December 2020 Newsletter

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December 2020 Newsletter

Re-Registration April 2021 - March 2022

 

Online re-registration process for 2021 – 2022 for UK participants and overseas laboratories not served by distributors 

 

The 2021/22 online re-registration form for UK NEQAS for Microbiology will be available through the secure login area of our website from 05 January 2021.
Participants can review and amend their current participation requirements (please note, if no changes required submission of form is still required) confirming participation requirements for the new financial year.

Once re-registration details have been finalised the form should be submitted via the online portal.

Participants can amend the form multiple times up until the 12 February 2021. Once details are submitted an option to print or save updated information as a record is advised.

During the re-registration period of 05/01/21 and 12/02/21 participants are encouraged to make any change requests using the online form.
Re-registration for participants with a distributor shall be contacted by their distributor.

Yours sincerely

UK NEQAS Microbiology Operations team

 

UKAS 17043 Accreditation

UK NEQAS for Microbiology were due a full Reassessment audit for ISO 17043 (Proficiency Testing) this May 2020.

However due to the unprecedented climate with COVID-19, it was agreed to postpone the audit and reschedule for November/December 2020.

Challenging though it seemed, with social distancing measures to be maintained and no external visitors permitted on site, the audit was successfully conducted via a series of assessment interviews through virtual meetings over the several days scheduled.
We are happy to announce we have been granted continued accreditation pending resolution of some minor findings.

We are excited to announce that our two newly developed EQA schemes:

Gastrointestinal Virus scheme and CoV SARS-2 scheme will be undergoing Extension to Scope in the near future, to be established as fully accredited schemes.

UK NEQAS Parasitology Teaching Programme
Migrating to Online teaching

 

The UK NEQAS Parasitology Teaching Programme organises regional courses in different geographical areas throughout the UK and the Republic of Ireland. The regional venues cover the areas where UK NEQAS registered laboratories are situated. Currently, the following locations are used: Birmingham, Cardiff, Dublin, Dundee, Exeter, London, Preston, and Newcastle.

The teaching programme offers one-day practical courses covering faecal and blood parasites. The main objective of these courses is to provide both educational and practical support to registered participants.

Considering the current COVID19 pandemic, face to face teaching has either been suspended or seriously curtailed in terms of the numbers of students that can be taught in groups. This has meant that the UK NEQAS Parasitology teaching programme could not continue with its face-to-face teaching and has had to adapt to the changing circumstances. A very challenging task was how one goes about adapting the traditional face-to face laboratory sessions to teaching in an online environment allowing participants to continue to receive the same quality of teaching or learning experience they are used to.

The theoretical underpinning of my strategy to convert face-to-face teaching to online learning is based on Professor Gilly Salmon’s 5-step model of online and blended learning. Professor Gilly Salmon is a digital learning innovator and is currently Academic Director for Open Education Services in the UK and she is also affiliated with University of Western Australia. The 5-stage model provides a framework for a learning scaffold which is essentially a pedagogy (a journey of how teachers teach in theory and practice).

After months of preparation, the UK NEQAS Parasitology Teaching Programme transferred to the online environment on 21/9/20. Enrolment of participants is linked to the annual UK NEQAS re-registration process. Both the administrative and teaching work are handled in Microsoft Teams. Microsoft Forms is used for quizzes and feedback surveys whilst Microsoft OneNote is used to provide copies of the Faecal and Blood bench manuals.

About twelve 3-hour teaching sessions have been conducted so far, with 4 sessions remaining to finish the scheduled 2020 programme. Positive feedback has been received from all 12 teaching sessions, as shown by the following examples:

“This was a very good refresher in which I enjoyed participating.” Dublin participant 6/10/20.

“The instructor was clear and precise, the course was a little succinct but clearly communicated throughout. The instructor was also patient when there were a few technological difficulties. Overall a good course and the quiz was helpful. Guidance was appreciated in the form of page numbers from the manual!!” London venue participant 19/10/20

“The course was very helpful. I liked the fact that it was not a plain speech from the tutor but also involved participants.” Preston venue participant 26/10/20.

“Very enjoyable and informative event. A shame it could not be done as a face to face given the current situation and as such no ‘practical’ aspects were involved in the course, but the slides provided and the quiz were a great substitute. Many thanks.” Birmingham venue participant 4/11/20.

The 2020-programme ends on 18/1/2021 with Newcastle venue participants in attendance.

 

How do people learn and how do we teach them?

In my teaching job, I let people learn by letting them do something practical to reinforce what I have given them theoretically in the introductory lectures. I use the SMART acronym (Specific, Measurable, Achievable, Relevant, Time-related) to guide my teaching practice. I do this by:

  1. Giving a formal Introductory lecture tailored to the practical work and coupled with the background theoretical information the learners require. This takes about an hour.

    Image 1: Cyst of Chilomastix mesnili (“Lemon-shaped)

  2. Allowing people to have some control over their own learning whilst at the same time paying attention to the bench manuals provided. They are given 1 hour to diagnose cases using digital images. Collaboration is encouraged.

Image 2: Ovum of Bertiella sp. (“Coke-can lid”)

  1. Building connections between what is being learned and the experiences of the learners. I did this by mingling with them during the practical sessions and having conversations with them regarding any problems they may be encountering. But in this online teaching, I spend about an hour discussing the exercise in section 2, helping them to make connections with their contribution to patient management.

Letting the learners fill in feedback forms at the end of the course has helped me to restructure my lesson plan on an ongoing basis. As the online teaching continues, it is hoped that study samples will be posted to participants’ laboratories for them to have hands-on experience in identifying parasites.

 

Dr Samuel Boadi

Parasitology Teaching Programme Manager.

 

SCHEME UPDATES

SARS- CoV-2 images

UK NEQAS for Microbiology: Molecular detection of SARS-CoV-2 EQA

The unprecedented pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causing Coronavirus disease 2019 (COVID-19) is posing challenges for SARS-CoV-2 testing laboratories in the UK and worldwide. These laboratories have to cope with increased testing demands to identify and maintain the required containment of affected individuals as well as delay and mitigation of spread of the disease. Molecular detection or antigen testing from respiratory specimens are the mainstay for the detection of SARS-CoV-2.

Other hurdles that some of these laboratories face are sourcing of reagents and testing kits and have resorted to run different assays on multiple testing platforms, adding another layer of complexity to the testing, quality control and validation of results, warranting a need to participate in an external quality assessment (EQA) program on a regular basis.

UK NEQAS for Microbiology has successfully introduced an EQA for molecular assays to provide an aspect of quality assurance to laboratories performing molecular detection of SARS-CoV-2, thus enabling them to monitor, evaluate and improve their performance. An EQA to monitor the performance of SARS- CoV-2 antigen detection assays is currently under development and likely to be available soon.

The UK NEQAS for Microbiology molecular detection of SARS-CoV-2 EQA was evaluated through two pilot studies and now runs on a monthly basis. The monthly distributions consist of two freeze-dried specimens and participants have to report on the presence or absence of SARS-CoV-2. The first pilot distribution was dispatched in May 2020 and the first live distribution on the 3rd August. There have already been 3 successful live distributions to date (29th Oct 20).

Interest in this scheme is increasing globally with participants from Armenia (AM), Austria (AT), Belgium (BE), Croatia (HR), Czech Republic (CZ), Ethiopia (ET), Falkland Islands (FK), France (FR), Gibraltar (GI), Greece (GR), Ireland (IE), Italy (IT), Portugal (PT), South Africa (ZA), Spain (ES), Sweden ( SE), Switzerland (CH) and the UK. The percentage of registrants vary between countries with 65% being from the UK as illustrated in Figure 1.

Participants registered for this EQA use varying methodologies that require different extraction, elution, reaction volumes as well as targeting different regions of SARS-CoV-2 genome (some assays having more than one viral gene target). The combinations of these factors greatly influence the sensitivity of the assays as shown in our reports.

From the data gathered, roughly, 49% of assays target the E gene, 22% target the ORF region including the RNA-dependent RNA polymerase (RDRP) gene, 22% the N gene and the remaining 7% the S gene. Figure 2 illustrates the genomic organisation of SARS-CoV-2, used as targets by the different assays.

Figure 2: Genomic organisation of SARS-CoV-2

(Source: Swiss Institute of Bioinformatics https://viralzone.expasy.org/9076)

If your laboratory is running molecular assays for the detection of SARS-CoV-2,   this EQA would certainly be beneficial to your laboratory. This EQA is supported by Department of Health & Social Care (DHSC), UK and NHS England.

Some of the benefits include a monthly distribution with a two week period for examination and reporting results, followed by intended results the following day after the distribution has closed.

A detailed report follows within 10 days after the intended results have been published. This report highlights the performance of the different assays reported by the participants, at the same time being educational with up-to-date information on the evolution of COVID-19 globally.

More information about the UK NEQAS for Microbiology Molecular detection of SARS-CoV-2 EQA scheme and a  recent report  can be accessed through the  following link:

http://www.ukneqasmicro.org.uk/images/pdf/SARS-CoV-2.pdf

For further information and registration, please contact us by email:  organiser@ukneqasmicro.org.uk

Multiplex detection of respiratory viruses

UK NEQAS for Microbiology has launched a new special survey in collaboration with NHS England – Multiplex detection of respiratory viruses. This is a bespoke survey for UK participants performing multiplex molecular testing for SARS-CoV-2, Influenza virus, and RSV.

Several providers of diagnostic assays such as Roche, Cepheid, Seegene, and bioMérieux (to name but a few) have recently introduced diagnostic panels for the simultaneous testing of respiratory pathogens that include SARS-CoV-2 among the targets. The ‘Multiplex detection of respiratory viruses’ special survey was set up to support UK diagnostic labs during the early stages of implementing these assays by providing EQA specimens specifically designed for multiplex testing.

Participants of the special survey can expect specimens to contain SARS-CoV-2, Influenza virus (types A and B), and RSV (types A and B). The pathogen selection was determined in collaboration with NHS England and represents pathogens included in the majority of available multiplex respiratory panels. Participants will also have the option to report on RSV type and Influenza virus A subtype, if applicable.

The first distribution of the ‘Multiplex detection of respiratory viruses’ was dispatched on the 7th of December 2020 to 65 participating laboratories. Two further distributions will follow on the 15th of February 2021 and the 15th of March 2021. Registration for the February and March distributions will open in January 2021 to UK laboratories. As the special survey is supported by PHE all distributions are provided free of charge to participants. More information to potential participants will become available on the UK NEQAS for Microbiology website in January 2021.

Bacteriology Scheme Updates

General bacteriology

Distribution 4771 September 2020

A Campylobacter jejuni from a simulated faecal sample was distributed in the September 2020 distribution. The presence of significant intestinal pathogens was queried.

This is the first distribution since the re-categorization of C. jejuni from advanced to core and as less than 80% of participants reported to species level, this specimen was not scored. To follow recommendations from the standard microbiology investigation procedure (SMI: B30), reporting to genus level is acceptable, an amended report was issued and a full score allocated for those participants reporting to genus level.

Antimicrobial susceptibility

UK NEQAS for Microbiology report susceptibility results in accordance with the most current guidelines. However, we acknowledge that some clinical laboratories may require a transition period and therefore we will not score interpretations of antimicrobial susceptibilities that differ between the current and previous version of published guidelines.

We are happy to announce the successful appointment of Dr Mandy Wootton, our expert advisor for antimicrobial susceptibility scheme.  Regular expert comments accompany each report for this scheme, which provide invaluable educational value for the distribution.

We would like to thank you for completing the questionnaire allowing us to determine the methods currently used to perform susceptibility testing. From this, we are now in the process of determining how to use this information to allow us to improve our reports going forward.

Community medicine

From April 2021, specimens distributed in this scheme requesting antimicrobial susceptibility testing will include expert commentary in the published reports. This will provide participants additional information on data analysis of the antimicrobial susceptibilities, enhancing the reports educational value.

Clostridioides difficile (formerly Clostridium difficile)

The name of this scheme has been successfully changed to be in-line with the updated nomenclature.

 

EQA in development

Carbapenemase producing organism’s (CPO) pilot – UK only

We have had a lot of interest in participation, therefore we have kept the pilot to UK based laboratories only, with the aim to being an established EQA in April 2022.

It is our hope, that we can deliver this scheme using a more authentic sample type. With this aim, we are currently performing stability testing on various types of liquid swabs. The first pilot will be dispatched in early 2021.

 

Virology Scheme Updates

The molecular detection of SARS-CoV-2 scheme

Is operating as a live scheme since August 2020 on a monthly basis, with performance now being assessed and therefore scoring applicable for each specimen (table 1). Extension to scope has been applied for this scheme to be established as a fully accredited scheme.

Table1 Summary of scoring:

Score Score Score Description
CV pos CV eq CV neg
2 0 -1 SARS-CoV-2 positive
0 2 0 SARS-CoV-2 equivocal
-1 0 2 SARS-CoV-2 negative

Virus identification scheme

 

Unfortunately the decision had to be made to cancel distributions for UK NEQAS for Virus identification scheme for the EQA distribution programme starting April 2021.

Launched in 1971, the Virus identification scheme was delivered to provide an EQA for laboratories performing various methods for identification, including virus culture, immunofluorescence and more recently molecular methods. The interest in this scheme has declined over the years due to the introduction of new methodologies such as molecular testing. However, we felt it was important to keep this external quality assessment scheme available for educational purposes.

Unfortunately, our priorities were redefined due to the COVID- 19 situation and we have been working diligently on different SARS-CoV-2 EQA schemes to assist laboratories both nationally and internationally.

These assessment programmes have been focussing on respiratory viruses prevalent during the winter season (winter distribution) and those prevalent during the summer season (summer distribution) e.g.  distribution of   measles, enteroviruses, CMV and HSV.

There are alternative schemes available to participate in, if your laboratory is currently using molecular methods to compensate the gap for your external quality assessment exercise:

  • Molecular detection of respiratory viruses includes an extended panel of respiratory viruses that are suitable for testing using molecular methods
  • Molecular detection of viruses in CSF include distribution of viruses such as HSV, VZV and enteroviruses.

 

Please find link to our molecular schemes and to ascertain whether these EQA’s meet your needs in replacement of the Virus identification scheme.

http://www.ukneqasmicro.org.uk/images/pdf/DOC.0401.pdf

If you need any further assistance or advice please contact us via the organiser email: organiser@ukneqasmicro.org.uk and we will be happy to work with you to resolve any queries.

Molecular detection of HEV RNA

The delivery of this scheme will continue to be provided with a reduction in the numbers of distributions per annum, from three to two.

 

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Further Updates

UK NEQAS for Microbiology will be celebrating our 50th anniversary in 2021

UK NEQAS for Microbiology will be celebrating a significant milestone in its service history in 2021- our 50th anniversary!

Our services started in May 1971 and since then we have evolved to become one of the leading EQA providers worldwide.

We hope to celebrate with all our stakeholders in some way over the upcoming year and will inform you of the events that will highlight the achievements over the last 50 years and a possible look forward to the next 50 years.

Antimicrobial Susceptibility Testing Specialist Advisory group – Malcolm Armstrong

When I recently informed the Antimicrobial Susceptibility Testing Specialist Advisory group (ASTSAG) that I would be retiring soon and how much I will miss being part of this team, I was kindly thanked for my contributions for 13 years of attendance….13 years!!!

To be honest, I must say that initially I always attended these meetings with trepidation…I felt I was walking in the shadow of giants, experts in the field of the complex world of antimicrobial susceptibility testing and resistance mechanisms.

However, over time I gradually felt part of the team and although a small cog in a big machine I felt I was contributing in helping making a difference in the scheme of things.

A fair proportion of the meetings was discussion around which organisms to include in the distributions and which antibiotics to test them against, so with my laboratory experience I could actually contribute to this area of discussion.

I would like to thank each member of the ASTSAG for making my 13 years attendance so enjoyable it has been a pleasure working with such great minds.

Malcolm to ASTSAG Keep safe, Keep up the good work listening-out, Malcolm.

 

Antimicrobial Susceptibility EQA- Expert comments, by Dr Mandy Wootton

I started providing expert comments to the antimicrobial susceptibility testing (AST) scheme in August 2020, having been interested in antimicrobial resistance and susceptibility testing for over 25 years. Training in both Nottingham and Bristol led to a position in Cardiff where I have developed an antimicrobial resistance reference laboratory for Wales. Since then I have been involved with the British Society of Antimicrobial Chemotherapy (BSAC) and the European Committee for Antimicrobial Susceptibility Testing (EUCAST) helping to develop susceptibility testing methods, breakpoints and guidelines as well as providing educational workshops and events to UK laboratory staff.

Antimicrobial resistance (AMR) is increasing throughout the world. Infections caused by these AMR bacteria are difficult to treat, often because the number of effective agents is low. Clinicians responsible for treating patients are usually guided by the susceptibility testing results from the microbiology laboratory. Therefore, the importance of accurate susceptibility testing results gained from standardised methods is paramount.

Keeping up to date with new antimicrobial resistance mechanisms, new agents and the increasingly complex testing guidelines is difficult for busy laboratory staff. However, susceptibility testing results are the most important result we report to clinicians. Guidelines change each year to improve the accuracy of the tests or improve interpretation for the clinicians. So a little time should be made each year for staff to understand the changes.

In providing expert comments for the AST scheme, I aim to include details of antimicrobial resistance mechanisms, explanations of anomalous results and remark on areas of testing which require improvement, to get the best results possible. After all, the best susceptibility testing results mean the clinician has the best possible data with which to treat the patient and the patient has the best possible chance of recovery – It’s what we all work towards.

 

UK NEQAS scientific day scheduled on 27th Nov 2020 – postponed

The Microbiology division of UK NEQAS runs a scientific meeting for its participants every year on the last Friday of November.

The preparation and planning for the next scientific meeting starts immediately after. The organising committee gathers at the venue and we start proposing topics based on the comments received from delegates.

For the meeting scheduled on the 27th November 2020, the organising committee came up with the title “Treatment and Management of Infection Matters to Us!”

Soon after at the beginning of January 2020, we met and started discussing about possible topic to cover and drawing a list of potential speakers. These meetings are carried out regularly every month to ensure that we are on track. Since WHO had declared COVID-19 pandemic, we thought COVID-19 would be a very important topic to cover and by November, the pandemic would be over and there would be a lot of information for the speakers to share with the audience. On treatment and management of infection as per our scientific meeting’s title.

As the situation started evolving and UK went into lockdown, the scientific committee met up and evaluated the situation. In May, we took the decision to cancel the face to face event.

On the 21st May, we communicated this decision to the UK NEQAS steering committee.

One of the suggestions that was made at that time was to look at possibilities of organising a virtual meeting. The members of the steering committee were concerned that several other scientific meetings have been postponed, leaving a void in the CPD activities of healthcare professionals.

The scientific organising committee took the advice of the steering committee feeling invigorated by the support and started looking at ways of organising a virtual meeting.

The speakers were contacted and the scientific content was taking shape, when we hit another hurdle of getting the appropriate platform to organise this meeting virtually.
As we were not well versed organising meetings virtually, we finally decided to cancel the meeting and start working towards organising one for 2021 instead.

As UK NEQAS for Microbiology will be celebrating its 50th anniversary, we are hoping to combine the scientific meeting that is being planned with this big event.

For those who attend our scientific meeting regularly, we do apologise for not hosting one this year, but hope that next year we will be in a position to provide you with a very exciting scientific program.

Watch this space!

 

Customer Satisfaction Survey

Dear Participant

UK NEQAS for Microbiology is committed to ensuring that our service remains relevant for your laboratory.

If you haven’t already done so, we would appreciate you taking a couple of minutes to complete this short questionnaire by the end of day on Monday 4th January 2021 to help us identify areas where we can improve our service to you.

https://surveys.phe.org.uk/TakeSurvey.aspx?SurveyID=76KM7p511

Your feedback is vital in assisting us in making future changes.

Thank you for your continued support.

Kind regards
Pratima Mahajan
Quality Manager

GOOD NEWS

 

We would like to welcome the following new starters

Ganesh Giri – Distributor & Operations Manager (05/08/2020)

Fariba Kirwan– Operations Administrator (01/09/2020)

Anisa Hussain– HCS Support Worker (16/09/2020)

Chizaram Nwankwo – Health & Safety Coordinator (24/11/2020)

Dipali Pindoria – Healthcare Scientist Specialist (07/12/2020)

 

 

We wished farewell to the following staff:

Juma Akhtar – Healthcare Scientist Associate (23/10/2020)

Cangul Seran – Specialist Biomedical Scientist (23/12/2020)

Teodoro Fajardo – FTC Healthcare Scientist Team Manager (05/01/2021)

 

 

We would like to welcome back Katie Minns from Maternity leave (07/12/2020)

UK NEQAS Christmas closure 2020

UK NEQAS for Microbiology will be closed 25 December 2020 to 1 January 2021.

We will respond to any queries upon our return on 4 January 2021

Thank you to all our participants, distributors, steering committee and advisory members, expert advisors, freight-forwarders, panel members and Public Health England for their continued support during this challenging year . We look forward to working with you in 2021

 

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