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D. Laboratory Tests for Diagnosing Infections; Methods for Antibacterial Susceptibility Testing

 

Meet-the-Experts

 

MALDI-ToF Mass Spectrometry: Implementation and Impact on Patient Care

Matrix assisted laser desorption ionization-time-of-flight (MALDI-ToF) mass spectrometry is increasingly used in clinical microbiology laboratories for identification of bacteria and fungi. Two experts will discuss MALDI-ToF mass spectrometry in clinical microbiology. Dr. Nathan A. Ledeboer will focus on laboratory implementation and workflow issues surrounding. Dr. Stefan Zimmermann will discuss the impact on patient care of this new technology.

Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Describe how to implement MALDI-ToF mass spectrometry into the clinical microbiology laboratory, including workflow and financial aspects; and
• Assess the impact of MALDI-ToF mass spectrometry on patient care. 

Experts: 
Nathan A. Ledeboer, PhD; Med. Coll. of Wisconsin, Milwaukee, WI.
Stefan Zimmermann, MD; Univ. Hosp., Heidelberg, Germany.

 

Optimal Diagnostic Testing for Clostridium difficile in Clinical Practice

Diagnostic testing for Clostridium difficile continues to evolve, yet there are many unanswered questions. This presentation will focus on the repertoire of test methods available for C. difficile testing and their strengths and weaknesses. In addition, the session will address the impact of newer molecular methods on C. difficile prevalence and infection control practices. Ample time will be provided for audience questions and comments.

Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Describe the strengths and weaknesses of current methods for C. difficile testing;
• Evaluate data presented on comparative methods for C. difficile detection; and 
• Discuss the impact of molecular testing on C. difficile prevalence and infection control practice. 

Experts: 
Mark Wilcox, MD; Leeds Teaching Hosp. NHS Trust, Leeds, United Kingdom.
Vivian G. Loo, MD, MSc; McGill Univ. Hlth. Ctr., Montreal, Canada.

 

Syphilis Diagnostics: Traditional Versus New Algorithm

This session will be a point-counterpoint discussion of the traditional and newer testing algorithms for the diagnosis of syphilis and will address some of the controversies involved in the selection of a syphilis screening algorithm. The role of the various tests will be described as well as the pros and cons of the different diagnostic approaches. A research agenda to provide the evidence needed to generate more refined guidance for the use of treponemal tests for syphilis screening will be discussed.

Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Describe the traditional and reverse sequence algorithm for the diagnosis of syphilis;
• Identify the strengths and weaknesses of each approach; and 
• Assess the impact of the algorithm on patient care and public health practice. 

Experts: 
Kimberly Workowski, MD; Emory Univ. Sch. of Med., Atlanta, GA.
Khalil G. Ghanem, MD, PhD; Johns Hopkins Univ. Sch. of Med., Baltimore, MD.

 

Symposia

 

 

Antimicrobial Susceptibility Update

In this session, up-to-date CLSI and EUCAST recommendations and guidelines regarding antimicrobial susceptibility testing will be presented. There will be special focus on antimicrobial susceptibility testing of multidrug-resistant gram-negative rods, yeast, molds and non-tuberculous mycobacteria. Challenges, controversies and the current state-of-the-art will be addressed.

Upon completion of this Symposium Session, the participant should be able to:

• Review current CLSI and EUCAST guidelines regarding antimicrobial susceptibility testing;
• Assess what clinicians should know about and when to request antimicrobial susceptibility testing for clinical care; and 
• Review unsettled issues and pitfalls of current antimicrobial susceptibility testing, methods and their clinical application. 

Conveners: 
Jean Patel, PhD; CDC, Atlanta, GA.
Rafael Canton, PhD; Inst. Ramón y Cajal de Investigación Sanitaria, Hosp. Univ. Ramón y Cajal, Madrid, Spain.

Presentations:  
Antifungal Susceptibility Testing Update: Yeast and Molds
Annette W. Fothergill, MA, MBA; Univ. of Texas Hlth. Sci. Ctr., San Antonio, TX.

Antimicrobial Susceptibility Testing of Non-Tuberculous Mycobacteria and its Clinical Relevance
Edward Kuijper, MD, PhD; Leiden Univ. Med. Ctr., Leiden, Netherlands.

 

Best Practices: Diagnosis of Viral Causes of Hepatitis

This session will review the risk factors, clinical presentation and epidemiology of viral causes of hepatitis and the current knowledge on the various tests available for the diagnosis of acute and chronic hepatitis. The use nucleic acid based tests for disease and/or treatment monitoring, and the use of host-specific nucleic acid tests will be discussed, as well the role of genetic diversity and genotyping on clinical outcome and management of disease. The major viral infections will be covered including hepatitis A and E, Hepatitis B, Hepatitis C, and hepatitis due to the herpes viruses (cytomegalovirus, Epstein Barr virus and herpes simplex virus).

Upon completion of this Symposium Session, the participant should be able to:

• Identify the best tests to diagnose viral causes of hepatitis;
• Describe the types and uses of nucleic acid tests for diagnosis and monitoring treatment of viral hepatitis; 
• Describe the genetic markers that have been defined to be associated with infection and treatment outcome; and 
• Assess the impact of viral genome variability on the clinical outcome of chronic hepatitis. 

Conveners: 
David Anderson, PhD; Macfarlane Burnet Inst. for Med. Res. and Publ. Hlth., Melbourne, Australia.
Marie Landry, MD; Yale Univ. Sch. of Med. and Yale New Haven Hosp., New Haven, CT.

Presentations: 
Hepatitis A and E
David Anderson, PhD; Macfarlane Burnet Inst. for Med. Res. and Publ. Hlth., Melbourne, Australia.

Diagnosis of Hepatitis B and Monitoring of Antiviral Therapy
Fabien Zoulim, MD, PhD; Lyon Univ., Lyon, France.

Hepatitis C Virus
Alexandra Valsamakis, MD, PhD; Johns Hopkins Hosp., Baltimore, MD.

Herpes Viruses (CMV, EBV, HSV) 
Marie L. Landry, MD; Yale Univ. Sch. of Med. and Yale New Haven Hosp., New Haven, CT.

 

Epidemiology and Diagnosis of Febrile Illness in the Era of Global Climate Change

Infectious diseases typical of tropical climates are beginning to appear in more temperate zones. Global travel is also creating opportunities for more exposure to zoonotic pathogens. This session will present pertinent information on the changing epidemiology of five major diseases responsible for febrile illnesses worldwide, namely dengue, malaria, rickettsial infections, leptospirosis and Chikungunya fever. The presenters will also discuss the approach to the clinical and laboratory diagnosis of these syndromes.

Upon completion of this Symposium Session, the participant should be able to:

• Describe the global reach of dengue, malaria, rickettsial diseases, Chikungunya virus and leptospirosis;
• Recognize the clinical manifestations of each of the etiologies of febrile illness that are discussed; and 
• Assess the progress and limitations of diagnostic tests for each infection or syndrome. 

Conveners: 
Megan Reller, MD, PhD; The Johns Hopkins Univ. Sch. of Med., Baltimore, MD.
Delia Enria, MD, MPH; Inst. Natl. de Enfermedades Virales Humanas, Pergamino, Argentina.

Presentations: 
Dengue
Delia Enria, MD, MPH; Inst. Natl. de Enfermedades Virales Humanas, Pergamino, Argentina.

Challenges for the Detection of Malaria Infections in both Endemic and Non-Endemic Countries at a Time of Changing Weather Patterns
Colin J. Sutherland, PhD, MPH; London Sch. of Hygiene and Tropical Med., London, United Kingdom.

Leptospirosis
Albert I. Ko, MD; Yale Sch. of Publ. Health, New Haven, CT.

Rickettsial and Ehrlichial Infections
Megan E. Reller, MD, PhD; The Johns Hopkins Univ. Sch. of Med., Baltimore, MD.

Therapeutic Targets for Chikungunya Virus
Mark Heise, PhD; Univ. of North Carolina, Chapel Hill, NC.

 

 

Interactive Symposia

 

 

Cases in Clinical Microbiology

To provide an interactive presentation of clinical cases and correlations with microbiology laboratory findings that demonstrate some of the pitfalls of microbial identification. This session will help the audience recognize some of these less appreciated clinical presentations of microorganisms and help them choose appropriate methods to arrive at the correct diagnosis and microbe identification.

Upon completion of this Interactive Symposium, the participant should be able to:

• Describe the advantages and limitations of certain conventional and contemporary diagnostic methods used for the identification of microbial pathogens;
• Describe laboratory investigations in sick travelers returning from tropical regions; and 
• Assess the laboratory approach to the diagnosis of infectious diseases. 

Convener: 
Deirdre Church, MD, PhD; Univ. of Calgary and Calgary Lab. Services, Calgary, Canada.

Presentations: 
Cases 1 and 2
Deirdre Church, MD, PhD; Univ. of Calgary, Calgary Lab. Services, Calgary, Canada.

Cases 3 and 4
Duane W. Newton, PhD; Univ. of Michigan Hosp. and Hlth. Ctr., Ann Arbor, MI.

Cases 5 and 6
Dominic E. Dwyer, MD; Westmead Hosp. Univ. of Sydney, Sydney, Australia.

Cases 7 and 8
Guy Thwaites, MD, PhD; Imperial Coll., South Kensington, United Kingdom.

 

Challenges in the Diagnosis and Clinical Interpretation of Infections with Gram-Positive Rods

Aerobic gram-positive rods continue to challenge clinicians and microbiologists. The taxa within this large group continue to expand. This session will use case scenarios to illustrate clinical presentations of some of the emerging and important pathogens among the aerobic Actinomycetes. Each presenter will provide the essentials of laboratory diagnosis using conventional as well as emerging technologies.

Upon completion of this Interactive Symposium Session, the participant should be able to:

• Describe the broad range of infections caused by the aerobic Actinomycetes;
• Discuss the importance of accurate diagnosis of the various genera within this group; 
• Develop an approach to the diagnosis of the important pathogens; and
• Identify the new technologies for identification of the aerobic gram-positive rods. 

Conveners: 
Guido Funke, MD; Gartner and Colleagues Lab., Ravensburg, Germany.
Patricia S. Conville, MS; FDA, Silver Spring, MD.

Presentations: 
Corynebacteria
Guido Funke, MD; Gaertner and Colleagues Lab., Ravensburg, Germany.

Non-Tuberculous Mycobacteria
Christine Y. Turenne, PhD; Saskatchewan Disease Control Lab., Regina, Canada.

Challenges in the Identification of Nocardia Species
Patricia S. Conville, MS; FDA, Silver Spring, MD.

Tsukamurella/Gordonia
Richard J. Wallace Jr., MD; Univ. of Texas Hlth. Sci. Ctr., Tyler, TX.