CAP Pro Course - Immunology - Molecular Amplification Methods for Detection of Infectious Diseases

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Author: Kevin Foley PhD, MT, DABCC
Reviewers: Heather MacDonald, M(ASCP), MB(ASCP); David J. Moffa, Ph.D. BCLD

Continuing Education Credits

Objectives

  • Identify the advantages of nucleic acid amplification testing (NAAT) for detection of infectious diseases and discuss factors that could limit effectiveness.
  • Explain the difference between target amplification and signal amplification and give examples of each method.
  • Describe the principles of polymerase chain reaction (PCR) and reverse transcriptase polymerase chain reaction (RT-PCR).
  • Identify procedural processes that are necessary when using amplification methods to ensure reliable test results.

Course Outline

  • Identify the advantages of nucleic acid amplification testing (NAAT) for detection of infectious diseases and discuss factors that could limit effectiveness.
      • Key Benefits of Molecular Methods
      • Key Benefits of Molecular Methods: Improved Sensitivity of Detection
      • Key Benefits of Molecular Methods: Reduced Turnaround Time
      • Key Benefits of Molecular Methods: Ease of Performance
      • Specificity and Sensitivity of Laboratory Methods for Detection of Bordetella pertussis as an Example
      • Preanalytical Factors Affecting Nucleic Acid Amplification Testing (NAAT)
      • Molecular testing in the medical or clinical laboratory science refers to which of the following?
      • A technologist in the microbiology laboratory is looking for a new influenza assay and is considering a molecular assay. Which of the following is tru...
      • A laboratory supervisor is considering a molecular assay for the detection of Giardia. Which of the following is not an expected advantage with a mole...
      • While NAATs are usually much more specific than non-NAAT methods, which is an example of an infectious agent that still exhibits issues with specifici...
      • Four nasopharyngeal swabs are brought into the laboratory for a methicillin-resistant Staphylococcus aureus (MRSA) PCR test. All four swabs are slight...
  • Explain the difference between target amplification and signal amplification and give examples of each method.
      • Categories of Molecular Assays
      • Polymerase Chain Reaction (PCR)
      • Other Target Amplification Methods
      • Examples of Signal Amplification Methods
      • Newer Assays
      • Multiplexing
      • A newly-hired technologist is training in the microbiology laboratory and learning the laboratory's urine Chlamydia assay. The assay requires that sam...
      • If a new PCR test was needed in your laboratory to detect COVID-19 virus (a respiratory RNA virus), which would be true?
      • A technologist is troubleshooting an HPV hybrid capture assay. He is finding that all samples, including positive controls, are negative. Which of the...
      • As the new supervisor of a microbiology laboratory, you are considering a new molecular platform for gastrointestinal pathogen testing. The brochure f...
      • A diagnostics vendor is asking your laboratory to consider using its multiplex blood culture pathogen instrument. The test utilizes the cartridge show...
      • A laboratory is considering a new molecular assay for HIV-1 viral loads. In this assay, the presence of specific HIV sequences is measured using label...
      • A new assay is being validated in your laboratory for the detection of Neisseria meningitidis. The new assay uses four primers that create a dumbbell-...
      • Which of the following is not a target amplification method?
  • Describe the principles of polymerase chain reaction (PCR) and reverse transcriptase polymerase chain reaction (RT-PCR).
      • Polymerase Chain Reaction (PCR)
      • Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)
      • Detection of PCR Products
      • Microarrays
      • Real-Time PCR
      • Melt Curve Analysis
      • If a clinical laboratory uses an assay that employs reverse transcriptase, what can be definitively concluded?
      • The accompanying figure shows which of the following types of molecular assay?
      • You overhear a colleague talking about a 'real time' assay that is being validated for the detection of Trichomonas vaginalis. Which of the following ...
      • FDA-emergency use authorization (EUA) has been given to a new assay that is being used to detect a new DNA-virus that is causing an outbreak in your p...
  • Identify procedural processes that are necessary when using amplification methods to ensure reliable test results.
      • Concerns for Cross-Contamination
      • Designated Work Areas and Processes
      • Required Work Skills and Process Controls
      • Your hospital is building a new molecular laboratory testing space adjacent to the main laboratory. You propose the accompanying layout for the rooms ...
      • For the last three months, the daily percent positivity rate for your laboratory's COVID-19 test has been about 2.8%. When reviewing last night's run ...
      • Which statement below best summarizes the contamination risk experienced by molecular laboratories?
      • A laboratory is considering an HPV assay and asks the vendor the following question, "Does this assay give a negative result if there is no specimen i...
      • Which of the following spaces is not specifically recommended in the processing of molecular testing and workflow?
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS, MT, and MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author: Kevin F. Foley, PhD, DABCC, MT, SC is the director of clinical pathology for the Kaiser Permanente Northwest region. He also teaches clinical chemistry at Oregon Health Sciences University. Dr. Foley earned his PhD in clinical pharmacology and toxicology at East Carolina School of Medicine in North Carolina. He recieved a PhD in clinical pharmacology and toxicology from Brody School of Medicine, Greenville, NC. He has been working in laboratory medicine for over 15 years, starting his career as a medical technologist.
Reviewer Information: Heather MacDonald, M(ASCP), MB(ASCP) has over 10 years of clinical laboratory experience and oversees a Molecular Diagnostics Laboratory. She is currently the Advanced Diagnostics Manager for Children's Healthcare of Atlanta in Georgia. Along with performing routine diagnostic assays, implementing laboratory-developed qualitative and quantitative molecular assays (both singleplex and multiplex) is her primary focus. Heather has published numerous articles and presents her research at national and international meetings. She has also worked with numerous corporations to bring commercial assays to market.
Reviewer Information: David J. Moffa, PhD, BCLD, has over 30 years of experience in the healthcare industry as an executive manager, clinical laboratory director, and medical laboratory scientist. He is currently a technical consultant for Kentmere Healthcare, Wilmington, DE, and until his retirement, was the Regional Director for LabCorp, Inc. He holds a PhD in medical biochemistry from the School of Medicine, West Virginia University.

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