Getting a jump on infections
Infection identification gets high-tech boost at Grand River Hospital
KITCHENER — New high-tech equipment in Grand River Hospital’s microbiology lab is speeding up identification of infections to get patients on the best treatment faster.
The Kitchener hospital is already making use of a biotyper that cuts identification times of various pathogens by at least a day, and it’s readying a new automated system for preparing specimens for analysis.
Both are quicker and more accurate than the previous methods — a plus for doctors and patients. Faster results mean doctors “can treat more appropriately sooner,” said Carol Ellis, senior medical laboratory technologist.
It’s also a boon for the busy microbiology lab, which tests nearly 165,000 specimens every year.
The biotyper has been a great addition to the lab to quickly identify bacteria, yeast and fungi.
“It’s the one machine I would never give back,” Ellis said.
Organisms from a patient specimen, such as a swab, stool or urine sample, are cultured and
then applied to a specialized target plate with little wells.
A solution is added to extract the proteins and then it’s hit with a laser to electrically charge the proteins, causing them to fly up a tube. That time is calculated to determine molecular mass, which is then compared to a large database to identify the organism. The whole process takes five to 10 minutes. Most organisms isolated from patient specimens take 24 to 48 hours to grow on a culture plate. Before the new machine, an additional 24 hours or more would be needed for identification.
That gets an answer to the doctor a day earlier, or a week for some specimens that had to be sent to a Toronto lab for testing. They’ve also used the machine for positive blood cultures, getting an answer in four hours rather 48 hours later.
Not only is it faster, “it’s more accurate,” Ellis said. “It’s looking at the molecular mass of the organism itself.”
The lab runs 60 to 70 organisms in a day, or about 25,000 tests a year.
“It’s changed the workflow quite a bit,” Ellis said.
The new plate streaker is poised to change that even more by automating another vital task in the lab.
The first step in determining what type of infection a patient is battling requires growing colonies of the organisms from fluid samples so they can be tested.
Before, a lab tech would open the sample bottle, dip a swab into the fluid and spread it across a petri dish, which would then go into an incubator to grow.
The new plate streaker automates the whole process.
A sample placed inside is opened, a small amount of fluid gathered and then added to a petri dish along with a small magnetic ball, which is drawn across the medium many times with a magnet.
“Way more sample is being spread out across the plate,” said Paula Young, senior medical laboratory technologist.
And it’s done exactly the same way every time, reducing the variability when done by hand, not to mention the repetitive strain lab techs were prone to considering this process is done in Grand River’s lab 100,000 times a year.
That precision means there are more isolated colonies to work with on each petri dish, making it easier to gather samples to test. When done by hand, sometimes the colonies are difficult to separate and need to be grown again — adding at least another day.
The automated streaker works like an assembly line, with the petri dish travelling along a conveyor for each step before ending in a pile ready to go in an incubator. It all starts with the sample and its label, which tells the machine what type of medium and incubation condition is needed.
“The arm picks up the sample. It reads the bar code,” Young said.