Microbiology Newsletter July 2018

 

NEW SCHEMES

 
Due to the high morbidity and mortality rates associated with cryptococcal infections, in particular meningitis, rapid and accurate cryptococcal antigen detection tests are necessary to identify infected persons as early as possible leading to better patient treatment and prognosis.

Detecting cryptococcal antigen is the standard first-line in diagnosing cryptococcosis. Latex agglutination (LAT) and enzyme immunoassay (EIA) are commonly used in diagnostic and reference laboratories while lateral flow assay (LFA) is also used as a point of care test (POCT).

After successful pilot studies conducted in 2016/2017 involving participating laboratories worldwide, UK NEQAS are pleased to have distributed the first panel in July 2018. The first distribution dispatched involved 76 participating laboratories with a two week return of results period.

The results will be analysed, method data collated and the report will be published on the UK NEQAS website to allow participants to monitor and compare their own performance.

The scheme consists of three distributions per year, with two specimens per distribution.

To enrol for participation in this scheme please visit our website at www.ukneqasmicro.org.uk or email us at organiser@ukneqasmicro.org.uk for registration and for any further enquiries

 

Accrediting body recommendation:: 
If your laboratory provides the service, you should participate in the EQA

 

Fungal diseases kill more than 1.5 million and affect over a billion people  worldwide. Due to more aggressive medical care, including immunosuppressive therapy and ICU care has greatly increased the population of patients at risk of invasive fungal infection (IFI).
The most widely used diagnostic techniques have low sensitivity and are time consuming, which has resulted in a need for faster methods with greater sensitivity.

Most pathogenic fungi (except Cryptococcus and Mucoraceous moulds) have (1-3)-beta-D-Glucan (BDG), a polysaccharide in their cell walls and minute but detectable quantities are released into the circulation during infection. Detection of elevated levels of BDG is an aid to the presumptive diagnosis of IFI in at risk patients. Although the kits high negative predictive value, the results have a greater impact in excluding IFD.

Direct communication from our participants and a plethora of publications have indicated an increased interest in performing BDG detection in the diagnosis of IFI. A questionnaire will be distributed to our participants registered for our mycology schemes in the September distributions, to ascertain the degree of interest to participate in the pilot studies. Look out for an update in our December newsletter. For now, any queries regarding the development of this EQA, please contact UK NEQAS for Microbiology at organiser@ukneqasmicro.org.uk

 

 

 

 

SCHEME UPDATES 


In the last newsletter we informed you that identification would no longer be part of the Antimicrobial Susceptibility (AS) scheme, so that the focus would be entirely on antimicrobial susceptibility testing. We also announced changes to the antimicrobial panel for Haemophilus influenzae. Participants should be aware that antimicrobial panels do change on an annual basis, in line with current advice from our panel of experts and following changes in EUCAST guidelines.

In the past, we have always treated the samples in this scheme as being from blood culture, which has limited our ability to quality assess some organism-antibiotic combinations, particularly for urinary tract infections. We are now (from April 2018) distributing organisms from a range of specimen types including blood (which will remain the dominant specimen type), CSF, urine, respiratory samples, swabs and faeces. Please be aware of the change as the range of agents (and in some cases the testing method) will differ from that used previously for the AS scheme. We intend that these changes will allow a broader range of scenarios and specimens to be tested as part of EQA.
UK NEQAS for Microbiology has introduced a one day workshop for healthcare and medical professionals who have little experience of handling and identifying clinically significant filamentous fungi.

Participation in the UK NEQAS Mycology Teaching Workshop will help increase accuracy of identification skills and confidence in reporting for a range of fungi. This teaching programme is intended to complement the educational aspects of the UK NEQAS for Microbiology Mycology Scheme.

Delegates have the opportunity to examine fungal cultures and identify characteristics of the isolates via phenotypic and microscopic techniques. The day encompasses clinically significant fungal pathogens including: Aspergillus spp, mucoraceous moulds, dermatophytes and non-dermatophytes.

UK NEQAS for Microbiology delivered its first one-day workshop twice in September 2017. The feedback from questionnaires received from 77 of the 80 delegates deemed the workshop a huge success. Due to overwhelming interest, the one-day workshop will be held again this year on three separate dates.

Venue: University of Westminster, London
Date: 11, 12 and 13 September 2018.

 
This course has proven so popular that unfortunately we are fully subscribed. It is strongly recommended to express interest in attendance during annual re-registration (January-February) of our schemes to avoid disappointment.
The scheme remains in pilot status, with the primary function of the scheme being to support continuing professional development (CPD). Accordingly, a wide range of topics continues to be covered by the scheme. However, while the scheme continues in pilot status, there is no formal performance monitoring by the Scheme Organiser. A £60 charge was introduced for the scheme from April 2018 and 311 participants have re-registered. Participants continue to declare only a few of the distributions to be ‘out of scope’ for their practice, and this is mainly where virologists do not attempt the microbiology scenarios. Mean participation for each distribution from January to May was 197 (range 173 to 214).
The format for questions and answers continues to be multiple choice, with 2 to 4 MCQs for each topic. This format allows individual scores to be provided to participants, however there is currently no formal performance monitoring by the Scheme Organiser while the scheme is in pilot status. For a question to be scored 80% participants must agree with the scheme panel’s intended answer (and there must be no good evidence provided by participants that the intended answer is incorrect). Most questions in the scheme have been suitable for scoring and concordance of results for the period April to September can be seen in the figure. The new format also allows records of participation to be provided to individuals, as evidence that can be used to support appraisal and revalidation (for UK medical specialists).
Table. Topics covered by the Interpretive Comments scheme during 2018
Distribution Topic Topic area
January Syphilis serology Sexual Health
February Prostate biopsy Urology
March VZV in pregnancy Obstetrics
April Possible cutaneous diphtheria SSTI
May Neonatal chlamydia Paediatrics
June Helicobacter pylori in pregnancy Gastroenterology

 

 The December 2017 ‘distribution’ was a survey which sought feedback on seven distributions (Microbiology and Virology) during the period April to October 2017. There were 408 registered participants by December 2017. 110 (95%) respondents to the survey were from the UK and the main specialities of respondents were Medical Microbiology (92%) and Virology (8%).

  • 98 (92%) of respondents indicated that the range of topics was ‘about right’; two participants felt it was ‘too wide’ and one that it was ‘too narrow’. Five respondents made free text comments about the scope of topics, but there were no particular themes arising.
  • 67 (58%) of the participants indicated that the format and detail of the case information were ‘good’; 42 (36%) ‘satisfactory’; and 3 (2.6%) ‘poor’. Three respondents made free text comments about the format of case information, but there were no particular themes arising.
  • 51 (44%) participants indicated that the format of the questions was ‘good’; 56 (48%) ‘satisfactory’; and one (0.8%) ‘poor’. Eight respondents made free text comments about the format of case information. Themes arising were ambiguity of questions/answers (5), brevity of answers (2) and a suggestion to provide answers immediately (1).
  • The overall level of difficulty of the cases was ‘about right’ according to 87% (101/116) participants. Two (1.7%) respondents indicated that the level of difficulty was ‘too easy’ and one (0.86%) ‘too difficult’. Twelve respondents made free text comments about the format of case information. Themes arising were scope of practice impacting on difficulty (4), variable level of difficulty (4) and personal experience impacting on difficulty (2).
  • 70 (60%) participants indicated that the format of the reports was ‘good’; 39 (34%) ‘satisfactory’; and three (2.6%) ‘poor’. Five respondents made free text comments about the format of case information, but there were no particular themes arising.
  • Since there has been debate recently about scoring and performance monitoring in interpretive EQA schemes, participants were asked ‘What is your personal view about whether the scheme should continue with scoring and performance monitoring?’. 89 (77%) indicated that scoring and performance monitoring should continue and 27 (23%) indicated that it should stop.
 
The survey results, including individual comments, are helpful in understanding how the scheme is viewed by participants and are considered during the running and development of the scheme. A clear majority of respondents indicated that the topics and level of difficulty are about right. However, they also indicated that there may be potential to improve the format and detail of the case information, the format of the questions and the format of reports.

Accreditation 

A Maintenance of UK NEQAS for Microbiology’s accreditation to ISO 17043:2010 was granted by UKAS for another year after a highly successful surveillance visit in May. Responses to our applications for extension to scope are awaited. These were submitted last year for the Viral gastroenteritis, Fungal biomarkers and Molecular detection of respiratory viruses schemes. The recent surveillance visit for UK NEQAS for Parasitology was also given a recommendation for continued accreditation. Both sections of this UK NEQAS division are operated by Public Health England.

Good News

Professor Peter Chiodini, who is the scheme organiser for our parasitology EQA schemes since 1986, was recognised for his services to parasitology and malaria and awarded an OBE  in the Queen’s Birthday Honours.

Professor Chiodini is consultant parasitologist at the Hospital for Tropical Diseases, and holds various senior positions including being the Director of the PHE Malaria Reference Laboratory and the PHE National Parasitology Reference Laboratory.

Professor Chiodini is thrilled at receiving this award and very proud that the work of UK NEQAS Parasitology has been recognised in this manner. He stated; “many years ago, Sir William Osler said- “As is our pathology, so is our practice." This remains the case and modern medicine depends on high quality diagnostic tests. Our mission in UK NEQAS Parasitology is to ensure that standards are maintained and raised yet further, ensuring our ability to detect and treat the whole range of parasites that present to us.”

Expression of Interest

The Chair of the steering committee for the Microbiology division of United Kingdom National External Quality Assessment Service (UK NEQAS), Prof Peter Hawkey, is inviting applications from qualified clinical scientists to join as a member of the Steering Committee for UK NEQAS - Microbiology division. The Steering Committee members are independent experts that advise UK NEQAS on schemes.
 
About membership to UK NEQAS Microbiology division
 
The member of UK NEQAS - Microbiology division will be an expert in the field of microbiology and will provide advice on formulation and delivery of new EQA. 
The steering committee member will also need to work collaboratively with the Chair, other members of the Microbiology Steering Committee, the different special advisory groups depending on area of expertise (VSAG, ASTAG), the Director of UK NEQAS for Microbiology, the different scheme organisers and managers to provide strategic advice and challenges.
 
Members of the Microbiology Steering Committee have an important role in contributing to the Committee’s discussion and his or her independence must be beyond question. The member should not be employed by, or receive personal remuneration from industrial organisations or pressure groups that can have an impact on EQA delivery during his or her term of appointment.
 
Committee members and the Chair do not receive a salary but they can claim for reasonable travel expenses for attendance of meetings.
 
How to apply - Closing Date 31 August 2018
 
If you are interested to join the Microbiology Steering Committee of UK NEQAS, please send your current curriculum vitae and a covering letter to Dr Sanjiv Rughooputh, who will also be very happy to answer any further questions that you may have.

Contact: Dr Sanjiv Rughooputh
Director  UK NEQAS for Microbiology
National Infection Service, Public Health England
61 Colindale Avenue, London, NW9 5EQ
Email: sanjiv.rughooputh@phe.gov.uk
Tel :(+44) 0208 327 6913

About UK NEQAS Microbiology Division 


UK NEQAS Microbiology division (http://www.ukneqasmicro.org.uk)  (UK NEQAS for Microbiology, Parasitology and Antibiotics assays) was established in 1969 providing external quality assessment service in the field of Microbiology. It forms part of UK NEQAS, (https://ukneqas.org.uk) a consortium of EQA providers in the UK. UK NEQAS is a not for profit organisation. The income generated by participants' subscriptions is used to for the delivery of schemes the participants subscribe to and for the development of new EQA schemes for the interest of patients.
 
Currently there are more than 50 UKAS accredited schemes to the ISO/IEC 17043:2010 standards that are offered. There are several new schemes under development.
The Chair of the steering committee for the Microbiology division of United Kingdom National External Quality Assessment Service (UK NEQAS), Prof Peter Hawkey will be stepping down in November 2018 after leading the committee for numerous years. Prof Hawkey is inviting applications to join as Chair of the steering Committee for UK NEQAS Microbiology division. The Steering Committee members are independent experts that advise UK NEQAS on schemes.
 
About the  Chair for UK NEQAS Microbiology division
 
The Chair of UK NEQAS Microbiology division will be an expert of national or, ideally, international standing, preferably in the field of microbiology. The successful candidate will lead the formulation and delivery of new EQA. 
The UK NEQAS Chair will also need to work effectively with the Microbiology steering committee, UK NEQAS board of trustees, the different special advisory groups (VSAG, ASTAG), the Director of UK NEQAS for Microbiology, the different scheme organisers and managers to provide strategic advice and challenges. 
The Chair of the Microbiology steering committee has a vital role in guiding and communicating the committee’s discussion and his or her independence must be beyond question. The Chair of the Microbiology Steering Committee should not be employed by, or receive personal remuneration from industrial organisations or pressure groups that can have an impact on EQA delivery during his or her term of appointment.
 
Committee members and the Chair do not receive a salary but they can claim for reasonable travel expenses for attendance of meetings.
 
How to apply - Closing Date 31 August 2018

If you are interested in being considered for this post, please send your current curriculum vitae to Prof Peter Hawkey


Contact: Professor Peter M Hawkey BSc, Phd,DSc, MBBS, MD, FRCPath, FFPath, FRCPI
Professor of Clinical and Public Health Bacteriology,
Institute of Microbiology and Infection,
University of Birmingham,
B152TT, UK
Tel: +44 (0) 121 414 3113,
Mobile: 07764285879
Email: p.m.hawkey@bham.ac.uk and CC belinda.stobbs@phe.gov.uk


About UK NEQAS Microbiology Division 


UK NEQAS Microbiology division (http://www.ukneqasmicro.org.uk)  (UK NEQAS for Microbiology, Parasitology and Antibiotics assays) was established in 1969 providing external quality assessment service in the field of Microbiology. It forms part of UK NEQAS, (https://ukneqas.org.uk) a consortium of EQA providers in the UK. UK NEQAS is a not for profit organisation. The income generated by participants' subscriptions is used to for the delivery of schemes the participants subscribe to and for the development of new EQA schemes for the interest of patients.
 
Currently there are more than 50 UKAS accredited schemes to the ISO/IEC 17043:2010 standards that are offered. There are several new schemes under development.

 

INTERNATIONAL MEETINGS


The 28th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2018), was held in Madrid, Spain on the 21-24 April 2018. More than 12,000 participants from around the world attended, with more than 3,000 abstracts presented at the congress as oral sessions, posters, or e-Posters. Five members of staff from UK NEQAS for Microbiology & UK NEQAS for Parasitology were successful in having abstracts accepted, and presented two e-Posters (one with an oral session), two posters and one oral session on the following topics:
 
 

The EARS-Net study and Commercial assays detecting HPV genotypes data were selected as e-posters and provided the option for delegates to view the posters throughout the duration of the four day conference. The EQA study on Cryptococcal antigen detection was presented as a paper poster and this provided an excellent opportunity to meet with delegates and potential participants.

The primary objective for attending this international conference, was to present our work but to also have the occasion to attend the plethora of excellent and exciting presentations on topics of interest.

UK NEQAS MEETINGS

The UK NEQAS consortium meeting will be on 14 and 15 November 2018 in Birmingham.

UK NEQAS Microbiology Annual Scientific Meeting 2018
UK NEQAS - Microbiology Division Scientific User Day Meeting for 2018 will be held on Friday 30 November, at the Holiday Inn Bloomsbury, London WC1N 1HT.

The theme for 2018 is: ‘Rapid Diagnoses Matter to Us’

 
This full day meeting includes prominent speakers on a wide range of topics including a review of current technology, future developments, hot clinics, practiced examples of the fields of microbiology and antimicrobial resistance and the value of rapid diagnoses. There will be the opportunity to meet staff involved in the delivery of the bacteriology, mycology, antibiotic assays, virology and parasitology schemes. Delegates will also be able to visit several manufacturers’ stands during the meeting.
 
Please email userday@ukneqasmicro.org.uk for further details, including cost and registration.
 
All at UK NEQAS for Microbiology look forward to seeing you there.

New Staff

Jane Appiah - Health & Safety and Training Manager 

Josephine Fitzpatrick - Administrative Assistant 

Natasha Galloway - Healthcare Scientist Specialist 

Binta Hanakuka - Healthcare Scientist Practitioner

Muna Jama - Healthcare Scientist Assistant

Vuyelwa Nkomo - Healthcare Scientist Practitioner

Diana Southern - Laboratory Support Staff

Aneta Stranc - Deputy Quality / Project Leader

Irena Venn - Healthcare Scientist Practitioner

Katie Wright - Healthcare Scientist Team Manager

 

The Operations' team members are:

Mr Ushmanthe Arachchige

Mrs Rinu Bandopadhyay

Miss Josephine Fitzpatrick

Mrs Nazma Kadri

Mrs Vay Mistry

Mr Vipul Sharma

 


Please contact our Operations team if you have any customer queries on: organiser@ukneqasmicro.org.uk