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The Changing Landscape of Tracking Infectious Diseases


Managing New Diagnostic Tests in Colorado 

Alicia Cronquist, RN, MPH, Foodborne Disease Program Manager, Communicable Disease Branch, Colorado Department of Public Health and Environment, Denver, shared some specific updates about how CIDT has affected surveillance and isolate recovery in Colorado.
“So far, in 2016, 40% of bacterial enteric cases reported were tested using PCR,” she said. And reflex culture was performed for 89% of the cases of Salmonella, Shigella, and STEC infection that were diagnosed using multiplex PCR testing.
According to Cronquist, routine survey of clinical laboratory methods began in 2009 in Colorado, as a way to ensure accurate case reporting. She highlighted that, although labor intensive, it is important to collect the appropriate information from laboratories. With this in mind, disease surveillance databases in the state have been modified to capture data from newer diagnostic tests, and so that electronic laboratory reporting data flow correctly. Education and communication have been critical aspects of the process to improve accuracy of case reporting, in particular to help reduce the problem of human error in interpreting multiplex panel results. For example, some laboratory personnel may be confused by certain microorganism names (such as Shigella and STEC), she noted, but personnel must be able to differentiate these bacteria when they report cases.
Cronquist also noted that the preferred policy in Colorado is to perform isolate recovery at the clinical laboratory. In particular, this produces results more quickly, reduces concern about transport of raw specimens, and means that susceptibility test results are available more quickly for improved patient care
Clinical materials may also be sent to state public health laboratories for further characterization, especially in the case of priority pathogens such as STEC, Salmonella, Shigella, and Vibrio are priority pathogens, she added. In order to facilitate rapid transport of such specimens from clinical laboratories, the state public health laboratories provide a courier service and transport media, as well as written guidance based on studies performed by the Association of Public Health Laboratories.

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