{"id":70676,"date":"2023-08-07T14:03:35","date_gmt":"2023-08-07T20:03:35","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=70676"},"modified":"2024-07-18T14:29:17","modified_gmt":"2024-07-18T20:29:17","slug":"automation-gets-microbiology-lab-infection-results-to-doctors-faster","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/automation-gets-microbiology-lab-infection-results-to-doctors-faster\/","title":{"rendered":"\u201cA lifesaver\u201d: UCHealth\u2019s investment in automation gets microbiology lab infection results to doctors faster"},"content":{"rendered":"
<\/div>
\"Some
Some samples still require a manual approach: UCHealth Medical Laboratory Scientist Zoe Austin examines a specimen in the University of Colorado Hospital Clinical Laboratory. The Kiestra ReadA Compact intelligent incubation and imaging system is in the background. Photos by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n

The microbiology team at the UCHealth University of Colorado Hospital<\/a>\u00a0Clinical Laboratory on the Anschutz Medical Campus<\/a> has always been a hard-working group, and they have had to be.<\/p>\n

Each day, about 650 patient samples of blood, urine, and other bodily fluids arrive via pneumatic tube and dumbwaiter from all corners of University of Colorado Hospital along with satellite hospitals and clinics. A high-stakes, multi-step process ensues to help doctors identify what is causing illness and to suggest doses of the antibiotics, antifungals, and other treatments that help patients beat what could otherwise be life-threatening infections.<\/p>\n

For decades, it\u2019s been a manual process. Now there\u2019s Kiestra<\/a>.<\/p>\n

\"In
In the UCHealth microbiology lab, an agar plate containing a patient sample, lower right, rides a Kiestra conveyor belt toward the closed-loop incubation and imaging system.<\/figcaption><\/figure>\n

Kiestra is a sleek microbiology lab automation system made by New Jersey-based BD. Its arrival in July 2022 was timely. Demand for the microbiology lab\u2019s expertise has grown about 10% a year for more than a decade, with no end in sight, says Veronica Broslawik, the lab’s manager.<\/p>\n

The recently opened new inpatient tower<\/a> will add 215 beds to the 678 in University of Colorado’s existing two inpatient towers when fully staffed next year. Plus there\u2019s an ongoing national shortage of microbiology-lab talent.<\/p>\n

UCHealth\u2019s roughly $3 million investment in Kiestra is already paying dividends, Broslawik says.<\/p>\n

\u201cMicrobiology is in its renaissance era, or its industrial revolution,\u201d she says. \u201cWe\u2019re able to leverage these technologies that were never applied to the field.\u201d<\/p>\n

\"UCHealth
UCHealth Clinical Laboratory Technician Griffin Epps, foreground, and Michael Scheu, a lead medical laboratory scientist, work on different aspects of the Kiestra system.<\/figcaption><\/figure>\n

The workflow in a microbiology lab<\/strong><\/h2>\n

The microbiology laboratory\u2019s pre-renaissance workflow went roughly as follows. Samples arrived in test tubes. Microbiology staff gave each sample a quick look under the microscope to see if there were obvious infections. If so, they can let the doctor know whether it looks like Serratia marcescens<\/em><\/a> or Pseudomonas aeruginosa<\/em><\/a> or Escherichia coli<\/em><\/a> or one of many other unwelcome bodily invaders. But that was just triage.<\/p>\n

Some test tubes got incubated in what looked like six big refrigerators but in fact, are kept at 98.6 degrees \u2013 body temperature. Others got hand-pipetted onto agar plates seeded with growth media. Assuming they were bacterial or yeast (fungi, less common, took a different path) the agar plates were hand-carried to a different incubator, where they would spend the next 18 to 24 hours letting the bugs multiply.<\/p>\n

The agar plates then landed in tall stacks on the desks of microbiology lab experts, who inspected them with microscopes and made their calls as far as what was happening \u2013 if anything was happening \u2013 on the plates and what a doctor should consider prescribing to counter it.<\/p>\n

Some samples headed to a Bruker MALDI-TOF<\/a> mass spectrometer that could identify microbes by determining how light bounces off their many proteins. These results would also be shared with doctors on the floors.<\/p>\n

\"Epps
Epps loads test tubes filled with patient samples into the Kiestra\u2019s front end in UCHealth’s microbiology lab. The system automatically pipettes them onto agar plates for incubation.<\/figcaption><\/figure>\n

New technology in UCHealth’s microbiology lab<\/strong><\/h2>\n

With Kiestra, the processes are mostly the same. They\u2019re just more automated. Kiestra does the pipetting into the agar plates for most samples. Via blue conveyors, it sends the plates to a 0Kiestra ReadA Compact intelligent incubation and imaging system. This is a closed-loop system that first incubates, then takes up to 22 photographs at 25 megapixels each, creating highly detailed composite images that microbiologists then inspect on a screen, panning and zooming as they please.<\/p>\n

That closed-loop matters, Broslawik says. The unavoidable, constant opening and closing of incubator doors drops the temperature and slows microbial growth. Kiestra cuts incubation time by six to eight hours.<\/p>\n

\u201cWe\u2019ve reduced the time our patients are waiting for the results a lot,\u201d Broslawik says.<\/p>\n

The MALDI-TOF is still identifying its microbes, but it\u2019s been joined by a Kiestra module that can test different antibiotics and antibiotic doses in samples to see what kills the microbes \u2013 known in the business as \u201csusceptibility.\u201d That combination of speed and better information in the physician\u2019s hands \u201cabsolutely can be a life-saver,\u201d Broslawik says.<\/p>\n

\"UCHealth
UCHealth microbiology lab Supervisor Emilie Predota describes the microbes she\u2019s inspecting on an image supplied by the Kiestra system. The system delivers composites of multiple 25-megapixel, close-up images.<\/figcaption><\/figure>\n

\u2018Amazing\u2019 technologies and lab automation<\/strong><\/h2>\n

Members of the 43-person microbiology lab team are fans of the new system. Liz Kassner, a microbiology lab supervisor in her 43rd<\/sup> year in the lab, says change happens in the field, and it has been for the better.<\/p>\n

\u201cThe technology that\u2019s come about in the last few years has just been amazing,\u201d she says. \u201cKiestra fits right into that.\u201d<\/p>\n

The automation lets her focus on what she views as her primary role: to use her skills and long experience to teach others the nuances of identifying what are often rare bugs.<\/p>\n

\u201cOur patients are very, very complicated. The kinds of organisms we isolate are unusual,\u201d Kassner says. \u201cYou wouldn\u2019t see these kinds of organisms in a community hospital\u201d<\/p>\n

Emilie Predota, a microbiology lab supervisor who has been with the lab for nine years, changes the brightness of a sample from a urine culture Kiestra had sent to her screen, zooms in, and marks bacterial colonies with a click-click-click. There\u2019s not an agar plate to be seen on her desk.<\/p>\n

\u201cI think it\u2019s made us more efficient in getting doctors their results,\u201d Predota says.<\/p>\n

Michael Scheu, a lead Medical Laboratory scientist, says Kiestra is improving consistency and efficiency while enabling the lab to do more with less.<\/p>\n

\u201cI think people fear that anytime the word \u2018automation\u2019 comes up, they\u2019re going to be out of a job,\u201d Scheu says. \u201cBut the truth of the matter is, we\u2019re opening a third tower. Our workload is not decreasing. We need assistance for all of us to do the work that we do.\u201d<\/p>\n

Broslawik agrees.<\/p>\n

\u201cIt takes the low-value-added things out so we can focus on the things we train to do as microbiologists,\u201d she says.<\/p>\n","protected":false},"excerpt":{"rendered":"

The microbiology team at the UCHealth University of Colorado Hospital\u00a0Clinical Laboratory on the Anschutz Medical Campus has always been a hard-working group, and they have had to be. Each day, about 650 patient samples of blood, urine, and other bodily fluids arrive via pneumatic tube and dumbwaiter from all corners of University of Colorado Hospital […]<\/p>\n","protected":false},"author":23,"featured_media":70682,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[586],"class_list":["post-70676","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-laboratory"],"acf":[],"yoast_head":"\nMicrobiology lab automation gets infection results to doctors faster - 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