Assessment of Improved Quality via the Adoption of Microbiology Automation
J Lau, J Larsen, T Grys, F Rice, E Graf- General Medicine
Abstract
Introduction/Objective
Our laboratory implemented a full COPAN WASPLab microbiology automation line in March of 2023. Prior to this implementation, our laboratory routinely observed potential bacterial contamination of sterile specimens, as well as culture plates in which the specimens were not struck out, due to a large number of new staff members and heavy workloads. Both of these quality issues directly impact patient care due to potential misleading or delayed results. We hypothesized that automation of the plating and incubation steps would reduce both of these quality issues significantly.
Methods/Case Report
Potential contamination and plates not struck were self-reported by technologists during pre- implementation (July 2022-Feb 2023) and post-implementation (Mar-Apr 2023) periods. Potential contamination was defined as one or two colonies of bacteria on a single agar plate, consistent with skin fora, from a normally sterile source specimen and reviewed by the Director for potential clinical correlation. Plates unstruck in the post- implementation period continued to include those manually set up. A 2 two proportion z-test was performed to compare pre and post implementation data.
Results (if a Case Study enter NA)
A total of 3,055 and 1,750 sterile source cultures were analyzed in the pre- and post-implementation periods, respectively. Of these, 109 versus 8 were designated as potential contamination, respectively, resulting in a significant reduction (Z stat 6.7, p<0.0001). For the plate streaking portion, 22,814 and 7,211 cultures were analyzed in the pre- and post-implementation periods, respectively. Of these, 21 versus 3 plates were not struck, respectively, resulting in a greater than 2-fold reduction per culture, but did not meet significance.
Conclusion
Implementation of microbiology automation significantly reduced skin flora contamination of sterile source cultures. Proportions of unstruck plates were also reduced, although these did not meet significance, likely due to the low numbers.