Catlab Reports Bulletin

Artificial intelligence applied to the diagnosis of urinary tract infections

Urinary tract infections (UTIs) are one of the most frequent reasons for medical consultation and one of the most common hospital-acquired infections. Urine culture is the reference test for their microbiological diagnosis; however, the large volume of samples processed makes it necessary to optimize their reading and interpretation in order to reduce turnaround times and improve clinical care.

The Microbiology laboratories of Catlab process tens of thousands of urine cultures annually, of which only a proportion are positive. In response to this reality, Catlab has embraced technological innovation by incorporating automated inoculation and incubation systems, as well as tools based on artificial intelligence.

In this context, the implementation of the UCA software (Urine Culture Application) stands out. This artificial intelligence application, integrated into the BD Kiestra™ system, enables the automatic analysis of urine culture images. UCA detects bacterial growth, performs a presumptive identification, calculates quantification, and integrates basic clinical data from the patient to standardize the interpretation of results.

This automation facilitates the early detection of positive cultures, speeds up result validation, reduces manual workload, and improves process traceability. Ultimately, the use of artificial intelligence in the diagnosis of UTIs makes it possible to deliver faster, more accurate, and more reliable results, contributing to more efficient and safer clinical decision-making.

Main pre-analytical incidents in emergency laboratory

According to the literature, the highest percentage of laboratory errors occurs in the preanalytical phase. These different incidents can have consequences at the clinical and economic levels, as well as affect patient safety.

The aim of this bulletin is to explain the incidents most frequently encountered in Catlab emergency laboratories, in order to raise awareness and help minimize errors

News of the UNE-EN ISO 15189:2023 standard : A paradigm shift for clinical laboratories.

In December 2022, twenty years after the first version, the 4th edition of the UNE-EN ISO 15189 standard was published. Developed and revised by a broad international consensus, this update emphasizes patient safety, risk management and operational flexibility. At Catlab, a process of adaptation to this standard has been followed, modifying the documentation and taking corrective actions to follow the new criteria specified in the standard.

Tumor markers and their usefulness in lung cancer

Catlab has recently added a range of tumor markers to our services portfolio, including a specific profile for lung cancer diagnosis. This bulletin presents a brief review focusing on the clinical utility of tumor markers.

The review begins with a general introduction to their application in oncology, before focusing specifically on lung cancer and the biomarkers that can contribute to its diagnosis.

Catlab User Satisfaction Analysis

During October and November 2024, Catlab conducted a new satisfaction survey targeting medical professionals at HUMT, CST, FHSJDM, and ICS. With 157 participants, results reflect a high level of confidence in analytical quality and communication with the laboratory.

The identification of strengths and opportunities for improvement is key to maintaining and enhancing service quality.

This report provides an overview of professionals' opinions and directs Catlab's next steps for improvement.

Immunophenotypic characterisation of Chronic Lymphoproliferative Disorders in our healthcare catchment Area: EuroFlow screening results from Catlab

Lymphoproliferative syndromes (CLPS) are neoplasms of mature B, T, or NK lymphocytes with clonal expansion and progressive accumulation in the blood, bone marrow, and lymph nodes. The WHO 2022 classification divides them into CLPS-B and CLPS-T/NK. Multiparametric flow cytometry is a key tool in the differential diagnosis between reactive lymphocytosis and CLPS through the analysis of the lymphocyte immunophenotype with fluorochrome-labeled antibodies. The Euroflow consortium designed the diagnostic algorithm that includes the Lymphoid Screening Tube (LST), a panel with 12 antibodies that allows the detection of phenotypic alterations in the different lymphocyte lines and their classification. Twenty-seven percent corresponded to CLL-B, 2% to CLL-T/NK, 3% were not assessable, and 6% were follow-up cases. Among SLPC-B, chronic lymphocytic leukemia (CLL-B) was the most common, followed by marginal zone lymphoma. As for SLPC-T/NK, the most frequently detected was large granular T-cell leukemia. The most prevalent entity is CLL-B, often detected in asymptomatic patients thanks to screening in routine blood counts. Overall, approximately one-third of the SLPCs performed showed aberrant phenotypes, reproducing the higher prevalence of SLPC-B over T/NK already described in the literature. Catlab expertise proves Euroflow LST as a fast and reliable tool for SPLC screening, facilitating referral to hematology and improving early detection in the population within our healthcare catchment area.

Alzheimer's disease: CSF and plasma biomarkers

Alzheimer's disease is a progressive neurodegenerative disorder that is the most common cause of dementia worldwide.

Biomarkers in CSF and plasma allow for diagnosis in preclinical and mild clinical stages of the disease, and in the future will be essential for monitoring neurological changes in response to drugs that prevent disease progression.

Contribution of diagnostic syndromic panels to emergency management Pediatric infectious: regarding an outbreak of Mycoplasma pneumoniae.

Atypical pneumonia is a common cause of respiratory infection in the paediatric population with Mycoplasma pneumoniae being one of the main aetiological agents. Rapid and accurate identification of M. pneumoniae is essential to guide antibiotic treatment, especially in the context of epidemic outbreaks, where clinical diagnosis may be non-specific. The introduction of multiplex syndromic panels in the emergency microbiology laboratory allows rapid and simultaneous detection of multiple pathogens. We have shown that this has a significant impact on antimicrobial prescribing in the paediatric population, reducing the unnecessary use of broad-spectrum antibiotics and favouring a targeted therapeutic approach, as the result is available in approximately 2 hours.

Procalcitonin and sepsis in critically ill patients

Sepsis is defined by the Sepsis-3 consensus as life-threatening organ dysfunction caused by a dysregulated host response to infection. Each hour of delay in diagnosis, attributable to failure to recognize it during patient admission, is associated with a 7% reduction in survival.

The need for early diagnosis has led to the search for a specific biomarker, which also allows risk stratification and prognosis and whose variation allows monitoring of subsequent evaluation. Procalcitonin (PCT) has revolutionized the management of sepsis, allowing a more accurate diagnosis and more efficient antibiotic management. This approach, combined with clinical strategies and the role of the laboratory, has significantly improved patient care.

The determination of PCT helps predicting bacterial infection, distinguishing it from viral infections and other inflammatory processes, and to differentiate between localized and systemic bacterial infection. It should not be used in isolation, but in combination with clinical evaluation and other microbiological data to make therapeutic decisions.

Multiple Myeloma: Genetic Study

Multiple myeloma (MM) is a hematologic cancer that affects plasma cells in the bone marrow, and chromosomal alterations are central to its diagnosis and prognosis. Genetic abnormalities include primary changes such as IGH gene rearrangements and secondary changes such as TP53 deletion, which influence survival and response to treatment. Prognosis is calculated using the international staging system (ISS), which is based on factors such as β2-microglobulin and albumin levels. Over time, revisions to the ISS have been developed to improve prognostic accuracy. The R-ISS adds the analysis of high-risk cytogenetic alterations such as t(4; 14), t(14; 16) and del(17p). Recently, the R2-ISS version incorporated the 1q gain alteration as a high-risk factor. These revisions help to tailor therapeutic strategies and improve patient outcomes. A key tool to identify these alterations is the fluorescence in situ hybridization (FISH) technique, which allows the detection of specific chromosomal abnormalities in plasma cells. At Catlab we perform the MultiFISH technique, which facilitates the analysis of the most relevant genetic alterations at once, improving diagnosis and personalization of treatment. In summary, the MultiFISH technique facilitates the detection of specific chromosomal alterations and guides the risk stratification,to provide personalized treatments and improve therapeutic response in patients with multiple myeloma.