By Jessica Monmaney, Associate Specialist, Infectious Disease and Food Safety, APHL
Since its inception in 2009, FoodCORE has allowed participating laboratories to increase outbreak response times through improvements in patient interviews, data processing and information sharing. A number of FoodCORE laboratories have continued to implement further measures to increase efficiency.
Specimen Courier Services
Six out of seven FoodCORE centers have introduced a courier service that allows them to improve turnaround times and address limitations of partner laboratories. Stacey Kinney, the Lab Director in Connecticut, notes that “we are not sure what will happen if funding is cut but if this happens, we are hoping this will be supported either through state funds or another federal grant. It has gotten positive reviews especially by hospital labs that do not have their own couriers and usually put the samples in the mail. We are getting samples quicker from these hospitals and [the courier service] has improved turnaround time.”
Concurrent Pulsed-Field Gel Electrophoresis (PFGE) and Serotyping
Standard protocol requires the serotyping of isolates before isolates can be subtyped through PFGE. This can often result in a significant delay, as well as an incomplete specimen record, as Tim Monson, the Lab Director in Wisconsin found upon his laboratory’s participation in FoodCORE: “Prior to becoming a FoodCORE center…[subtyping] took anywhere from six to eight days. Since becoming a FoodCORE center in the fall of 2010, it takes only three days to receive and upload PFGE patterns on average. In addition, PFGE subtyping all Salmonella isolates has paid off since the fall of 2010 with the contribution of S. Nchanga, S. Enteritidis, S. Bareilly, S. Schwarzengrund, S. Baildon, S. Pomona and S. Litchfield isolates…to national clusters of illness. None of the aforementioned serotypes would have been PFGE subtyped routinely prior to becoming a FoodCORE center. “
Molecular Serotyping
The process of serotyping allows laboratories to determine which bacterial isolates will cause diseases (i.e. are pathogenic, versus non-pathogenic). Previous methodologies utilized antisera to identify types of bacteria that were more pathogenic than others. Molecular serotyping has emerged as a means to acquire more specific information more efficiently. The Chief of New York City’s public health laboratory, Laura Kornstein, is beginning to see how switching to molecular serotyping is affecting her laboratory, and has found that although the change was made as recently as December 2012. “This is already having a positive impact on our Salmonella PFGE turnaround times.”
The measures above allow FoodCORE centers to increase laboratory efficiency and to further their quality improvement efforts, but require adequate funds to initiate and maintain. State and local public health laboratories hope that federal funding will continue to support them in their efforts.
