Catlab Reports Bulletin
The Catlab Reports Bulletin is published monthly. Until the publication of the Catlab website, it was mailed electronically to our clients. It consists of a monograph related with laboratory topics. Each month it addresses a different area of Catlab; the topics can be more specific (concrete diagnostic techniques) or deal with more generic aspects (Quality, Management, …).
The use of rapid diagnostic tests are useful for the management of patients with acute pathology who consult in the emergency room,as long as we can change the therapeutic attitude. Indiscriminate use can lead to a misinterpretation of results.
In the microbiology area and paediatrics, we have drawn up a document with indications for use of the Filmarray™ respiratory panel in paediatrics.
Optimization of time and improvement in quality in the genetics service by automating tests with the ELITe InGenius analyzer
Genetics protocols are normally characterized by high complexity and multiple manual processes. Many of these protocols, such as those based on real-time polymerase chain reaction (qPCR), are similar to those used in the Molecular Microbiology section. Taking advantage of the fact that this section made progress in the acquisition of automated equipment due to the SARS-CoV-2 pandemic, the genetics section has proceeded to integrate a part of our activity into this equipment, achieving a substantial improvement in terms of reduction of response times, a reduction in both technical and medical dedication time, lower risk of pre- and post-analytical errors and better traceability of the entire procedure.
ISO 14001
implementation at Catlab. Challenges and opportunities
The climate context in which we find ourselves makes the awareness of all parties to confront it increasingly relevant. Thus, in Catlab, since 2017, an Environmental Management system aligned with the sustainable development objectives began to be implemented, culminating in the ISO14001 Environmental Management certification. During this period, various actions have been carried out, such as the analysis of the carbon footprint and an improvement action plan, aiming at continuous improvement through the application of risk and opportunity matrices reviewed annually.
Informed consent for genetic studies: array-CGH and exome sequencing
Genetic studies available nowadays provide a large amount of information, which can be complex, difficult to understand and assimilate.
In the genetics area of Catlab we have written a complete document, approved by the Healthcare Ethics Committee of the Mutua de Terrassa University Hospital, which contains the necessary information to guide both doctors and patients. This document also contains the consent itself, which must be signed, prior to obtaining the samples and their analysis, by both the patient and the health professional.
This document will be available to all professionals through HCIS, and will be recorded in the patient's medical history.
Antiphospholipid antibodies: detection and clinical relevance
In the laboratory, what classically defines Antiphospholipid Syndrome (APS) is the persistent presence of so-called antiphospholipid antibodies. These constitute a heterogeneous family of autoantibodies that are directed against proteins that intervene in the coagulation cascade and that have an affinity for phospholipids on cell surfaces. Antibodies with the greatest clinical relevance are those included in the laboratory requirements of the APS classification criteria. These antibodies, called classical antiphospholipid antibodies, are anti-cardiolipin and anti-β2-glycoprotein I of isotype IgG and IgM and lupus anticoagulant. In addition to these antibodies included in the classification criteria, antibodies against other phospholipids and cofactors, against specific domains of the cofactors or IgA isotype have also been described. These new antibodies, or non-classical antiphospholipid antibodies, have clinical significance yet to be established and their possible etiopathogenic role is much less known. Below we will review detection and relevance of these antibodies.
Role of Flow Cytometry in the Study of Lymphoplasmacytic Lymphoma
Flow cytometry represents a key tool for the differential diagnosis of Lymphoplasmacytic Lymphoma (LLP) along with other laboratory techniques since it is often difficult to reach a concrete diagnosis. For this reason in Catlab we have added the CD13 antibody in the CLPD-B study panel and we have made a retrospective internal review of its usefulness for the diagnosis of this entity.
Study of drugs of abuse in urine in the emergency laboratory. Protocol for suspected chemical submission
In Catlab hospital emergency laboratories, drugs of abuse are analyzed in urine using a rapid lateral flow immunochromatographic screening test.
It should be noted that this test provides a qualitative preliminary analytical result and has limitations that are important to be aware of. This article summarizes the main factors that can interact with this test to produce false-positive and false-negative results as well as the cut-off points and detection window for each substance.
High Performance Liquid Chromatography-Mass Spectrometry
Recently, and in collaboration with the Hospital Pharmacy Service of the Hospital
Mutua Terrassa University, a high-efficiency chromatography analytical system in tandem with a mass spectrometry detector (HPLC-MS) has been incorporated into Catlab.
This combination of analytical techniques will allow our laboratory to have,the considered, gold-standard method in clinical laboratory, and thus have the ability to measure analytes with great sensitivity and specificity. The study of immunosuppressants will be the first to make use of this technique and new ones will be added later.
Changes in the reporting of antibiotic susceptibility in the reporting of
microbiology New interpretation of susceptibility categories S, I and
R.
As of June 2022, the categories used to generate Microbiology culture sensitivity reports in Catlab have been modified in order to include the new recommendations of the European Committee for Antimicrobial Susceptibility Testing (EUCAST).
Thus the less problematic definitions Susceptible(S) and Resistant(R) remain, but the term Intermediate(I) disappears and the term Sensitive: Susceptible to Increased Exposure: S(EI) begins to be used. This new term refers to microorganisms where treatment will increase therapeutic success by increasing antibiotic exposure, dosage or concentration at the site of infection. At Catlab, the Microbiology department remains available to clarify any doubts.
Role of Monocytic subpopulations on the differential diagnosis of the Chronic myelomonocytic leukemia
Chronic myelomonocytic leukemia (CMML) is a clonal hemopathy characterized by persistent monocytosis in peripheral blood along with somatic mutations. In recent years, several studies have shown that specific variations in the percentage of monocytoid subpopulations can become a specific and rapid marker to differentiate CMML from other neoplasms or reactive monocytosis.
Catlab has internalized the study of monocytoid subpopulations, performed in the Cytometry department, to contribute to the differential diagnosis of this hematological neoplasm.