April 23, 2015
Dear Friends and Colleagues,
Trekkies have to wait until next year for “Star Trek 3” to reach the movie theaters. But as I learned during this week’s Lab Recognition Week, we’re already experiencing futuristic innovations in our NCH microbiology lab that would have made Gene Roddenberry, the original creator of the Star Trek television series, proud.
Indeed, as Lab Director Jodi Cooper and Microbiology Manager Robin Williams showed me this week, our twelve microbiology lab technologists are putting new technologies to work every day, and will soon incorporate three new revolutionary platforms which will change the dynamics of this science.
- Bruker MALDI uses the older technology of mass spectrometry in a new way. In the past, it took two days to identify bacteria taken from a person’s culture. Now, after 24 hours of incubation, a swab size sample can be placed into a counter-top machine with 63 other samples, and all are indentified within minutes. Amazing! This mass spectrometry can also identify fungi and yeast, which used to take weeks. Tuberculosis identification will soon be added to this MALDI platform and the identification of tuberculosis will become much more rapid. Knowing what the offending organism is in a fraction of the time leads to more effective earlier treatment.
- Biomerieux BioFire is capable of identifying 22 different upper respiratory infections within one hour of a patient’s specimen arriving in the lab. Pertussis (Whooping Cough), which is sadly on the rise due to some folks not getting immunized, is one contagious disease that will be identified more quickly as a result of this platform. Blood cultures will soon be analyzed by BioFire, including those which are resistant to three different types of antibiotics.
- Cepheid GeneXpert is another method to detect tuberculosis in a mere two hours from the direct specimen—another medical miracle! When I started in medicine more than 45 years ago, if you couldn’t identify the tuberculosis bacilli in the sputum under a microscope, you were forced to wait six weeks for the culture to grow and subsequently be identified. But today, two hours. Wow! Drug resistance, another significant problem, also can be recognized early so treatment can be adjusted. This will help avoid excess or inadequate treatment.
Each of these new technologies is first validated by taking existing positive cultures, identified with conventional technologies, and simultaneously testing them with the new technology to make certain there is agreement.
Coming soon is a gastrointestinal panel, which includes norovirus and parasites. Also on the horizon are a lower respiratory panel and a panel for meningitis. All will allow for a diagnosis within one hour. We are rapidly becoming a “Stat” micro-lab, denoting the quick-turnaround (from the Latin statim for “immediately”). Again, unheard of when I started in medicine. In those days, we treated first empirically and then waited for confirmation. There were always unexpected surprises. Now, our lab results, when verified by our experienced microbiology lab technologists, are added instantly to a patient’s electronic medical record, immediately available to all those caring for the patient.
Medicine has come so far in such a short time. One example is our “Star Trek” laboratory technology at NCH, which is way ahead of other hospitals across the nation. Our lab technology is another leading agent of change, helping all of us live longer, happier, and healthier lives.
Allen S. Weiss, M.D., President and CEO
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