OBJECTIVETo compare different techniques of endoscope sampling to assess residual bacterial contamination.DESIGNDiagnostic study.SETTINGThe endoscopy unit of an 1,100-bed university hospital performing ~13,000 endoscopic procedures annually.METHODSIn total, 4 sampling techniques, combining flushing fluid with or without a commercial endoscope brush, were compared in an endoscope model. Based on these results, sterile physiological saline flushing with or without PULL THRU brush was selected for evaluation on 40 flexible endoscopes by adenosine triphosphate (ATP) measurement and bacterial culture. Acceptance criteria from the French National guideline (<25 colony-forming units [CFU] per endoscope and absence of indicator microorganisms) were used as part of the evaluation.RESULTSOn biofilm-coated PTFE tubes, physiological saline in combination with a PULL THRU brush generated higher mean ATP values (2,579 relative light units [RLU]) compared with saline alone (1,436 RLU; P=.047). In the endoscope samples, culture yield using saline plus the PULL THRU (mean, 43 CFU; range, 1–400 CFU) was significantly higher than that of saline alone (mean, 17 CFU; range, 0–500 CFU; P<.001). In samples obtained using the saline+PULL THRU brush method, ATP values of samples classified as unacceptable were significantly higher than those of samples classified as acceptable (P=.001).CONCLUSIONPhysiological saline flushing combined with PULL THRU brush to sample endoscopes generated higher ATP values and increased the yield of microbial surveillance culture. Consequently, the acceptance rate of endoscopes based on a defined CFU limit was significantly lower when the saline+PULL THRU method was used instead of saline alone.Infect Control Hosp Epidemiol 2017;38:1062–1069

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The antiphospholipid syndrome (APS) is defined in a patient if at least one clinical and one laboratory criterion are fulfilled. The clinical criterion is characterized by the manifestation of recurrent vascular thrombosis and/or pregnancy morbidity. For the presence of the laboratory criterion, antiphospholipid antibodies (APA) must be demonstrable in patient's plasma on two or more occasions at least 12 weeks apart. As the incidence of the clinical symptoms is high and symptoms may be attributable to many other underlying factors, diagnosis of the APS relies mainly on the laboratory criterion.The laboratory detection of aPL consists of phospholipid-dependent coagulation tests for the detection of lupus anticoagulant (LAC) and immunoassays for the measurement of anti-cardiolipin antibodies Abstract Introduction: Lupus anticoagulant (LAC) testing is a multistep procedure including screening, mixing, and confirmation tests. STA Coag Expert is a software module for STA R Max and STA Compact Max analyzers which includes an on-demand LAC algorithm, based on ISTH guidelines, for automatic interpretation, calculation, and launch of assays in LAC interpretation ("Stago coag algorithm"). Materials and methods: One hundred ninety four patient samples were analyzed in parallel and interpreted manually and automatically by LAC algorithms. LAC algorithms use identical flowcharts and cutoff values as in daily practice. Differently, it only uses index of circulating anticoagulant (ICA), whereas in routine also normalized ratios were assessed for interpretation of mixing tests. Interpretation of dRVVT and aPTT pathways and final conclusions were compared between both approaches. Results: Compared to routine interpretation, LAC algorithm showed a sensitivity of 94% and a specificity of 100% for LAC detection, when discrepancies due to measured clotting times between both analyzers were excluded. Three false negatives were due to different interpretation of dRVVT mixing test. Discrepancies in interpretation of the aPTT mixing test (n = 11) did not result in discrepant final LAC result, all having negative confirmation tests. No false positives were observed. With LAC algorithm, hands-on time reduced from 200 to 80 minutes. Conclusion: The LAC algorithm of the STA Coag Expert shows good comparability to the manual interpretation of LAC and may be used to assist laboratories in automatic launching of additional tests and in interpretation of LAC according to ISTH guidelines. This way the STA Coag Expert LAC algorithm may improve interlaboratory and STA comparability of LAC results. K E Y W O R D S evaluation, lupus anticoagulant, lupus anticoagulant algorithm, rules engine, STA R Max | 413 How to cite this article: Florin L, Desloovere M, Devreese KMJ. Evaluation of an automated algorithm for interpretation of lupus anticoagulant testing. Int J Lab Hematol.

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Objective In this study, the performance of 2 commercially available SARS-CoV-2 antibody assays is evaluated. Methods The Siemens SARS-CoV-2 Total (COV2T) and IgG (COV2G) antibody tests were evaluated on a Siemens Atellica IM1300 analyzer. Imprecision was assessed with the CLSI EP15 protocol using positive controls. Ninety control group specimens were analyzed for specificity, and 175 specimens from 58 patients with polymerase chain reaction–confirmed SARS-CoV-2 were measured for the sensitivity and kinetics of the antibody response. Results Within-run and total imprecision were acceptable for both assays. Both tests showed a specificity of 100%. Sensitivity earlier in the disease state was greater for the COV2T assay than for the COV2G assay, but sensitivity &gt;14 days after onset of symptoms approached 100% for both. For all patients, antibody titers remained above the seroconversion cutoff for all follow-up specimens. Conclusion This study shows acceptable performance for both the Siemens COV2T and COV2G test, although seroconversion occurs earlier with the COV2T test.

BackgroundSystemic sclerosis (SSc) and primary biliary cholangitis (PBC) are autoimmune diseases that may occur concomitantly and are both strongly associated with disease-specific autoantibodies. This study investigated the prevalence and fine specificity of PBC-specific serology (PBC-Ab) and associations with the SSc-subtypes and SSc-specific antibodies as well as the association with cholestatic liver enzymes. Furthermore, three different techniques for the detection of PBC-Ab were compared.MethodsSerum of 184 Belgian SSc patients with a known SSc-antibody profile, was analyzed for PBC-Ab (antimitochondrial antibodies [AMA], anti-Gp210, anti-Sp100 and anti-PML) using indirect immunofluorescence (IIF) analysis on human epithelioma-2000 (HEp-2000) cells (ANA-IIF, Immunoconcepts) and liver-kidney-stomach tissue sections (IIF-LKS) (Menarini), and a line immunoblot (LB) (EuroImmun). Alkaline phosphatase/γ-glutamyl transferase (ALP/GGT) were evaluated at time of first sampling (t0) and after 3 years of follow-up (t3).ResultsPBC-Ab were present in 13% of patients and significantly correlated with centromere antibodies (anti-CENP-B), but not correlated with the limited cutaneous SSc subgroup (lcSSc). The most frequent reactivities were AMA (11%, with 9% AMA-M2) and Sp-100 antibodies (5%), showing a major overlap. There was no relevant association between the presence of PBC-Ab and ALP or GGT elevation at t0 nor at t3. Detection of AMA with IIF-LKS is comparable to LB. ANA-IIF screening was less sensitive compared to LB.ConclusionsA wide range of PBC-Ab is detectable in SSc in the absence of cholestatic liver enzyme elevations, even after 3 years of follow-up. However, as these antibodies may precede PBC-disease up to 10 years further prospective follow-up of our cohort will be necessary.

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