Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 11 de 11
Filter
1.
Nano Lett ; 21(3): 1508-1516, 2021 02 10.
Article in English | MEDLINE | ID: covidwho-1049951

ABSTRACT

Following the COVID-19 outbreak, swabs for biological specimen collection were thrust to the forefront of healthcare materials. Swab sample collection and recovery are vital for reducing false negative diagnostic tests, early detection of pathogens, and harvesting DNA from limited biological samples. In this study, we report a new class of nanofiber swabs tipped with hierarchical 3D nanofiber objects produced by expanding electrospun membranes with a solids-of-revolution-inspired gas foaming technique. Nanofiber swabs significantly improve absorption and release of proteins, cells, bacteria, DNA, and viruses from solutions and surfaces. Implementation of nanofiber swabs in SARS-CoV-2 detection reduces the false negative rates at two viral concentrations and identifies SARS-CoV-2 at a 10× lower viral concentration compared to flocked and cotton swabs. The nanofiber swabs show great promise in improving test sensitivity, potentially leading to timely and accurate diagnosis of many diseases.


Subject(s)
/instrumentation , Nanofibers , /virology , /statistics & numerical data , False Negative Reactions , Humans , Materials Testing , Microscopy, Electron, Scanning , Nanofibers/ultrastructure , Nanotechnology , Specimen Handling/instrumentation , Specimen Handling/methods , Specimen Handling/statistics & numerical data
3.
J Clin Microbiol ; 58(9)2020 08 24.
Article in English | MEDLINE | ID: covidwho-835425

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has led many clinics to move from clinician-collected to self-collected oropharyngeal swabs for the detection of sexually transmitted infections (STIs). Before this change, however, self-collection was used primarily for genital and anorectal infections, with only limited studies on the performance of self-collection of oropharyngeal swabs for oropharyngeal STI detection. The Melbourne Sexual Health Centre (MSHC) changed from clinician-collected to self-collected oropharyngeal swabs for oropharyngeal gonorrhea and chlamydia screening on 16 March 2020 in order to reduce health care worker risk during the COVID-19 pandemic. We compared the proportions of valid and positive samples for gonorrhea and chlamydia among men who have sex with men (MSM) in two time periods; the clinician collection period, between 20 January and 15 March 2020, and the self-collection period, between 16 March and 8 May 2020. A total of 4,097 oropharyngeal swabs were included. The proportion of oropharyngeal swabs with equivocal or invalid results for Neisseria gonorrhoeae was higher in the self-collection period (1.6% [24/1,497]) than in the clinician collection period (0.9% [23/2,600]) (P = 0.038), but the proportions did not differ for the detection of Chlamydia trachomatis The positivity rates of oropharyngeal N. gonorrhoeae (adjusted prevalence ratio [PR], 1.07 [95% confidence interval {CI}, 0.85 to 1.34]) (P = 0.583) and oropharyngeal C. trachomatis (adjusted PR, 0.84 [95% CI, 0.51 to 1.39]) (P = 0.504) specimens did not differ between the two periods. Self-collected oropharyngeal swabs for the detection of N. gonorrhoeae and C. trachomatis have acceptable performance characteristics and, importantly, reduce health care worker exposure to respiratory infections.


Subject(s)
Chlamydia Infections/diagnosis , Gonorrhea/diagnosis , Homosexuality, Male/statistics & numerical data , Pharyngeal Diseases/diagnosis , Specimen Handling , Adult , Betacoronavirus , Coronavirus Infections , Humans , Male , Mass Screening/methods , Mass Screening/statistics & numerical data , Oropharynx/microbiology , Pandemics , Pneumonia, Viral , Retrospective Studies , Self Care , Specimen Handling/methods , Specimen Handling/statistics & numerical data , Young Adult
4.
Lab Med ; 51(6): e83-e86, 2020 Nov 02.
Article in English | MEDLINE | ID: covidwho-766711

ABSTRACT

OBJECTIVE: Reorganization of the emergency department (ED) during the COVID-19 pandemic implied closure of the ED-dedicated laboratory and manual transport of all specimens to the dislocated central laboratory. The impact of such reorganization on laboratory turnaround time (TAT) was examined. METHODS: The TAT from blood sampling to specimen reception (TAT1), from specimen reception to test reporting (TAT2), and from sampling to test reporting (TAT3) were compared between the pandemic peak month in 2020 and the same month in 2019. We evaluated whether TAT2 fulfills the recommended 60-minute criteria. RESULTS: A statistically significant difference was observed for all comparisons (P <.001), with TAT1 prominently contributing to TAT3 prolongation (from 48 minutes to 108 minutes) and exceeding the recommended 60-minute criteria. The TAT2 was extended from 33 minutes to 49 minutes. CONCLUSION: An ED reorganization compromised the usual laboratory services for patients in the ED, with manual specimen delivery being the main cause for TAT prolongation.


Subject(s)
Clinical Laboratory Services/statistics & numerical data , Laboratories, Hospital , Specimen Handling/statistics & numerical data , Coronavirus Infections , Humans , Pandemics , Pneumonia, Viral , Time Factors
5.
J Clin Microbiol ; 58(9)2020 08 24.
Article in English | MEDLINE | ID: covidwho-622362

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has led many clinics to move from clinician-collected to self-collected oropharyngeal swabs for the detection of sexually transmitted infections (STIs). Before this change, however, self-collection was used primarily for genital and anorectal infections, with only limited studies on the performance of self-collection of oropharyngeal swabs for oropharyngeal STI detection. The Melbourne Sexual Health Centre (MSHC) changed from clinician-collected to self-collected oropharyngeal swabs for oropharyngeal gonorrhea and chlamydia screening on 16 March 2020 in order to reduce health care worker risk during the COVID-19 pandemic. We compared the proportions of valid and positive samples for gonorrhea and chlamydia among men who have sex with men (MSM) in two time periods; the clinician collection period, between 20 January and 15 March 2020, and the self-collection period, between 16 March and 8 May 2020. A total of 4,097 oropharyngeal swabs were included. The proportion of oropharyngeal swabs with equivocal or invalid results for Neisseria gonorrhoeae was higher in the self-collection period (1.6% [24/1,497]) than in the clinician collection period (0.9% [23/2,600]) (P = 0.038), but the proportions did not differ for the detection of Chlamydia trachomatis The positivity rates of oropharyngeal N. gonorrhoeae (adjusted prevalence ratio [PR], 1.07 [95% confidence interval {CI}, 0.85 to 1.34]) (P = 0.583) and oropharyngeal C. trachomatis (adjusted PR, 0.84 [95% CI, 0.51 to 1.39]) (P = 0.504) specimens did not differ between the two periods. Self-collected oropharyngeal swabs for the detection of N. gonorrhoeae and C. trachomatis have acceptable performance characteristics and, importantly, reduce health care worker exposure to respiratory infections.


Subject(s)
Chlamydia Infections/diagnosis , Gonorrhea/diagnosis , Homosexuality, Male/statistics & numerical data , Pharyngeal Diseases/diagnosis , Specimen Handling , Adult , Betacoronavirus , Coronavirus Infections , Humans , Male , Mass Screening/methods , Mass Screening/statistics & numerical data , Oropharynx/microbiology , Pandemics , Pneumonia, Viral , Retrospective Studies , Self Care , Specimen Handling/methods , Specimen Handling/statistics & numerical data , Young Adult
7.
J Appl Lab Med ; 5(6): 1194-1205, 2020 11 01.
Article in English | MEDLINE | ID: covidwho-646320

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) was formally characterized as a pandemic on March 11, 2020. Since that time, the COVID-19 pandemic has led to unprecedented demand for healthcare resources. The purpose of this study was to identify changes in laboratory test utilization in the setting of increasing local incidence of COVID-19. METHODS: We performed a retrospective assessment of laboratory test order and specimen container utilization at a single, urban tertiary care medical center. Data were extracted from the laboratory information system database over a 10-week period, spanning the primordial inflection of COVID-19 incidence in our region. Total testing volumes were calculated during the first 2 and last 2 weeks of the observation period and used as reference points to examine the absolute and relative differences in test order volume between the prepandemic and COVID-19 surge periods. RESULTS: Between February 2, 2020, and April 11, 2020, there were 873 397 tests ordered and final verified. The in-house SARS-CoV-2 PCR positivity rate for admitted patients in the last week of the observation period was 30.8%. Significant increases in workload were observed in the send-out laboratory section and for COVID-19 diagnosis (PCR) and management-related testing. Otherwise, there was a net decrease in overall demand across nearly all laboratory sections. Increases in testing were noted for tests related to COVID-19 management. Viral transport media and citrated blue top containers demonstrated increases in utilization. CONCLUSION: Increasing local incidence of COVID-19 had a profound impact on laboratory operations. While volume increases were seen for laboratory tests related to COVID-19 diagnostics and management, including some with limited evidence to support their use, overall testing volumes decreased substantially. During events such as COVID-19, monitoring of such patterns can help inform laboratory management, staffing, and test stewardship recommendations for managing resource and supply availability.


Subject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Services/statistics & numerical data , Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/diagnosis , Facilities and Services Utilization/statistics & numerical data , Pneumonia, Viral/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Humans , Incidence , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Polymerase Chain Reaction/statistics & numerical data , Reagent Kits, Diagnostic/statistics & numerical data , Retrospective Studies , Specimen Handling/instrumentation , Specimen Handling/statistics & numerical data
8.
Clin Chem Lab Med ; 58(9): 1433-1440, 2020 08 27.
Article in English | MEDLINE | ID: covidwho-605893

ABSTRACT

Objectives: A global survey was conducted by the IFCC Task Force on COVID-19 to better understand how general biochemistry laboratories manage the pre-analytical, analytical and post-analytical processes to mitigate biohazard risks during the coronavirus disease 2019 (COVID-19) pandemic. Methods: An electronic survey was developed to record the general characteristics of the laboratory, as well as the pre-analytical, analytical, post-analytical and operational practices of biochemistry laboratories that are managing clinical samples of patients with COVID-19. Results: A total of 1210 submissions were included in the analysis. The majority of responses came from hospital central/core laboratories that serve hospital patient groups and handle moderate daily sample volumes. There has been a decrease in the use of pneumatic tube transport, increase in hand delivery and increase in number of layers of plastic bags for samples of patients with clinically suspected or confirmed COVID-19. Surgical face masks and gloves are the most commonly used personal protective equipment (PPE). Just >50% of the laboratories did not perform an additional decontamination step on the instrument after analysis of samples from patients with clinically suspected or confirmed COVID-19. A fifth of laboratories disallowed add-on testing on these samples. Less than a quarter of laboratories autoclaved their samples prior to disposal. Conclusions: The survey responses showed wide variation in pre-analytical, analytical and post-analytical practices in terms of PPE adoption and biosafety processes. It is likely that many of the suboptimal biosafety practices are related to practical local factors, such as limited PPE availability and lack of automated instrumentation.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Laboratories, Hospital/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Risk Management/statistics & numerical data , Surveys and Questionnaires , Containment of Biohazards/statistics & numerical data , Disease Outbreaks , Humans , Infection Control/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , Specimen Handling/statistics & numerical data
11.
Diagn Interv Radiol ; 26(4): 323-332, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-154916

ABSTRACT

Coronavirus disease 2019 (COVID-19) has recently become a worldwide outbreak with several millions of people infected and more than 160.000 deaths. A fast and accurate diagnosis in this outbreak is critical to isolate and treat patients. Radiology plays an important role in the diagnosis and management of the patients. Among various imaging modalities, chest CT has received attention with its higher sensitivity and specificity rates. Shortcomings of the real-time reverse transcriptase-polymerase chain reaction test, including inappropriate sample collection and analysis methods, initial false negative results, and limited availability has led to widespread use of chest CT in the diagnostic algorithm. This review summarizes the role of radiology in COVID-19 pneumonia, diagnostic accuracy of imaging, and chest CT findings of the disease.


Subject(s)
Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Radiology/standards , Thorax/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Algorithms , Artificial Intelligence , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Diagnosis, Differential , Disease Outbreaks , False Negative Reactions , Female , Health Services Accessibility/statistics & numerical data , Health Services Accessibility/trends , Humans , Male , Middle Aged , Pandemics , Pneumonia/diagnostic imaging , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Radiography/standards , Radiology/trends , Reverse Transcriptase Polymerase Chain Reaction/methods , Sensitivity and Specificity , Specimen Handling/statistics & numerical data
SELECTION OF CITATIONS
SEARCH DETAIL