Abstract
BackgroundConventional bacterial stool culture is one of the more time-consuming tests in a routine clinical microbiology laboratory. In addition, less than 5 % of stool cultures yield positive results. A molecular platform, the BD MAX™ System (BD Diagnostics, Sparks, MD) offers the potential for significantly more rapid results and less hands-on time. Time-motion analysis of the BD MAX Enteric Bacterial Panel (EBP) (BD Diagnostics, Quebec, Canada) on the BD MAX System was compared to conventional stool culture in the microbiology laboratory of a tertiary care pediatric hospital.MethodsThe process impact analysis of time-motion studies of conventional cultures were compared to those of EBP with 86 stool specimens. Sample flow, hands-on time, processing steps, and overall turnaround time were determined and analyzed. Data were obtained and analyzed from both standard operating procedures and direct observation. A regression analysis was performed to ensure consistency of measurements. Time and process measurements started when the specimens were logged into the accessioning area of the microbiology laboratory and were completed when actionable results were generated.ResultsWith conventional culture, negative culture results were available from 41:14:27 (hours:minutes:seconds) to 54:17:19; with EBP, positive and negative results were available from 2:28:40 to 3:33:39.ConclusionsThis study supports the suggestion that use of the EBP to detect commonly encountered stool pathogens can result in significant time savings and a shorter time-to-result for patients with acute bacterial diarrhea.
Highlights
Conventional bacterial stool culture is one of the more time-consuming tests in a routine clinical microbiology laboratory
The objective of this study was to examine the laboratory impact of a new molecular platform on turnaround time, associated laboratory processes, and the cost of providing results with this system compared to conventional culture methods
To eliminate any potential of operator-to-operator bias during the study, 11 different laboratory technologists were observed performing all pre-analytical, analytical, and post-analytical culture procedures which occurred at five different laboratory stations: specimen receipt, specimen plating and incubation, culture reading, automated identification (Vitek 2 System, bioMérieux, Marcy l’Etoile, France) and shigatoxin testing (Immunocard STAT! EHEC, Meridian Bioscience, Cincinnati, Ohio, USA)
Summary
Conventional bacterial stool culture is one of the more time-consuming tests in a routine clinical microbiology laboratory. Time-motion analysis of the BD MAX Enteric Bacterial Panel (EBP) (BD Diagnostics, Quebec, Canada) on the BD MAX System was compared to conventional stool culture in the microbiology laboratory of a tertiary care pediatric hospital. Diarrhea results in approximately 760,000 preventable deaths of children under the age of five years. Diarrhea in this age group is a leading cause of malnutrition. The objective of this study was to examine the laboratory impact of a new molecular platform (use of the BD MAX Enteric Bacterial Panel on the BD MAX System) on turnaround time, associated laboratory processes, and the cost of providing results with this system compared to conventional culture methods.
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