering a comprehensive evaluation of the nanotube-based detection system's performance in diagnostics procedure. Conclusions Unlike conventional blood culture and qPCR, our technology, delivers outcomes with heightened sensitivity, cost-effectiveness, and time efficiency. Our t
背景 真菌感染检测对于优化治疗策略、预防并发症、提高整体健康水平、减轻经济负担和防止传播至关重要。根据美国疾病预防控制中心(CDC)的数据,真菌疾病每年导致 75,000 人入院治疗,900 万人次门诊就诊,预计 2021 年美国将有 7,199 人死亡。受人口膨胀和治疗策略不断变化等因素的影响,真菌感染的发病率不断上升,这给实现早期准确诊断带来了越来越大的挑战。亟需改进检测方法,以及时发现包括念珠菌在内的各种真菌感染,包括从皮肤问题到可能致命的全身性疾病,最终降低相关的发病率和死亡率。在免疫系统受损的人和住院病人中,可能危及生命的严重和深度感染很常见。在接受器官移植、免疫抑制治疗、糖尿病、近期使用广谱抗生素、使用导管和住院时间较长的患者中,这种风险明显升高。与传统技术相比,我们的研究旨在引入利用碳基纳米材料检测真菌感染的创新方法,该方法具有成本效益高、操作简便、时间效率高等显著优势。方法 我们的技术利用碳基纳米材料检测真菌感染,尤其是念珠菌感染。样品与预置的碳基纳米材料传感器接触,传感器保持在特定的退火温度,促进核酸杂交。随后,可观察到碳纳米管电信号的变化,表明导电性发生了变化。这种变化可以测量连续电流上的电压差,与样品中的目标物浓度相关联,从而实现对特定微生物的检测。在进行负实验时,碳基纳米材料的电特性没有发生变化。结果 初步研究结果表明,使用碳基纳米材料传感器不到 15 分钟就能检测到样品中存在特定微生物。将碳纳米管测量获得的电信号幅度值与定量 PCR (qPCR) 的相应 CT 值进行比较分析,可深入了解电读数与分子定量之间的相关性,从而全面评估基于纳米管的检测系统在诊断程序中的性能。结论 与传统的血液培养和 qPCR 不同,我们的技术具有更高的灵敏度、成本效益和时间效率。我们团队的样本采集方法简单易行,显著减少了样本制备的复杂性,无需拆卸即可妥善处理样本容器和传感器部件。碳基纳米材料等先进技术具有更高的灵敏度和经济、快速的检测能力,是准确、高效诊断真菌感染的理想选择。因此,采用这种技术不仅能提高诊断效率,还能通过及时和有针对性的治疗干预改善患者的预后。
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引用次数: 0
B-184 Purifying High-Quality Genomic DNA From Frozen Blood Samples Stored up to 1.5 Years at -20°C B-184 从零下 20°C 保存长达 1.5 年的冷冻血液样本中纯化高质量基因组 DNA
IF 9.3 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-02 DOI: 10.1093/clinchem/hvae106.544
A Wood, Y Wang
Background Maintaining DNA integrity in blood samples, from transport to storage to processing, is crucial to the success of downstream applications, especially regarding diagnostic applications. Additionally, due to the invasive nature of collecting blood samples, minimizing resampling to avoid excess patient pain and cost of collection and transportation are important to consider. Having the option to store and maintain portions of blood samples in the freezer enables future retesting without recollection. Since -20°C freezers generally are more affordable, require less energy, and have smaller footprints than -80°C freezers, demonstrating frozen blood stability at -20°C temperatures could decrease sampling burdens for labs with facility constraints. Methods Whole blood was collected into 9mL vacuum tubes (HemaSure-OMXP) from healthy donors. Aliquots of whole blood and buffy coat samples were stored at -20°C and thawed for genomic DNA extractions (QIAamp DNA Blood Mini Kit, Qiagen) at a range of different timepoints; frozen whole blood samples were processed at 0, 49, 141, and 148 days and frozen buffy coat samples were processed at 7, 27, 36, 185, 246, 373, 394, 584, and 604 days. Purified gDNA was quantified with Qubit (Broad Range dsDNA Assay, ThermoFisher) and qualified with Nanodrop One Microvolume UV-Vis Spectrophotometer (ThermoFisher) and TapeStation (Genomic DNA ScreenTape, Agilent Technologies). Results No significant decrease was observed for DNA yield and quality between fresh and frozen whole blood samples. Average DNA yields from 200 μL whole blood were 4.5 ± 2.2 μg and 5.3 ± 1.2 μg for fresh and frozen blood respectively. Average DNA integrity (DIN) was 6.9 ± 0.4 and 7.1 ± 0.3 for fresh and frozen blood respectively. Donor differences in blood samples can help explain the variance in DNA yields reported. No significant decrease was observed for DNA yield and quality in buffy coat samples frozen for longer at -20°C. In total, 84 whole blood and 25 buffy coat samples were processed in this study. Conclusions Although buffy coat samples tended to have higher yields than whole blood, due to the higher amount of white blood cells present, both sample types provided sufficient amounts of gDNA for downstream applications. Freezing blood samples for future testing can be effective at reducing the need for resampling without sacrificing the nucleic acid yield or quality of fresh samples. Additionally, as technological advancements are made for equipment and assays, frozen blood samples can be retested and compared to previous results for improved diagnostic decisions, done without requiring recollection from labs and patients.
背景 从运输、储存到处理,保持血液样本中 DNA 的完整性对下游应用的成功至关重要,尤其是在诊断应用方面。此外,由于采集血液样本具有侵入性,因此必须考虑尽量减少再次采样,以避免给病人带来过多痛苦,并降低采集和运输成本。选择在冷冻室中存储和保存部分血液样本,可以在未来进行重新检测,而无需重新采集。与 -80°C 冷冻机相比,-20°C 冷冻机通常更经济实惠、能耗更低、占地面积更小,因此,证明冷冻血液在 -20°C 温度下的稳定性可以减轻设施有限的实验室的采样负担。方法 将健康献血者的全血采集到 9mL 真空管(HemaSure-OMXP)中。冷冻全血样本在 0 天、49 天、141 天和 148 天时进行处理,冷冻水溶液样本在 7 天、27 天、36 天、185 天、246 天、373 天、394 天、584 天和 604 天时进行处理。纯化的 gDNA 用 Qubit(Broad Range dsDNA Assay,ThermoFisher)定量,并用 Nanodrop One Microvolume UV-Vis Spectrophotometer(ThermoFisher)和 TapeStation(Genomic DNA ScreenTape,Agilent Technologies)鉴定。结果 观察发现,新鲜和冷冻全血样本的 DNA 产量和质量没有明显下降。新鲜和冷冻的 200 μL 全血平均 DNA 产量分别为 4.5 ± 2.2 μg 和 5.3 ± 1.2 μg。新鲜和冷冻血液的平均 DNA 完整性(DIN)分别为 6.9 ± 0.4 和 7.1 ± 0.3。献血者血液样本的差异有助于解释所报告的 DNA 产量差异。在-20°C下冷冻更长时间的水溶液样本的DNA产量和质量没有明显下降。本研究共处理了 84 份全血样本和 25 份水溶液样本。结论 虽然由于白细胞含量较高,水溶液样本的产量往往高于全血样本,但两种样本都能为下游应用提供足量的 gDNA。在不影响核酸产量或新鲜样本质量的前提下,将血液样本冷冻以备将来检测,可有效减少重新采样的需要。此外,随着设备和检测技术的进步,冷冻血液样本可以重新进行检测,并与之前的结果进行比较,以改进诊断决策,而无需实验室和患者重新进行回忆。
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引用次数: 0
B-205 Performance of a Novel Fluorogenic Assay for Detection of Carbapenemase-producing Enterbacteriaceae B-205 检测产碳青霉烯酶肠杆菌科细菌的新型荧光测定的性能
IF 9.3 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-02 DOI: 10.1093/clinchem/hvae106.565
Z Zhou, S Li, D Jiang, Z Wang, Y Wang, Y Zhang, H Wang, Y Su
Background In recent years, under the selective challenge of antibiotics, the variety and number of drugresistant pathogenic microorganisms have increased significantly, which brings great challenges to clinical diagnosis and treatment, especially the infection caused by carbapenem resistant Enterobacteriaceae (CRE). Carbapenemases production is the main mechanism of drug resistance of Enterobacteriaceae to carbapenems. Drug resistance of Carbapenems can be caused by three mechanisms, resulting in the production of five major Carbapenemases. These are Klebsiella pneumoniae enzyme (KPC), New Delhi metal β-lactamase (NDM), carbapenem hydrolyzed oxalase (OXA-48 like), integrin-encoded metal β- lactamase (VIM) and IMP (Imipenemase). The real-time fluorescence quantitative PCR (qPCR) method based on molecular beacons was combined with the melting curve analysis to identify five drug resistance genes simultaneously by a single PCR reaction, with rapid detection, high sensitivity and strong specificity. Based on this principle, we developed the novel fluorogenic assay for rapid detection of Carbapenemases in multidrug-resistant Enterobacteriaceae (Dynamiker Biotechnology (Tianjin) Co., Ltd.). Methods We evaluated the performance of the novel fluorogenic assay for rapid detection of Carbapenemases in multidrug-resistant Enterobacteriaceae, including the limit of detection (LoD) and cross-reactivity, and compared it with the lateral flow immunochromatography assay (LFA). Results The LoD ranged from 75-450 CFU/mL for the five carbapenemase genes. The analytical specificity for target genes was 100%, as assessed with a panel of 15 pathogens, which indicated no cross-reactions. Comparison of qPCR and LFA results from twenty-three CRE clinical isolates with characterized carbapenemase content demonstrated a complete agreement (Table 1). Conclusions The novel fluorogenic assay for rapid detection of Carbapenemases in multidrug-resistant Enterobacteriaceae is an accurate and rapid method to identify KPC, NDM, VIM, IMP and OXA-48-like carbapenemases in the clinical microbiology laboratory, which can guide infection control programs to limit the spread of these organisms.
背景 近年来,在抗生素的选择性挑战下,耐药病原微生物的种类和数量显著增加,给临床诊断和治疗带来了巨大挑战,尤其是耐碳青霉烯类肠杆菌科细菌(CRE)引起的感染。碳青霉烯酶的产生是肠杆菌科细菌对碳青霉烯类产生耐药性的主要机制。对碳青霉烯类产生耐药性有三种机制,导致产生五种主要的碳青霉烯酶。它们分别是肺炎克雷伯菌酶(KPC)、新德里金属β-内酰胺酶(NDM)、碳青霉烯水解草酸酯酶(OXA-48 like)、整合素编码金属β-内酰胺酶(VIM)和亚胺培南酶(IMP)。基于分子信标的实时荧光定量 PCR(qPCR)方法与熔融曲线分析相结合,通过一次 PCR 反应同时鉴定五种耐药基因,具有检测速度快、灵敏度高、特异性强等特点。根据这一原理,我们开发了用于快速检测多重耐药肠杆菌科细菌中碳青霉烯酶的新型荧光检测试剂盒(戴纳米克生物技术(天津)有限公司)。方法 我们评估了用于快速检测耐多药肠杆菌科细菌中碳青霉烯酶的新型荧光测定的性能,包括检测限(LoD)和交叉反应,并将其与侧流免疫层析测定(LFA)进行了比较。结果 五种碳青霉烯酶基因的检出限为 75-450 CFU/mL。通过对 15 种病原体进行评估,目标基因的分析特异性为 100%,无交叉反应。对 23 个具有碳青霉烯酶含量特征的 CRE 临床分离物的 qPCR 和 LFA 结果进行比较,结果完全一致(表 1)。结论 用于快速检测多重耐药肠杆菌科细菌中碳青霉烯酶的新型荧光测定是在临床微生物实验室中鉴定 KPC、NDM、VIM、IMP 和 OXA-48 类碳青霉烯酶的一种准确而快速的方法,可指导感染控制计划以限制这些微生物的传播。
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引用次数: 0
A-210 Ldl-c to non-hdl-c ratio method: a simple way to determine bias for ldl-c methods on hypertriglyceridemic samples A-210 降密度脂蛋白胆固醇与非降密度脂蛋白胆固醇比值法:确定高甘油三酯血症样本降密度脂蛋白胆固醇方法偏差的简单方法
IF 9.3 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-02 DOI: 10.1093/clinchem/hvae106.208
T A Gcingca, M Sampson, J W Meeusen, L J Donato, A S Jaffe, A T Remaley
Background Beta-quantification (BQ) is the reference method for LDL-C but is not widely available. It is difficult, therefore, for clinical laboratories to independently assess the accuracy of their methods for either calculating or directly measuring LDL-C. Our goal was to investigate if an interrelationship between the tests in the standard lipid panel could be used to compare the performance of different LDL-C methods against BQ, specifically in samples with hypertriglyceridemia, a major cause of bias for LDL-C testing. Methods BQ results from Mayo Medical Labs (n=39,667) and the NIH (n=18,338) were used to identify a linear relationship by least-squares regression analysis between lipid panel test results and LDL-C to facilitate a statistical comparison between different LDL-C methods. Results It is well established that the number of VLDL particles increases as TG increases, because VLDL is the main carrier of TG. As a consequence, the ratio of LDL-C to non-HDL-C is inversely related to TG, which can be made linear by taking the square root of TG (Figure). Nearly identical regression equations were found for this relationship, using two different BQ datasets. When LDL-C was calculated by either Sampson equation, the LDL-C/non-HDL-C regression lines nearly overlapped with the one for BQ. In contrast, the Martin equation showed a positive bias with increasing TG, whereas the Friedewald equation showed a negative bias, consistent with past reports on their LDL-C biases with hypertriglyceridemia. In the UKBiobank, the Beckman direct LDL-C showed a positive bias for TG, which was confirmed in CAP proficiency test surveys. By simulation analysis, approximately 80 samples with high (>200 mg/dL) and low (<100 mg/dL) TG is statistically sufficient to assess if the LDL-C/non-HDL-C regressions lines of LDL-C methods differ from BQ. Conclusions The LDL-C/non-HDL-C ratio method is a simple way to examine LDL-C methods for bias on hypertriglyceridemic samples.
背景β定量法(BQ)是低密度脂蛋白胆固醇(LDL-C)的参考方法,但并不普及。因此,临床实验室很难独立评估其计算或直接测量低密度脂蛋白胆固醇方法的准确性。我们的目标是研究标准血脂组合中各检测项目之间的相互关系,以比较不同 LDL-C 方法与 BQ 的性能,特别是在高甘油三酯血症样本中的性能,高甘油三酯血症是造成 LDL-C 检测偏差的主要原因。方法 使用梅奥医学实验室(人数=39,667)和美国国立卫生研究院(人数=18,338)的 BQ 结果,通过最小二乘回归分析确定血脂组合检测结果与低密度脂蛋白胆固醇之间的线性关系,以便对不同的低密度脂蛋白胆固醇检测方法进行统计比较。结果 众所周知,VLDL 颗粒的数量会随着 TG 的增加而增加,因为 VLDL 是 TG 的主要载体。因此,低密度脂蛋白胆固醇(LDL-C)与非高密度脂蛋白胆固醇(Non-HDL-C)的比值与总胆固醇(TG)成反比,取总胆固醇(TG)的平方根可使两者成线性关系(如图)。通过使用两个不同的 BQ 数据集,我们发现这种关系的回归方程几乎完全相同。用桑普森方程计算低密度脂蛋白胆固醇时,低密度脂蛋白胆固醇/非高密度脂蛋白胆固醇回归线与 BQ 回归线几乎重合。相比之下,马丁方程随着 TG 的增加而出现正偏倚,而弗里德瓦尔德方程则出现负偏倚,这与过去关于高甘油三酯血症时 LDL-C 偏倚的报告一致。在英国生物库中,贝克曼直接 LDL-C 对 TG 呈正偏倚,这在 CAP 能力测试调查中得到了证实。通过模拟分析,约 80 份高 TG(200 mg/dL)和低 TG(100 mg/dL)样本在统计学上足以评估 LDL-C 方法的 LDL-C/non-HDL-C 回归线是否与 BQ 不同。结论 低密度脂蛋白胆固醇/非高密度脂蛋白胆固醇比值法是检查高甘油三酯血症样本中低密度脂蛋白胆固醇方法偏差的一种简单方法。
{"title":"A-210 Ldl-c to non-hdl-c ratio method: a simple way to determine bias for ldl-c methods on hypertriglyceridemic samples","authors":"T A Gcingca, M Sampson, J W Meeusen, L J Donato, A S Jaffe, A T Remaley","doi":"10.1093/clinchem/hvae106.208","DOIUrl":"https://doi.org/10.1093/clinchem/hvae106.208","url":null,"abstract":"Background Beta-quantification (BQ) is the reference method for LDL-C but is not widely available. It is difficult, therefore, for clinical laboratories to independently assess the accuracy of their methods for either calculating or directly measuring LDL-C. Our goal was to investigate if an interrelationship between the tests in the standard lipid panel could be used to compare the performance of different LDL-C methods against BQ, specifically in samples with hypertriglyceridemia, a major cause of bias for LDL-C testing. Methods BQ results from Mayo Medical Labs (n=39,667) and the NIH (n=18,338) were used to identify a linear relationship by least-squares regression analysis between lipid panel test results and LDL-C to facilitate a statistical comparison between different LDL-C methods. Results It is well established that the number of VLDL particles increases as TG increases, because VLDL is the main carrier of TG. As a consequence, the ratio of LDL-C to non-HDL-C is inversely related to TG, which can be made linear by taking the square root of TG (Figure). Nearly identical regression equations were found for this relationship, using two different BQ datasets. When LDL-C was calculated by either Sampson equation, the LDL-C/non-HDL-C regression lines nearly overlapped with the one for BQ. In contrast, the Martin equation showed a positive bias with increasing TG, whereas the Friedewald equation showed a negative bias, consistent with past reports on their LDL-C biases with hypertriglyceridemia. In the UKBiobank, the Beckman direct LDL-C showed a positive bias for TG, which was confirmed in CAP proficiency test surveys. By simulation analysis, approximately 80 samples with high (>200 mg/dL) and low (<100 mg/dL) TG is statistically sufficient to assess if the LDL-C/non-HDL-C regressions lines of LDL-C methods differ from BQ. Conclusions The LDL-C/non-HDL-C ratio method is a simple way to examine LDL-C methods for bias on hypertriglyceridemic samples.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
B-031 A new Ready to use Bio-Rad Quality Control to Streamline Daily Workflow B-031 全新即用型 Bio-Rad 质量控制,简化日常工作流程
IF 9.3 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-02 DOI: 10.1093/clinchem/hvae106.395
A M Yagoot, H Khalil, M Alharbi, G Almalayo, A Borai
Background A comprehensive Quality Management System starts with performing a daily Quality Control (Q.C.) process. The daily Q.C. process monitors the Instrument’s optimal performance and detects shifts and trends. However, the existing traditional daily Q.C. process is not only prone to manual errors, but also time consuming, costly and labor intensive. We evaluated a Bio-Rad InteliQTM Load and go Quality Control that comes in a barcoded tube ready to be loaded. We monitored the workflow efficiency gained in comparison to the traditional quality control material that comes in glass vials. Methods We evaluated the new quality control material ready to load on the instrument. This new Q.C. (Bio-Rad InteliQ Assayed Multiqual Control - 3 levels) were processed in parallel with our routine Q.C. (Bio-Rad Assayed Chemistry Lyphocheck vials - 2 levels). We performed the evaluation on Abbott Architect c8000 Chemistry analyzers in our central Laboratory (NGHA-Jeddah). The Q.C. was stored frozen. Before testing it was thawed at room temperature as per the insert instruction. Over a 5 days period, in parallel with our routine quality control, we run the new Q.C. Two times per day for 33 analytes. We monitored the processing time difference between the new and current approaches. We monitored the stability of all the analytes in the tube after Two days and again after Five days. We also monitored the cost effectiveness, labor intensiveness, probability of operator error and the overall improvement in workflow and Turn Around Time. Results Over the evaluation period, we observed the following: - Saving 40 minutes in average per week only for chemistry Q.C (time spent in reconstituting, mixing and aliquoting old Q.C) - 100% reduction in waste of plastic consumables such as pipette and plastic tubes. - Save an average of 1.0 ml dead volume in every 5.0 ml old Q.C. vial (20% of the volume, hence saving 20% of the total Q.C. cost). The dead volume wasted due to aliquoting step using the old Q.C. - 100% Eliminated delays caused by operator error such as wrong reconstitution, inadequate mixing and wrong Q.C. aliquoting. Not needed for the InteliQ. - High score of staff satisfaction. - Stability of the 32 analytes was excellent except that of Co2, which deteriorated by 14% after Two days as indicated in the insert package. Co2 day five result deteriorated by 34%. Conclusions Bio-Rad InteliQ is easy to use. It saves time and cost. When combined with Unity Q.C. data management solution it can streamline Q.C. workflow, eliminate operator errors, reduce T.A.T. and increase the overall laboratory performance. It may also work optimally with Instruments that have on-board fridge for Q.C.
背景 一个全面的质量管理系统始于执行日常质量控制 (Q.C.) 流程。日常质量控制流程监控仪器的最佳性能,并检测变化和趋势。然而,现有的传统每日质控流程不仅容易出现人工错误,而且耗时、耗资、耗力。我们评估了 Bio-Rad InteliQTM 加载和去质控系统,该系统装在条形码试管中,随时可以加载。与传统的玻璃瓶装质控品相比,我们对工作流程的效率进行了监测。方法 我们对可直接装入仪器的新型质控物进行了评估。新质控品(Bio-Rad InteliQ Assayed Multiqual Control - 3 级)与常规质控品(Bio-Rad Assayed Chemistry Lyphocheck vials - 2 级)同时处理。我们在中心实验室(NGHA-吉达)的雅培 Architect c8000 化学分析仪上进行了评估。质控品冷冻保存。检测前,按照说明书在室温下解冻。在为期 5 天的时间里,我们在进行例行质量控制的同时,每天对 33 种分析物运行两次新的 Q.C.。我们监测了新方法和当前方法的处理时间差异。两天后和五天后,我们分别监测了试管中所有分析物的稳定性。我们还监测了成本效益、劳动强度、操作员出错的概率以及工作流程和周转时间的整体改善情况。结果 在评估期间,我们观察到以下几点:- 仅化学质控品每周平均节省 40 分钟(用于重新配制、混合和等分旧质控品的时间) - 塑料消耗品(如移液器和塑料管)的浪费减少 100%。- 平均每 5.0 毫升旧质控品瓶可节省 1.0 毫升死体积(体积的 20%,因此可节省质控品总成本的 20%)。由于使用旧 Q.C. 进行等分步骤而浪费的死体积 - 100% 消除了因操作员错误(如错误的复溶、不充分的混合和错误的 Q.C. 等分)而造成的延误。InteliQ 不需要。- 员工满意度高。- 32 种分析物的稳定性都很好,只有 Co2 除外。二氧化碳的第五天结果恶化了 34%。结论 Bio-Rad InteliQ 易于使用。它节省了时间和成本。与 Unity Q.C. 数据管理解决方案结合使用,可以简化 Q.C. 工作流程,消除操作员错误,减少 T.A.T.,提高实验室整体性能。它还可以与带有板载 Q.C. 冰箱的仪器配合使用,达到最佳效果。
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引用次数: 0
B-006 Use of Sysmex UN-3000 Research Parameters for Semiquantitative Analysis of Urine Microscopic Elements B-006 使用 Sysmex UN-3000 研究参数对尿液微量元素进行半定量分析
IF 9.3 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-02 DOI: 10.1093/clinchem/hvae106.370
M Nakashima, H Shelestak, M Lauren, M Chappell
Background Microscopic examination of urine is an important component of urine analysis. However, it is labor-intensive and requires a skilled microscopist. The Sysmex UN-3000 (Kobe, JP) combines a Siemens CLINITEK Novus (Munich, GER) with a Sysmex UF-5000 flow cytometer and Sysmex UD-10 digital imaging device for fully automated urine analysis. It is FDA-approved for quantitation of red and white blood cells, epithelial cells, casts, and bacteria. It also flags for other particles such as sperm, yeast, pathologic casts, and crystals, which can then be confirmed on the UD-10. We sought to determine if and how the UF-5000 research parameter results could be used for semi-quantitative grading of pathologic casts, squamous epithelial cells, non-squamous epithelial cells, and crystals to match our reporting system. Methods Urine samples were analyzed by the UN-3000 and by manual review of urine sediment per laboratory protocols. Epithelial cells and crystals grades were none seen, few, moderate, many. Cast grades were 0, 1-3, 4-10, and >10. Results of manual microscopy were used to determine numerical cutoffs for the UF-5000 results which would agree within one grade in ≥90% of samples. Sperm and yeast are reported as either present or absent. For these particles, manual microscopy was compared to the results of the UF-5000 flagging and subsequent review of the UD-10 images. Results Rate of agreement between the methods is shown in the table. For sperm the UN-3000 showed 91.7% sensitivity and 100% specificity; for yeast, 93.8% sensitivity and 97.7% specificity. Conclusions We were able to use the research parameters from the UF-5000, in conjunction with the UD-10, to perform semi-quantitative grading. Adoption of this analyzer increases automation, with 70% of samples auto-validating per our protocols, while still conforming to our previous reporting system.
背景 尿液显微镜检查是尿液分析的重要组成部分。然而,显微镜检查是一项劳动密集型工作,需要熟练的显微镜操作人员。Sysmex UN-3000(日本神户)将西门子 CLINITEK Novus(德国慕尼黑)与 Sysmex UF-5000 流式细胞仪和 Sysmex UD-10 数字成像设备结合在一起,实现了全自动尿液分析。它经 FDA 批准,可用于定量检测红细胞、白细胞、上皮细胞、凝集块和细菌。它还能标记其他颗粒,如精子、酵母、病理石膏和结晶,然后在 UD-10 上进行确认。我们试图确定 UF-5000 研究参数结果是否以及如何用于病理铸型、鳞状上皮细胞、非鳞状上皮细胞和结晶的半定量分级,以与我们的报告系统相匹配。方法 使用 UN-3000 分析尿液样本,并按照实验室规程手动查看尿沉渣。上皮细胞和结晶分级为未、少、中、多。铸型等级为 0、1-3、4-10 和 >10。人工显微镜检查的结果被用来确定 UF-5000 结果的数值临界值,在≥90% 的样本中,数值临界值在一个等级之内。精子和酵母报告为存在或不存在。对于这些微粒,人工显微镜与 UF-5000 标记的结果进行了比较,随后对 UD-10 图像进行了审查。结果 两种方法的一致率见表。对于精子,UN-3000 的灵敏度为 91.7%,特异性为 100%;对于酵母,灵敏度为 93.8%,特异性为 97.7%。结论 我们能够将 UF-5000 的研究参数与 UD-10 结合使用,进行半定量分级。采用这种分析仪提高了自动化程度,70% 的样本可根据我们的协议自动验证,同时仍符合我们以前的报告系统。
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引用次数: 0
B-068 Plasma calprotectin as an index of draining tunnel formation in Hidradenitis suppurativa B-068 血浆钙蛋白是引流性化脓性扁桃体炎隧道形成的一项指标
IF 9.3 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-02 DOI: 10.1093/clinchem/hvae106.430
A Havelka, T Kanni, E J Giamarellos-Bourboulis
Background Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease which affects areas rich in apocrine glands. The main disease manifestations are inflammatory nodules (IN) and draining tunnels (dT). The course and progression of the disease are difficult to predict. There is currently lack of any broadly accepted biomarker which may inform on the activity of hidradenitis suppurativa (HS). Draining tunnel (dT) formation is the hallmark of HS in the affected skin. The existence of a biomarker which may predict dT formation before dTs appear in skin may become a tool for early biological treatment. Calprotectin, also known as S100 A8/A9 protein has been shown to be involved in various inflammatory conditions, including HS. Aim of this study was to evaluate circulating calprotectin as an index of dTs in the affected skin. Methods The study group consisted of 40 patients with confirmed HS and varying disease activity, assessed by number of dTs and International Hidradenitis Suppurativa Severity Score System (IHS 4 score) . Plasma samples were collected and stored at -80°C until analysis. Calprotectin was measured with GCAL® turbidimetric assay (Gentian AS, Norway). Results Fifteen patients had mild HS and 25 patients had moderate/severe HS. Positive association was found between circulating calprotectin and the absolute dT count (Pearson’s r2 = +0.750; p<0.0001) and the IHS4 (International HS 4 score) (Pearson’s r2 = +0.671; p<0.0001). Circulating calprotectin was significantly increased in patients with more than 2 dTs. Plasma calprotectin greater than 0.5 mg/L was associated with odds ratio 8.00 (1.87 to 34.22; p = 0.005) for 2 or more dTs. Conclusions Calprotectin is presented, for the first time, as a biomarker which indicates the formation of dTs in the skin. Its use as surrogate of early start of biologicals and response to treatment remains to be explored.
背景化脓性扁桃体炎(HS)是一种慢性炎症性皮肤病,好发于分泌腺丰富的部位。主要表现为炎性结节(IN)和引流隧道(dT)。该病的病程和进展难以预测。目前,还没有任何被广泛接受的生物标志物可用于了解化脓性扁桃体炎(HS)的活动情况。引流隧道(dT)的形成是化脓性扁桃体炎在受影响皮肤上的标志。如果有一种生物标志物可以在皮肤出现引流隧道之前预测引流隧道的形成,那么这种生物标志物就有可能成为早期生物治疗的工具。钙粘蛋白(又称 S100 A8/A9 蛋白)已被证明与包括 HS 在内的多种炎症有关。本研究的目的是将循环钙蛋白作为受影响皮肤中 dTs 的指标进行评估。方法 研究组由 40 名确诊为 HS 的患者组成,根据 dTs 数量和国际湿疹严重程度评分系统(IHS 4 分)评估不同的疾病活动性。采集的血浆样本在分析前保存在零下 80 摄氏度的环境中。钙蛋白用 GCAL® 比浊法(挪威 Gentian AS 公司)测定。结果 15名患者为轻度HS,25名患者为中度/重度HS。发现循环钙蛋白与 dT 绝对计数(Pearson's r2 = +0.750;p<0.0001)和 IHS4(国际 HS 4 评分)(Pearson's r2 = +0.671;p<0.0001)呈正相关。有 2 个以上 dTs 的患者的循环钙蛋白明显增加。血浆钙蛋白大于 0.5 mg/L 与 2 个或 2 个以上 dTs 的几率比为 8.00(1.87 至 34.22;p = 0.005)。结论 Calprotectin 首次作为一种生物标志物显示皮肤中 dTs 的形成。将其用作生物制剂早期启动和治疗反应的替代物还有待探索。
{"title":"B-068 Plasma calprotectin as an index of draining tunnel formation in Hidradenitis suppurativa","authors":"A Havelka, T Kanni, E J Giamarellos-Bourboulis","doi":"10.1093/clinchem/hvae106.430","DOIUrl":"https://doi.org/10.1093/clinchem/hvae106.430","url":null,"abstract":"Background Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease which affects areas rich in apocrine glands. The main disease manifestations are inflammatory nodules (IN) and draining tunnels (dT). The course and progression of the disease are difficult to predict. There is currently lack of any broadly accepted biomarker which may inform on the activity of hidradenitis suppurativa (HS). Draining tunnel (dT) formation is the hallmark of HS in the affected skin. The existence of a biomarker which may predict dT formation before dTs appear in skin may become a tool for early biological treatment. Calprotectin, also known as S100 A8/A9 protein has been shown to be involved in various inflammatory conditions, including HS. Aim of this study was to evaluate circulating calprotectin as an index of dTs in the affected skin. Methods The study group consisted of 40 patients with confirmed HS and varying disease activity, assessed by number of dTs and International Hidradenitis Suppurativa Severity Score System (IHS 4 score) . Plasma samples were collected and stored at -80°C until analysis. Calprotectin was measured with GCAL® turbidimetric assay (Gentian AS, Norway). Results Fifteen patients had mild HS and 25 patients had moderate/severe HS. Positive association was found between circulating calprotectin and the absolute dT count (Pearson’s r2 = +0.750; p<0.0001) and the IHS4 (International HS 4 score) (Pearson’s r2 = +0.671; p<0.0001). Circulating calprotectin was significantly increased in patients with more than 2 dTs. Plasma calprotectin greater than 0.5 mg/L was associated with odds ratio 8.00 (1.87 to 34.22; p = 0.005) for 2 or more dTs. Conclusions Calprotectin is presented, for the first time, as a biomarker which indicates the formation of dTs in the skin. Its use as surrogate of early start of biologicals and response to treatment remains to be explored.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142369090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A-331 Monitoring Operators Proficiency at Point of Care is Crucial for Reliable Patient Values. A Practical Example with Patient Blood Chloride, Potassium and Sodium Measurands Assayed with i-STAT® A-331 监测操作员在护理点的熟练程度对于获得可靠的患者数值至关重要。使用 i-STAT® 分析患者血液中的氯化物、钾和钠测量值的实际例子
IF 9.3 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-02 DOI: 10.1093/clinchem/hvae106.325
V Genta, C M Aston, F M Alferes, P M Darville, S Shumate
Background While i-STAT® cartridges offer the Physician a spectrum of analytical methods at the point of care for prompt diagnosis and interventions, these methods have to be harmonized with the laboratory methods in order to reliably detect shifts and trends. With this practical example we illustrate the importance of a program of routine comparisons between the i-STAT® and laboratory methods to detect analytical differences exceeding the CLIA’s criterion and potentially having adverse clinical implications. Methods Patient blood chloride (Cl), potassium (K) and sodium (Na) values as obtained by nurses with i-STAT Chem 8 ™ cartridges (Abbott Laboratories) at the point of care, where daily compared with the values as obtained with the Laboratory method (two cobas 6000®, Roche Diagnostics) using green top BD® lithium heparin tubes (Becton Dickinson) collected within thirty minutes of the i-STAT assay. The data were electronically stored in RALS™ (RALS Informatics) and transferred to Minitab® (Version 21, Minitab Inc.) statistical software. The two analytical methods were compared using the orthogonal and the polynomial ordinary least squares (POLS) regression models and their graphic representations. The aptness of the methods was evaluated with the standardized residuals diagnostics for normality, independence, outliers (Standardized residual >|3|) and influential observations (Hi>0.5). For acceptance of the differences the CLIA’s total error criterion was employed. (CI: target value ± 5%; K: target value ± 0.5 mmol/L; Na: target value ± 4 mmol/L). Results In the first four months of the study the number of differences exceeding the CLIA’s criterion was not acceptable. [Cl: 10% (165/1564); K: 7% (109/1593); Na: 4% (66/1586)]. These differences were occurring throughout the analytical range (AMR). Consequently, the operator’s technique was suspected and the POCT senior technologists (CA, FA) adopted operator specific interventions. This strategy was effective in the following month and the improvements were maintained for seven consecutive months. Monthly differences exceeding the CLIA’s criterion decreased significantly [Cl:1.9% (52/2777): K:0.9% (25/2868): Na:0.5% (15/2896)]. This was clearly illustrated with the dot plot by date and the parallel box plots by month. Regression analysis showed that the orthogonal and the OLS models were equivalent. Cl: Orthogonal y=1.7+0.99x, OLS y=12+0.88x. K; Orthogonal y=0.2+1.2x, OLS y=0.1+0.96x. Na: orthogonal y=3+0.98x, OLS y=14+0.9x. Additionally, the POLS model showed a linear relationship within the AMR intervals with few outliers (Cl=11; K=7; Na=9), no influential observations (Hi<0.5) and equality of monthly regression lines (P>0.05). Conclusions The implementation of daily comparisons between patient values as obtained with the i-STAT method and those as obtained by the Laboratory method in the interval of thirty minutes, allowed the identification of individual operators r
背景 i-STAT® 血盒在医疗点为医生提供了一系列分析方法,以便及时诊断和干预,但这些方法必须与实验室方法协调一致,才能可靠地检测出变化和趋势。通过这个实例,我们说明了对 i-STAT® 和实验室方法进行例行比较的重要性,以发现分析差异超过 CLIA 标准,并可能对临床产生不利影响。方法 护士使用 i-STAT Chem 8 ™ 血盒(雅培实验室)在护理点获得的患者血氯 (Cl)、钾 (K) 和钠 (Na) 值,每天与使用绿色顶端 BD® 锂肝素试管(Becton Dickinson)在 i-STAT 检测后 30 分钟内收集的实验室方法(两支 cobas 6000®,罗氏诊断公司)获得的值进行比较。数据以电子形式存储在 RALS™ (RALS Informatics) 中,并传输到 Minitab® 统计软件(第 21 版,Minitab Inc.使用正交和多项式普通最小二乘法 (POLS) 回归模型及其图形对两种分析方法进行了比较。使用标准化残差诊断法对正态性、独立性、异常值(标准化残差>|3|)和有影响的观测值(Hi>0.5)进行了评估。对于差异的接受,采用了 CLIA 的总误差标准。(CI:目标值 ± 5%;K:目标值 ± 0.5 mmol/L;Na:目标值 ± 4 mmol/L)。结果 在研究的前四个月中,超出 CLIA 标准的差异数是不可接受的。[Cl:10% (165/1564);K:7% (109/1593);Na:4% (66/1586)]。这些差异出现在整个分析范围 (AMR)。因此,操作员的技术受到怀疑,POCT 高级技术员(CA、FA)采取了针对操作员的干预措施。这一策略在接下来的一个月里取得了成效,并连续七个月保持了改善。超过 CLIA 标准的月度差异显著减少 [Cl:1.9% (52/2777):K:0.9% (25/2868):Na:0.5% (15/2896)]。按日期绘制的点阵图和按月份绘制的平行方框图清楚地说明了这一点。回归分析表明,正交模型和 OLS 模型是等效的。Cl:正交 y=1.7+0.99x,OLS y=12+0.88x。K:正交 y=0.2+1.2x,OLS y=0.1+0.96x。Na:正交 y=3+0.98x,OLS y=14+0.9x。此外,POLS 模型在 AMR 间隔内显示出线性关系,异常值很少(Cl=11;K=7;Na=9),无影响观测值(Hi<0.5),月回归线相等(P>0.05)。结论 采用 i-STAT 方法获得的患者数值与实验室方法获得的患者数值在 30 分钟的间隔内进行每日比较,可以找出需要额外培训的个别操作员。这一策略确保了连续八个月的可靠运行。这项研究清楚地表明,在质量控制和质量保证实践中增加对操作员的持续监督和培训,可确保使用 i-STAT 获得的患者数值与使用实验室方法获得的患者数值具有互换性。使用适当的统计软件(如 Minitab)进行电子数据收集和分析,对于该计划的实施至关重要。
{"title":"A-331 Monitoring Operators Proficiency at Point of Care is Crucial for Reliable Patient Values. A Practical Example with Patient Blood Chloride, Potassium and Sodium Measurands Assayed with i-STAT®","authors":"V Genta, C M Aston, F M Alferes, P M Darville, S Shumate","doi":"10.1093/clinchem/hvae106.325","DOIUrl":"https://doi.org/10.1093/clinchem/hvae106.325","url":null,"abstract":"Background While i-STAT® cartridges offer the Physician a spectrum of analytical methods at the point of care for prompt diagnosis and interventions, these methods have to be harmonized with the laboratory methods in order to reliably detect shifts and trends. With this practical example we illustrate the importance of a program of routine comparisons between the i-STAT® and laboratory methods to detect analytical differences exceeding the CLIA’s criterion and potentially having adverse clinical implications. Methods Patient blood chloride (Cl), potassium (K) and sodium (Na) values as obtained by nurses with i-STAT Chem 8 ™ cartridges (Abbott Laboratories) at the point of care, where daily compared with the values as obtained with the Laboratory method (two cobas 6000®, Roche Diagnostics) using green top BD® lithium heparin tubes (Becton Dickinson) collected within thirty minutes of the i-STAT assay. The data were electronically stored in RALS™ (RALS Informatics) and transferred to Minitab® (Version 21, Minitab Inc.) statistical software. The two analytical methods were compared using the orthogonal and the polynomial ordinary least squares (POLS) regression models and their graphic representations. The aptness of the methods was evaluated with the standardized residuals diagnostics for normality, independence, outliers (Standardized residual >|3|) and influential observations (Hi>0.5). For acceptance of the differences the CLIA’s total error criterion was employed. (CI: target value ± 5%; K: target value ± 0.5 mmol/L; Na: target value ± 4 mmol/L). Results In the first four months of the study the number of differences exceeding the CLIA’s criterion was not acceptable. [Cl: 10% (165/1564); K: 7% (109/1593); Na: 4% (66/1586)]. These differences were occurring throughout the analytical range (AMR). Consequently, the operator’s technique was suspected and the POCT senior technologists (CA, FA) adopted operator specific interventions. This strategy was effective in the following month and the improvements were maintained for seven consecutive months. Monthly differences exceeding the CLIA’s criterion decreased significantly [Cl:1.9% (52/2777): K:0.9% (25/2868): Na:0.5% (15/2896)]. This was clearly illustrated with the dot plot by date and the parallel box plots by month. Regression analysis showed that the orthogonal and the OLS models were equivalent. Cl: Orthogonal y=1.7+0.99x, OLS y=12+0.88x. K; Orthogonal y=0.2+1.2x, OLS y=0.1+0.96x. Na: orthogonal y=3+0.98x, OLS y=14+0.9x. Additionally, the POLS model showed a linear relationship within the AMR intervals with few outliers (Cl=11; K=7; Na=9), no influential observations (Hi<0.5) and equality of monthly regression lines (P>0.05). Conclusions The implementation of daily comparisons between patient values as obtained with the i-STAT method and those as obtained by the Laboratory method in the interval of thirty minutes, allowed the identification of individual operators r","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142369089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A-107 Sample Matrix Matters: A Precision Study of BioRad, TechnoPath, and Patient Pooled Samples Across 20 High Volume Chemistries and Immunoassays A-107 样品基质的重要性:BioRad、TechnoPath 和患者共用样本在 20 种大样本量化学和免疫测定中的精密度研究
IF 9.3 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-02 DOI: 10.1093/clinchem/hvae106.106
K Sobhani, A K Quizon, R Masukawa, C Hernandez, I Peteros, E Manimtim
Background BioRad is a major provider of QC materials in the US with robust peer data, and Technopath has emerged as a recent competitor, especially on cost. While many factors are considered when selecting QC materials, primary considerations include commutability, matrix effects, decision levels, and acceptability limits. A couple studies comparing BioRad and Technopath QC performance were published in recent years. However, none have compared performance to patient-pooled samples. We undertook a comparison of BioRad/Technopath QC performance, with the addition of patient-pooled samples in order to assess potential matrix effects. Methods We compared precision for 20 high-volume chemistry/immunoassay tests (Table 1) across two levels of BioRad and Technopath QC and a patient pooled sample over 7 days on 2 Abbott Alinity-i and 4 Alinity-C instruments. Each immunoassay control level was run 5 times/day across 10 tests and 7 days per instrument, (i.e., 700 results/level), and the same for chemistry controls (1,400 results/level). Lithium-heparin plasma patient-pool was prepared by obtaining sufficient volume and preparing daily frozen aliquots (i.e., 1400 immunoassay and 2800 chemistry results). Results BioRad and Technopath Chemistry QCs were highly comparable with all levels demonstrating <1% CV difference. Notably, CO2, B12, FT4 pooled-patient CVs were >2% lower than the best performing high control. Additionally, greater differences in performance were observed across immunoassay controls with high BioRad QC performing better for 7 tests. Conclusions Chemistry QC for Technopath and BioRad are largely comparable (i.e., CV differences <1%). Overall, BioRad immunoassay control performance was slightly to somewhat better (i.e., B12, CA125, and CA15-3). B12 and CO2 were particularly unstable (as reflected by patient-pool CVs). That said, differences in performance were not untenable and could be handled based on a tailored approach of extending QC limits if assay/instrument performance allows, and/or changing control material or reagents on a tighter schedule.
背景 BioRad 是美国质控材料的主要供应商,拥有可靠的同行数据,而 Technopath 则是最近出现的竞争对手,尤其是在成本方面。虽然在选择质控材料时要考虑很多因素,但主要考虑因素包括可互换性、基质效应、决策水平和可接受性限制。近年来发表了几项比较 BioRad 和 Technopath QC 性能的研究。但是,没有一项研究比较了患者集合样本的性能。我们对 BioRad/Technopath QC 性能进行了比较,同时增加了患者样本库,以评估潜在的基质效应。方法 我们在 2 台雅培 Alinity-i 和 4 台 Alinity-C 仪器上比较了 20 种大批量化学/免疫测定(表 1)在两个级别的 BioRad 和 Technopath QC 中的精密度,以及 7 天内患者集合样本的精密度。每个免疫测定对照水平每天运行 5 次,每次 10 个测试,每台仪器运行 7 天(即 700 个结果/水平),化学对照也是如此(1400 个结果/水平)。锂肝素血浆患者库的准备工作是获取足够的血浆量,并每天制备冷冻等分样品(即 1400 份免疫测定结果和 2800 份化学结果)。结果 BioRad 和 Technopath 化学质控结果具有很高的可比性,所有水平的 CV 差异均为 1%。值得注意的是,二氧化碳、B12、绒毛膜促性腺激素(FT4)集合患者的 CV 值比性能最好的高对照组低 2%。此外,在免疫测定对照中观察到的性能差异更大,BioRad 的高 QC 在 7 项测试中表现更好。结论 Technopath 和 BioRad 的化学质控基本相当(即 CV 差异为 1%)。总体而言,BioRad 的免疫测定对照性能略好一些(如 B12、CA125 和 CA15-3)。B12 和 CO2 尤其不稳定(反映在患者池 CV 上)。尽管如此,性能上的差异并不是无法弥补的,可以在检测/仪器性能允许的情况下根据具体情况扩大质控限,和/或按更严格的时间表更换对照材料或试剂。
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引用次数: 0
Clinical Perspective on the Use of Urine as a Tissue Surrogate in the Diagnosis of Genitourinary Diseases. 将尿液作为组织替代物用于泌尿生殖系统疾病诊断的临床视角》(Clinical Perspective on the Use of Urine as a Tissue Surrogate in the Diagnosis of Genitourinary Diseases)。
IF 9.3 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-27 DOI: 10.1093/clinchem/hvae145
Yuan Liang,Ping Wang,Weimin Ci
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引用次数: 0
期刊
Clinical chemistry
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