News Trends Analysis

June 1, 2003
The ObservatoryJune 2003 NewsHIV/AIDS vaccine survey results. Many Americans wrongly believe that a preventive vaccine for HIV/AIDS has already been developed, according to a national survey of 3,500 people recently conducted by the National Institute of Allergy and Infectious Diseases (NIAID). Nearly half of African Americans surveyed (48%) and more than a quarter of Hispanics (28%) believe that an HIV vaccine already exists and is being kept a secret. Twenty percent of adults in the general population share that belief.The survey found significant support for HIV vaccine research, but indicated troubling misperceptions about efforts to develop a vaccine to prevent HIV infection. For example, only 58% of those surveyed understand that vaccine development requires testing potential vaccines on thousands of humans before approval. Nearly one-third mistakenly believe that the HIV vaccines being tested can cause HIV infection in clinical trial volunteers; an additional 44% were unsure. In the U.S., an estimated 900,000 people are living with HIV.
Lab testsFDA clears rapid test for Aspergillus infection. In mid-May, the Food and Drug Administration (FDA) cleared for marketing the first rapid laboratory test for a life-threatening invasive fungal infection that occurs in leukemia patients, organ and bone marrow transplant patients and patients whose immune systems are compromised by illness or chemotherapy. Platelia Aspergillus EIA, manufactured by Bio-Rad Laboratories, of Redmond, WA, detects Aspergillus galactomannan antigen in blood, and is a good indicator of invasive infection. Results are available in about three hours. By comparison, the standard culture method of testing for aspergillus takes a minimum of four weeks before results are available. Invasive aspergillus cases in the United States number a few thousand per year, but the disease is very serious and has a mortality rate of 50% to 100%.Its
Visit to 103th ASM, Washington, DC, 2003.Reported for MLO by: Colleen K. Gannon MT (AMT) HEW, MidMichigan Medical Center, Midland, MI One of the most important things I have learned at the American Society of Microbiology (ASM) meetings is that the cost for the book of abstracts ($40) is well worth the investment. My colleagues and I spend the rest of the year poring over the studies to determine which instruments to purchase based on performance and accuracy, which test kits have the best and least sensitivity and specificity, and what constitutes the best and least expensive method for culture identification and also, what is relevant and what is not. Having attended ASM meetings for 25 years, it is fascinating for me to recount the topics that have taken front-page status over the years: increasing resistance of infectious agents to commonly prescribed antibiotics, genital herpes virus, HIV, multiply resistant tuberculosis, tracking and controlling viral epidemics like SARS and West Nile virus and bioterrorism. Topics change as discoveries, treatments and prevention strategies have been found by the tremendous combined efforts of scientists throughout the world. Because I am a microbiology specialist in a hospital-based laboratory, my biggest concern today is the shrinking resources available to clinical laboratories, along with the growing demand for excellence. I mainly search for posters and oral sessions that will give me new ways to provide the best possible service for the least cost. Clinicians place great importance on the written word. Carefully report the information that will contribute to patient management and leave out the rest.  Sputum Gram Stain Dont: Sputum Gram Stain Do:Over 50 WBCs <10 Epith Cells/LPF Over 50 WBCs <10 Epith Cells/LPFMany gram positive cocci in pairs and lancets Many gram positive cocci
(suspect Streptococcus pneumoniae)
Few gram neg cocci Few gram pos rods Few mixed floraFew gram neg rods If it is normal or colonizing flora, why are you reporting it?Throat/Pharyngeal Culture Dont:  Throat/Pharyngeal Culture Do:
Many Streptococcus pneumoniae
Group A
Streptococcus pyogenes recovered

Few Staphylococcus aureus

Moderate Group A Streptococcus pyogenes

Perirectal Abscess Dont:
Perirectal Abscess Do:
Many Escherichiae coli
Reject this specimen with the comment:
  Not appropriate specimen for culture. (Incision and drainage accompanied by a broad-spectrum antibiotic is appropriate culture adds nothing to patient management.)

Many Klebsiellae pneumoniae

Many Viridans streptococci

Many Bacteroides fragilis

Many Prevotella species

Many Peptostreptococcus species
 Quality Assurance Studies have been stressed due to new CAP requirements, and I came back with several new topics to supplement the mundane:Monitor blood culture short draws by individual phlebotomist (adequate volume is the most important factor in recovery of the organism).Monitor number of blood culture sets obtained per septic episode. (Two 20 mL to 30 mL sets per episode in adults single sets are not acceptable unable to interpret significance of skin flora organisms).Monitor correlation of initial specimen gram stain with culture results.Showtime clarification. Darrell Harrington MT(ASCP), CLS(NCA), and Lab Clinical Education Coordinator for Methodist Hospitals in Gary, IN, reminded us that the American Society for Clinical Laboratory Sciences (ASCLS) is having its annual meeting Philadelphia, July 20-24, 2003, in conjunction with American Association for Clinical Chemistry (AACC) . The full title is the AACC/ASCLS Clinical Laboratory Expo. For more information, go to© 2003 Nelson Publishing, Inc. All rights reserved.