Among laboratories diagnosing gastrointestinal infectious (GI) disease, there is strong interest in moving from stool cultures to more modern approaches. After all, advanced molecular testing (such as nucleic acid amplification tests (NAATs) and PCR) offer significant benefits for patients, clinicians, and lab professionals alike [1].
But making the switch from conventional tests to newer molecular technologies is a multi-step process that can be daunting. Before proceeding, decision makers need to address several fundamental questions, including:
- Which type of molecular assays will be the most beneficial?
- Will lab staff need additional training to be able to implement these new tests successfully?
- What impact will molecular platforms have on reimbursements?
- How will new diagnostic methodologies integrate with legacy laboratory information management systems (LIMS)?
- How will enteric molecular assays change the lab’s outbreak response?
In a new webinar, Dr. Michael Perry, Deputy Lead Scientist, UK Anaerobe Reference Unit, Public Health Wales Microbiology Cardiff, University Hospital of Wales, tackles each of these issues (and more) head-on, offering valuable insights gleaned from the modernization of his unit’s enteric lab, which has been serving patients for more than a decade.
As Dr. Perry explains, the Anaerobe Reference Unit has long played a vital role in the UK’s preparedness for major global events. Indeed, it was planning for a global athletic competition in 2012 and a NATO Summit in 2014 that exposed the shortcomings of conventional culture microscopy and ultimately prompted his group to look for more effective and efficient testing technologies, he says.
PCR testing improves turnaround times, sensitivity, efficiency, and clinical relevance
Dr. Perry’s group has conducted multiple comparative analyses since demonstrating that NAATs can offer marked advantages across parameters. In the webinar, he notes the potential benefits of GI PCR panel testing are wide ranging, including, “improving our turnaround time somewhat significantly for some of our targets, increasing our sensitivity, increasing and broadening our pathogen coverage, certainly improving our labor efficiency, making our processes much more lean than they were at that point, augmenting the clinical relevance of our testing in terms of our positive and negative predictive values, and enabling us potentially to look at syndromic testing using large multiplex methods.”
The final portion of the webinar is devoted to key considerations for the implementation of GI PCR panel testing — from the patient’s, lab professional’s, and clinician’s perspective. Acknowledging that the complexity and variety of molecular testing options has increased dramatically over the past 10 years, Dr. Perry also shares several tips to help ease the transition from stool culture to more modern technologies. One of his top recommendations is to take the time to thoroughly research available testing options, liaising with clinical teams and other stakeholders, including industry partners.
Benefits of Molecular Testing with a GI PCR Panel
| Conventional Culture-based Testing | Molecular Testing |
|---|---|
| Slow turnaround times | Improved turnaround times |
| Suboptimal sensitivity/specificity | Increased sensitivity |
| Limited pathogen coverage | Broader pathogen coverage |
| Labor intensive and skill-rich processes | Lean and efficient labor processes |
| Requirement for multiple samples/sample separation | Results with augmented clinical relevance |
| Numerous, fragmented and confusing laboratory workflows | Syndromic testing enabled with multiplex methods |
“Engage very early with industry partners,” he advises. “Invite them to come and talk to you about what they have to offer and explain to them what you’re looking for. That will help the procurement process to be a lot more smooth and to make that as efficient as possible.”
To learn more about how advances in molecular testing platforms are changing the way GI diseases are diagnosed and to better understand how your lab can efficiently and effectively transition from conventional to more modern approaches, watch Talking diagnostics: A “culture” moving to PCR on demand. The webinar offers a blueprint for replacing stool culture with PCR diagnostics and features practical advice for lab modernization, including key considerations for reimbursement strategies and ways labs can increase their readiness to respond to outbreaks.
To learn more about the clinical value of molecular testing, please visit here.