Performance Evaluation of Early Sepsis Indicator at ASAN Medical Center ED

Sepsis is a prevalent, deadly, yet often elusive condition in emergency departments worldwide. Despite growing recognition in significance of timely identification and guidelines-defined interventions for improvement of patients’ outcomes, diagnosing sepsis in large group of patients who present with mild and non-specific initial symptoms challenges both clinical gestalt and institutional protocols. The decades-long quest for definitive sepsis biomarkers remains largely unfulfilled and utilization of biomarkers varies widely across countries and institutions.

In this webinar, two world-recognized emergency medicine experts in sepsis, Dr. Tiffany Osborn from Washington University, St. Louis, MO and Dr. Pierre Hausfater from Sorbonne University, Paris, France will introduce and discuss a novel hematologic parameter, Monocyte Distribution Width (MDW), recently cleared by the FDA and European Authorities for sepsis detection in the Emergency Department. MDW is available as a part of CBC with Differential test which is already routinely utilized as an early screening test for a variety of the conditions. They will discuss:

• The current state of clinical evidence for MDW derived from the series of multicenter studies
• The practical implications of these results to the U.S. and European standards of sepsis care

Presenters:

Tiffany Osborn, MD, MPH, is triple boarded in emergency medicine, U.S. critical care and European critical care.

Professor Hausfater started his career as an internal medicine specialist focused on autoimmune and inflammatory diseases.

Over-crowding at major hospitals is a major problem around the world. Dr. Seak examines the overcrowding and risk stratification in emergency department and the need for early detection of sepsis in the ED. In this webinar, Dr. Seak will discuss the importance of identifying sepsis earlier.

It may be very difficult for even the most experienced physician to detect sepsis earlier because the signs and symptoms of sepsis may be very non-specific and vague. There are many sources of infection that need to be identified and it’s often hard for emergency physicians to perform such kind of detection in very crowded, busy emergency departments. Dr. Seak looks at preliminary findings of a study examining 198 total adult patients. The primary outcome was to compare the diagnostic accuracy between MDW, WBC, and procalcitonin in predicting sepsis-2 and sepsis-3 patients.

After attending the webinar, you will be able to understand:

•Current and future detection tools for sepsis
•Learn about improved early detection of sepsis with the novel MDW biomarker
•Find out preliminary findings of the MDW study at one of the largest and busiest emergency departments in the world

Sepsis is a global problem with up to 49 million people affected by the condition worldwide.(1) The early detection of sepsis in the emergency department is a pressing problem. In this webinar, Dr. Chan-Jeoung Park, professor in the Department of Laboratory Medicine at ASAN Medical Center, University of Ulsan College of Medicine in Seoul, Korea will discuss Performance Evaluation of the Early Sepsis Indicator at ASAN Medical Center Emergency Department. Dr. Park’s clinical research examines the outcomes of 549 patients presenting to the emergency department, using sepsis-3 criteria for sepsis definition.

After attending the webinar, you will be able to:

Learn how MDW can be an effective and sensitive biomarker for sepsis detection in patients visiting the Emergency Department (ED)
Understand the performance of MDW for sepsis detection compared to other biomarkers, Procalcitonin and C-reactive Protein
See that the combination of MDW & WBC results can be obtained rapidly by CBC-Diff on DxH 900 and can be used as an aid in sepsis diagnosis in the ED

(1)Rudd, et al., Lancet. 2020 Jan 18; 395 (10219): 200-211.

As the 9th leading cause of death, chronic kidney disease (CKD) causes more deaths than breast or prostate cancer in the U.S.1 Early identification and timely, comprehensive therapeutic interventions can help drastically improve patient outcomes. However, the lack of standardized processes and screening methodologies can lead to misidentification or diagnostic uncertainty. Identifying the undiagnosed renal patient within the vast number of undifferentiated patients presented to physicians is challenging and can lead to potential treatment delays with associated increases in permanent damage or mortality.

During the webinar, Dr. Steve Ness and Dawn Tobin will discuss how teamwork between lab and clinical medicine can improve patient care through accurate classification, identification and diagnosis of patients with abnormal urine casts and/or crystals.

After this webinar, you will be able to:
•Familiarize yourself with an overview of the Renal System
•Explain the global impact & clinical importance of CKD
•Discern the different types of urinary casts & crystals and their role in assisting with patient diagnosis
•Describe the benefits of using automated digital microscopy to take the subjectivity out of urinalysis

P.A.C.E. credit is available for your participation.*

1.National Kidney Foundation. "Kidney Disease Basics."
www.kidney.org/news/newsroom/factsheets/kidneydiseasebasics. Accessed 12 Jun. 2020.

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical lab sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. Most programs also provide State of Florida credits (with valid license number). At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

In this webinar, Dr Elliott Crouser from Ohio State University will discuss sepsis epidemiology, definitions and implications of sepsis. He will introduce a novel sepsis biomarker Monocytes Distribution Width (MDW) that is intended for an aid in early detection of sepsis in adult patients in Emergency Department. MDW available automatically as a part of the most common triage test - CBC with Differential. MDW may be of highest utility in patients with low initial clinical suspicion and high diagnostic uncertainty for sepsis.

Additionally, you will hear Nan West, MT (ASCP) from Truman Medical Center who will share a patient case study of diagnostic challenges and importance of early identification of sepsis. Throughout the webinar the presenters will:

1. Discuss the current state of sepsis identification in the U.S.; approaches, outcomes, and opportunities
2. Review the novel sepsis biomarker for the emergency department MDW - available automatically as a part of CBC with Differential Test
3. Explain role of MDW for early sepsis detection while reviewing a patient case study
4. Describe the implementation of MDW in the clinical laboratory

For decades, cardiac troponin has been the preferred biomarker for helping to detect myocardial injury in acute care settings. The evolution of technology has led to the development of high sensitivity troponin assays that have greater precision at clinical decision points and enable lower limits of detection. This enhances clinicians’ ability to rule in or rule out acute myocardial infarction for timely intervention. Because of this, in 2018, “The Fourth Universal Definition of Myocardial Infarction” updated its guidelines to recommend the use of high sensitivity cardiac troponin assays that meet the precision criteria of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).1

Understanding the clinical utility and differences in high sensitivity cardiac troponin assays, compared to previous generation products, is vital to their implementation in the healthcare system. Cardiac troponin values , whole number reporting, the presence of acute ischaemia in patients presenting with chest pain, and sex-specific cutoffs all play a role in AMI diagnosis using high sensitivity troponin testing.

This webinar explores these and other topics to provide an overview of the benefits of high sensitivity cardiac troponin assays. Better understanding of the capabilities and value of this technology can further its adopting and success in clinical practice.

Sepsis is a growing healthcare crisis, causing over 11 million deaths worldwide. Early recognition and timely, comprehensive therapeutic interventions improve patient outcomes and have been codified in current clinical guidelines and government reporting requirements. However, non-specific presenting symptoms that mimic other diagnoses combined with multiple clinical definitions lead to diagnostic uncertainty. Identifying the undiagnosed septic patient within the sea of undifferentiated patients simultaneously presenting to the Emergency Department is challenging and can lead to potential treatment delays with associated increases in morbidity and mortality.

During the webinar, Dr. Osborn and Dr. Farnsworth will discuss how teamwork between the laboratory and clinical medicine can improve patient care through earlier identification and treatment of septic patients. They will discuss the challenges associated with current screening biomarkers, as well as the opportunities presented by a novel sepsis biomarker, monocyte distribution width.

After this webinar, you will be able to:
- Explain the relationship between early sepsis treatment and improved patient mortality
- Differentiate among Sepsis-2 and Sepsis-3 definitions and common sepsis screening criteria such as qSOFA and SIRS
- Review published evidence supporting the effectiveness of monocyte distribution width in early sepsis detection

P.A.C.E. credit is available for your participation.*

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. Most programs also provide State of Florida credits (with valid license number). At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

You combat multidrug-resistant organisms (MDROs) and bacterial infection daily, so you know the epidemiology is evolving into a global health crisis. However, recently introduced treatments—with emerging options in the pipeline—mark a new approach in the fight against antimicrobial resistance.

Join Dr. Jean Patel, principal scientist of scientific affairs at Beckman Coulter, as she presents the status of current drugs to fight bacterial infection, updated breakpoints and an antimicrobial treatment forecast. After watching this webinar, you will be better equipped to improve patient outcomes and advance antimicrobial stewardship by understanding the benefits and limitations of:

• Currently available MDRO treatment options
• Emerging Gram-positive and Gram-negative bacteria solutions
• Updated susceptibility-testing strategies

P.A.C.E. credit is available for your participation.*

Ideal For: Microbiologist, Antibiotic Stewardship Committee Member, Lab Director, Medical Director, Physician, Pathologist, Pharmacist, Infectious Disease Doctor, Infectious Disease Pharmacist, Infection Control Specialist

Presenter: Jean B. Patel, Ph.D., D(ABMM)

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. Most programs also provide State of Florida credits (with valid license number). At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

Learn about the primary pathogens isolated in cystic fibrosis patients and consider these microorganisms’ relative antimicrobial susceptibility. How do differing intrinsic resistance values from international authorities impact antibiotic management? What interpretive category breakpoints can be used with these opportunistic, environmental pathogenic, non-fermenting, Gram-negative bacteria in cystic fibrosis patients?

In this workshop, recorded at the 29th European Congress of Clinical Microbiology & Infectious Diseases, Dr. Samantha Sottotetti explains the importance of cystic fibrosis microbiology in Gram-negative, non-fermenting bacteria isolated from the respiratory tract of cystic fibrosis patients.

After viewing this webinar, you will be able to:

•Understand what bacteria colonize lungs of cystic fibrosis patients, and how MIC testing is performed
•Identify characteristics of colonization and phenotypes of P. aeruginosa, the major Gram-negative organism
•Describe other opportunistic pathogens—including A. xylosidans, S. maltophilia and B. cepacia—and antibiotic resistance for each organism

P.A.C.E. credit is available for your participation.*

Ideal For: Microbiologist, Laboratory Director, Physician, Pathologist

Presenter: Professor Dr. Samantha Sottotetti, Cystic Fibrosis Microbiology Laboratory

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. Most programs also provide State of Florida credits (with valid license number). At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

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Understand the challenges you will confront when interpreting antibiotic susceptibility test results based on minimum inhibitory concentration (MIC) accuracy. Ignoring uncertainty introduced through multiple factors—interlaboratory variability, biological differences, incubation temperature fluctuations, time ranges, proximity to breakpoints and others—influences the results of antimicrobial susceptibility test results.

In the webinar, Accuracy of MICs, recorded at the 29th European Congress of Clinical Microbiology & Infectious Diseases, Professor Dr. Sören Gatermann will review how correct classification of antibiotic resistance demands a persistent, multifaceted approach to analysis.

After viewing this webinar, you will be able to:

- Understand the sources of uncertainty in phenotypic antimicrobial susceptibility testing—variability between laboratories, bacterial variation, incubation temperatures, MIC breakpoint interpretation and others
- Learn about the new “Area of Technical Uncertainty” and other factors involved in setting EUCAST breakpoints
- Know the reasons behind some EUCAST breakpoints having no susceptible MIC interpretation

P.A.C.E. credit is available for your participation.*

Ideal for: Microbiologist, Pharmacist, Medical Director, Laboratory Director, Pathologist, Physician

Presenter: Sören Gatermann, Abteilung für Medizinische Microbiologie der Ruhr-Universität Bochum

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. Most programs also provide State of Florida credits (with valid license number). At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

Explore how systematic collection, analysis, interpretation and timely dissemination of minimum inhibitory concentration (MIC) data impacts the planning, implementation and evaluation of public health practice. Understand what impact high-level or low-level resistance mechanisms have on the interpretation of isolates distribution, which may help clinicians go beyond relying solely upon the breakpoints available today.

In this webinar, recorded at the 29th European Congress of Clinical Microbiology & Infectious Diseases, hear Professor Rafael Canton review why antimicrobial resistance, beyond the human side of medicine, is yet another public health approach clinicians need to address.

After viewing this webinar, you will be able to:

- Learn the importance of surveillance of antimicrobial resistance, and the international programs for antimicrobial resistance surveillance
- Understand the importance of MIC interpretation in public health surveillance, with examples for fluoroquinolones and cephalosporins
- Know how MICs can assist the user in simplification of complex resistance mechanisms, and the relevance of MICs when using molecular methods for surveillance

P.A.C.E. credit is available for your participation.*

Ideal for: Antimicrobial Stewardship Committee Member, Laboratory Director, Microbiologist

Presenter: Rafael Canton, Hospital Universitario Ramón y Cajal-IRYCIS

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. Most programs also provide State of Florida credits (with valid license number). At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

In this webinar, Dr. Ranjana Hawaldar will discuss a solution to help laboratories screen out samples that will not grow pathogenic bacteria prior to urine culture analysis. With this feature, laboratories can experience short TATs for negative results and support antimicrobial stewardship by helping to reduce the need for non-specific antibiotic treatment.

After watching the presentation, you will be able to:
- Discuss how UTIs impact healthcare settings and laboratory workloads
- Review current alternatives for UTI testing
- Assess the relevant factors associated with urine culture candidate screening
- Propose strategies to introduce a urine culture candidate screening process in the laboratory to avoid unnecessary urine cultures

P.A.C.E. credit is available for your participation.*

Presenter: Ranjana Hawaldar, M.B.B.S., M.D.

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. Most programs also provide State of Florida credits (with valid license number). At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

Adoption of high-sensitivity troponin assays that meet International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) guidelines is recommended by the recently released “Fourth Universal Definition of Myocardial Infarction.” By their high precision and analytic sensitivity, these assays offer new insights into troponin levels in women and other populations, including those with coronary artery disease. The assays also support shorter interval serial measurement strategies for managing patients with possible acute myocardial infarction in the emergency department (ED).

Many stakeholders in the healthcare system are impacted by these insights, including laboratorians, nurses, cardiologists and emergency medicine physicians. Understanding and addressing unique concerns of all stakeholder groups is key to the implementation of these new assays.

In this webinar, Dr. Jeannine Holden will discuss the concerns surrounding adoption of high-sensitivity troponin testing for patients with coronary artery disease and acute myocardial infarction.

After attending the webinar, you will be able to:

•Understand the IFCC’s precision requirements for high-sensitivity troponin assays
•Identify when to implement the recommended guidelines for use of high-sensitivity troponin testing
•Develop strategies for identifying and engaging cardiology and emergency medicine stakeholders
•Assess the impact of education on the adoption of high-sensitivity troponin assays

Antimicrobial resistance is rising, prompting clinical laboratories to find effective solutions for fast, accurate microorganism identification. MALDI-TOF mass spectrometry has emerged as a rapid, cost-efficient and clinically effective tool for identifying pathogens.(1,2)

In this webinar, Dr. Elizabeth Palavecino shares her laboratory’s clinical experience with MALDI-TOF mass spectrometry. This discussion explores the clinical effectiveness of this technology in patient management as well as the challenges of antimicrobial susceptibility reporting.

P.A.C.E. credit is available for your participation.*

Ideal for: Antimicrobial stewardship committees, laboratory directors, microbiologists

Presenter: Elizabeth Palavecino, M.D.

(1)Tan, KE et. al. “Prospective Evaluation of a Matrix-assisted Laser Desorption Ionization—Time of Flight Mass Spectrometry System in a Hospital Clinical Microbiology Laboratory for Identification of Bacteria and Yeasts: A Bench-by-bench Study for Assessing the Impact on Time to Identification and Cost-effectiveness. “J Clin Microbiol, 2012;50(10):3301–8.
(2)Cherkaoui, A et. al. "Comparison of Two Matrix-Assisted Laser Desorption Ionization—Time of Flight Mass Spectrometry Methods with Conventional Phenotypic Identification for Routine Identification of Bacteria to the Species Level.” J Clin Microbiol, 2010;48:1169–75.

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. Most programs also provide State of Florida credits (with valid license number). At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

Sepsis presents a global healthcare crisis, with more people dying from sepsis than from prostate cancer, colon cancer, breast cancer and AIDS combined.(1,2) Early intervention is critical, and the clinical laboratory plays a crucial role in early detection.

View this on-demand webinar to hear Mirta Gamez, MT(ASCP), CLS, explore the laboratory’s role in clinical sepsis diagnosis and treatment.

After attending this webinar, you will be able to:
-Articulate the basic etiology of sepsis and its impact on healthcare
-Identify the challenges that affect the rapid diagnosis of sepsis
-Guide how—and when—common sepsis biomarkers are used for detection and monitoring
-Advise on the role of the laboratory in sepsis diagnosis and management

P.A.C.E. credit is available for your participation.*

(1)Kumar G A et al. “Nationwide Trends of Severe Sepsis in the twenty First Century (2000-2007). Chest, 2011;16:1223–1231. doi: 10.1378/chest.11-0352.
(2)Hall MJ, Williams SJ, DeFrances CJ, Golosinsky A. “Inpatient Care for Septicemia or Sepsis: a Challenge for Patients and Hospitals.” Accessed on http://www.cdc.gov/nchs/data/databriefs/db62.pdf Apr 16, 2019.

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

Today’s laboratories are under constant pressure to provide high-quality service while improving turnaround times. The difficulty associated with meeting these challenges is compounded by recurring staff shortages and shrinking reimbursement rates.

Watch this webinar to learn how laboratories of any size can utilize workflow automation to:
•Deliver accurate results
•Provide efficient, consistent turnaround time
•Reduce pre-analytical errors


Discover the key differences between an automated workflow and integrated workcell approach to improving laboratory performance. In addition, you will see how automated workflows can help laboratories of any size conquer their most pressing challenges.


P.A.C.E. credit is available for your participation.*

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

The opiate crisis has reached epidemic proportions, evidenced by more than 17,000 deaths a year and $504 billion in economic costs in the U.S. alone¹. Healthcare providers and laboratories need highly specific tests that accurately detect drugs of abuse in patient-care, employment, athletic and prescription drug monitoring settings.

In this webinar, Dr. Mary Mayo discusses two highly sensitive assays—the Syva® EMIT® II Plus 6-Acetylmorphine (6-AM) and Buprenorphine (BUP)—that expand available options for drugs-of-abuse testing.

After attending this webinar, you will be able to describe the:
• Differences in opioid drugs
• Magnitude of the opioid epidemic
• Reasons to use specific drug tests related to opioids
• Performance characteristics of the Syva EMIT II Plus 6-AM and BUP assays

P.A.C.E. credit is available for your participation.*

Presenter: Mary Mayo, Ph.D.

Dr. Mary Mayo is a medical affairs manager with Beckman Coulter Diagnostics, with more than 25 years’ experience in the clinical laboratory. This includes twelve years as a laboratory director, nine years as director of clinical chemistry at a tertiary-care academic hospital and three years as the laboratory director of a commercial laboratory.

References:

¹ CDC. “Opioid Overdoses Treated in Emergency Departments.” https://www.cdc.gov/vitalsigns/opioid-overdoses/. Accessed 6 Mar 2018.

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. Most programs also provide State of Florida credits (with valid license number). At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.

Barbara L. Zimmer discusses trends in antibiotics and resistance, and the role microbiology laboratories play in staying ahead of their potentially damaging effects, such as longer illness, increased mortality, prolonged hospital length of stay and increased costs.

After attending this webinar, you will be able to:

• Better understand antibiotic resistance
• Position your laboratory to comply with antibiotic policies and recommendations
• More accurately test for and monitor antibiotic resistance in your laboratory

P.A.C.E. credit is available for your participation.*

Presenter: Barbara L. Zimmer, Ph.D.

Barbara L. Zimmer, Ph.D., is a principal scientist for Beckman Coulter. She is also a lecturer in mycology and infectious diseases in the Department of Dermatology at the University of California, Davis, School of Medicine. Dr. Zimmer is an advisor of the CLSI Subcommittee on Antimicrobial Susceptibility Testing. She was previously on the Board of Scientific Counselors’ Antimicrobial Resistance Working Group for the CDC and is the past industry advisor to the Microbiology Devices Panel of the Food and Drug Administration. She is the author of more than 30 papers and 130 posters and has presented approximately 100 scientific workshops.

*Beckman Coulter Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program. These credits are recognized by the State of California. Most programs also provide State of Florida credits (with valid license number). At this time, we cannot issue continuing education credits for those who provide healthcare (or work for an institution that provides healthcare) in Massachusetts or Vermont.