EH 2_2016

LABORATORY Automatic tasks: inoculation of patient specimens, sorting, imaging, processin Company banishes white from medical New tube with powder additive aids diabetes diagnoses Fast, efficient, cheaper microb Colour up yo Inhibiting rapid glucose breakdown Report: Sylvia Schulz Set up in the Department of Medical Microbiology and Hygiene, at Heidelberg University Hospital, the BD Kiestra TLA (Total Lab Automation) offers fully automated inoculation of patient specimens as well as sorting, imaging, processing and slides transportation to pre- defined work stations and diagnostic instruments, such as a mass spec- trometer. Sixty-eight systems have been installed worldwide; Germany has four in use in private microbiol- ogy labs. The ambitious aim is to offer results within 26 hours from receiv- ing the specimen – a major improve- ment over the 48 to 72 hours required today to identify a pathogen and test for possible resistances. ‘Currently available and feasible methods and hospital routines do not allow for further acceleration of microbiologi- cal diagnostics – this can only be achieved by automation,’ explains Professor Klaus Heeg, who is head of the Department. A month later, at the German Pavilion at ARAB LAB 2016 in Dubai, the firm was presenting lab personnel with this concept and reports: ‘We received a lot of questions: What’s high pressure laminate? What makes it eco-friendly? What kind of labora- tory furniture can be colour matched? Why is it antibacterial?’ Along with a ‘Colour up your lab’ leaflet, the company showed its his- to-pathology equipment, e.g. gross- ing tables, staining tables, prepara- tion cabinets, stainless steel furniture and more, and also presented a new brochure about exhaust systems for histo-pathologies. Leave behind those sterile white worlds However, Kugel was keen to point out that it not only manufactures this equipment but also provides plan- ning. ‘No matter if you’re looking for a partner for a sophisticated furnish- ing of an entire building complex or perhaps a partial fit out, we are your point of contact concerning the designing, developing and planning.’ Kugel is encouraging medical per- sonnel to leave those traditional ster- ile white worlds behind, stating that the ‘design possibilities are almost endless. The combination of different materials like wood with granite or the mixture of cold and warm tones gives your laboratory design that lit- tle extra something. ‘We do not limit ourselves to labo- ratory furniture and laboratory table plates, but rather we also colour Along with the increasing need to diagnose diabetes mellitus cases, gestational diabetes (GDM), the most common disease during preg- nancy, needs to be detected/ruled out at an early stage. If not identi- fied, GDM can lead to complications such as infections, premature births and long-term effects for the mother and child. However, the rapid breakdown of glucose (glycolysis) in venous blood samples complicates accurate diag- nosis of diabetes and can lead to a false negative result. Thus it is nec- essary to inhibit glucose breakdown immediately after blood collection. Various institutions, such as the Deutsche Diabetes Gesellschaft (German Diabetes Society),Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (German Society for Gynaecology and Obstetrics), and the American Diabetes Association have drafted guidelines, which rec- ommend the addition of a citrate- fluoride additive to maintain the ‘in vivo glucose level’. For this reason, Greiner Bio-One has launched a new tube, explain- ing: ‘The special feature of the new Vacuette FC Mix tube is the powder additive. It stabilises the glucose level immediately after collection for 48 hours. This allows a reliable diagnosis of diabetes conditions and avoids false negative analysis results. The stabilisation is carried out in the whole blood and therefore does not require immediate centrifuga- tion. Unlike in tubes where liquid is added, the finely granulated addi- The new system is not only expect- ed to speed up processes but also to increase safety and the quality of the results. The incoming specimens are prepared right away and processed after a defined incubation period. Whilst previously incubation times differed due to a wide variety of workflows, TLA offers a standard- ised procedure that provides homog- enous results and documents them – thus serving as a helpful quality assurance tool. Patients will benefit from lab auto- mation through faster treatment onset, e.g. antibiotics therapy, while the hospital expects to reduce length of stay. ‘With this new lab solution we want to show that even a uni- versity hospital can offer efficient, quick and inexpensive microbiology diagnostic services,’ says Irmtraut Gürkan, Commercial Director of the University Hospital Heidelberg. ‘Whenever a diagnosis is unclear, the patient is separated which hampers clinical workflows and binds capaci- ties. Thus a quick diagnosis is always desirable in terms of economics.’ match our preparation cabinets with the corporate identity of your labora- tory. All woods and raw materials that we use for our eco-friendly high pressure laminate solution come from sustainable managed forests with PEFC and FSC certificates. ‘Additionally, daily adjustments of production processes guarantee that 10 times less water and 40% less energy are used and 75 % of the waste is recycled or recovered. ‘During production of high-pres- sure laminate, fine paper layers as tive does not cause a dilution effect. There is no need to convert the measurement result.’ How the additive works ‘The citrate/citric acid buffer reduc- es the pH value in the sample,’ the manufacturer reports. ‘As a result, enzymes needed for the glycolysis process are inhibited and the actual “in vivo level” is stabilised from the start. The additive is completely dissolved, and therefore optimally mixed with the sample, after swivel- At this point, the hospital is leasing the lab solution, which comes with a price tag of €3 million, since public funding was denied. However, by the time the leasing contract runs out, the initial results of the study will be available – and hopefully support a second application for public money. ling ten times. In the case of storage between 4°C and room temperature, a further sodium fluoride additive ensures long-term stabilisation for 48 hours.’ The transparent PET plastic, shat- terproof tube comes with either a grey or pink security cap, allowing differentiation from standard glu- cose tubes. The cap is particularly easy to open and allows for hygienic working in the laboratory. Further details: www.gbo.com A fully automated clinical microbiology laboratory system went into service at Heidelberg University Hospital this April. Produced by the Dutch medical technology firm BD Life Science, this first installa- tion at a German university hospital will play a major role in a study exploring the potential benefits of lab automation in containing the spread of pathogens in a hospital This January, Kugel Medizintechnik, from Regensburg, Germany, announced an interesting new venture. Although a leading manufactur- er of equipment for pathology, histology and the laboratory for over 15 years, the firm launched its new Colour up your Lab design service. Color concepts in laboratories instead of sterile white In the new Vacuette FC Mix tube the glucose level is immediately stabilised after collection 18 EUROPEAN HOSPITAL  Vol 25 Issue 2/16

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