Events during September 2023
CONGRESS 2023 - Career and qualification progression in virology
27/09/2023
The dynamic of virological diagnosis has transformed dramatically over the past few years in light of the Covid-19 pandemic, with significant changes to equipment and technology, workforce, workload and expertise. This presentation looks at those changes and focuses on the challenges observed and how these will continue over the coming years for virology departments across the country.
CONGRESS 2023 - Whats new in Diagnostic Cytology (Reporting systems; biomarker testing)
27/09/2023
Whats new in Diagnostic Cytology (Reporting systems; biomarker testing)
CONGRESS 2023 - How to train your dragon . . . not to harm your workforce
27/09/2023
How to train your dragon . . . not to harm your workforce
CONGRESS 2023 - Molecular Pathology Service Delivery in Cancer: Focus on Next General Sequencing
27/09/2023
NGS for molecular profiling of cancer in routine practice.
There is legitimate expectation that molecular profiling of cancers can bring precious information to guide the treatment.
The clinically relevant alterations are of varied types: gene mutations, copy numbers, rearrangements, but also protein levels of expression. Profiling of tumours in routine practice is complex logistically, due to the high number of patients and targets, the small size of the samples and the quick turn around time required. An exhaustive assessment requires a variety of platforms.
Furthermore, it becomes relevant to repeat profiling on tissue and on blood during the patient’s treatment.
Next Generation Sequencing (NGS) offers the possibility of multiplex testing, with high sensitivity and specificity. There are multiple approaches: whole genome sequencing, whole exome sequencing and panels of varied sizes.
In practice, the focus is to concentrate on providing an exhaustive clinically relevant assessment for all patients, which is guided, for each type of tumour, by WHO and NICE or equivalent guidelines.
There has been initially an excess of enthusiasm about what NGS could offer in routine practice; the technology had yet not reached the stage of being implementable within clinical practice without significantly destabilising the management.
However, thanks to significant improvement, including automation of the process, efficient IT and Bioinformatics, NGS is now safely implementable.
Pending a coherent political and funding approach, molecular diagnostic laboratories are able to provide high throughout sequencing of tumours on real life tissue samples and on blood.
It is important to mention that the molecular diagnostic laboratories also need to maintain single gene testing, immunohistochemistry, FISH and to implement artificial intelligence based assays on tissue, which will be essential and complementary to NGS testing.
The results of the molecular profiling will need to be transcribed in a comprehensive, integrated and clinically relevant report.
There is legitimate expectation that molecular profiling of cancers can bring precious information to guide the treatment.
The clinically relevant alterations are of varied types: gene mutations, copy numbers, rearrangements, but also protein levels of expression. Profiling of tumours in routine practice is complex logistically, due to the high number of patients and targets, the small size of the samples and the quick turn around time required. An exhaustive assessment requires a variety of platforms.
Furthermore, it becomes relevant to repeat profiling on tissue and on blood during the patient’s treatment.
Next Generation Sequencing (NGS) offers the possibility of multiplex testing, with high sensitivity and specificity. There are multiple approaches: whole genome sequencing, whole exome sequencing and panels of varied sizes.
In practice, the focus is to concentrate on providing an exhaustive clinically relevant assessment for all patients, which is guided, for each type of tumour, by WHO and NICE or equivalent guidelines.
There has been initially an excess of enthusiasm about what NGS could offer in routine practice; the technology had yet not reached the stage of being implementable within clinical practice without significantly destabilising the management.
However, thanks to significant improvement, including automation of the process, efficient IT and Bioinformatics, NGS is now safely implementable.
Pending a coherent political and funding approach, molecular diagnostic laboratories are able to provide high throughout sequencing of tumours on real life tissue samples and on blood.
It is important to mention that the molecular diagnostic laboratories also need to maintain single gene testing, immunohistochemistry, FISH and to implement artificial intelligence based assays on tissue, which will be essential and complementary to NGS testing.
The results of the molecular profiling will need to be transcribed in a comprehensive, integrated and clinically relevant report.
CONGRESS 2023 - Monkeypox case management/infection control
27/09/2023
Monkeypox case management/infection control
CONGRESS 2023 - Can a laboratory investigate allergic reactions to COVID vaccines?
27/09/2023
Vaccinations to Covid 19 virus have been at the forefront of news headlines. One of the issues highlighted was the risk of adverse reactions, both allergic and non-allergic. This caused an influx of queries to Allergy services regarding patients who had suffered potential allergic reactions and posed the question, 'how can they be investigated'?
The laboratory has limited commercial assays to the components and excipients of vaccines. However, tests can potentially be modified or developed in-house to provide evidence of a potential allergy. They could also be utilised to determine if an alternative vaccination can be used. The testing strategy may need to be adapted on a case by case basis.
There is the potential that this could be used to develop a service for allergic reaction investigation for all vaccine types.
The laboratory has limited commercial assays to the components and excipients of vaccines. However, tests can potentially be modified or developed in-house to provide evidence of a potential allergy. They could also be utilised to determine if an alternative vaccination can be used. The testing strategy may need to be adapted on a case by case basis.
There is the potential that this could be used to develop a service for allergic reaction investigation for all vaccine types.
CONGRESS 2023 - Molecular Profiling of Acanthamoeba species directly from Ocular Tissue
27/09/2023
To explore the molecular profiles of Acanthamoeba from laboratory-confirmed Acanthamoeba keratitis (AK) cases reported within the United Kingdom (UK) using DNA taken directly from clinical samples.
Acanthamoeba species are free-living organisms responsible for causing a debilitating, sight-threatening disease of the cornea. Of the 24 known Acanthamoeba species, 14 cause AK.
Thirty-five Acanthamoeba DNA-positive corneal samples from the Scottish Microbiology Reference Laboratories (SMiRL), Glasgow collection were selected from cases reported from 2017 - 2019. Following extraction of the DNA directly from each clinical specimen, the DNA was subjected to in-depth molecular typing using a nested PCR / bi-directional sequencing approach.
Molecular profiling was successful for 32 samples which comprised of two genotypes namely T3 and T4. The T4 genotype were further sub-typed; five sub-types existed namely; T4A, T4B, T4C, T4E and T4F.
Using a molecular typing assay applied directly to corneal tissue, this study highlights the T4 genotype and the T4A subtype are the predominant molecular variants of Acanthamoeba to cause ocular disease in the UK. Gaining in-depth information on the molecular profiling of Acanthamoeba is essential to increase our knowledge and understanding of the epidemiology, transmission pathways and potential associations with clinical outcomes for this rare, yet potentially debilitating ocular disease.
Acanthamoeba species are free-living organisms responsible for causing a debilitating, sight-threatening disease of the cornea. Of the 24 known Acanthamoeba species, 14 cause AK.
Thirty-five Acanthamoeba DNA-positive corneal samples from the Scottish Microbiology Reference Laboratories (SMiRL), Glasgow collection were selected from cases reported from 2017 - 2019. Following extraction of the DNA directly from each clinical specimen, the DNA was subjected to in-depth molecular typing using a nested PCR / bi-directional sequencing approach.
Molecular profiling was successful for 32 samples which comprised of two genotypes namely T3 and T4. The T4 genotype were further sub-typed; five sub-types existed namely; T4A, T4B, T4C, T4E and T4F.
Using a molecular typing assay applied directly to corneal tissue, this study highlights the T4 genotype and the T4A subtype are the predominant molecular variants of Acanthamoeba to cause ocular disease in the UK. Gaining in-depth information on the molecular profiling of Acanthamoeba is essential to increase our knowledge and understanding of the epidemiology, transmission pathways and potential associations with clinical outcomes for this rare, yet potentially debilitating ocular disease.