- 24 hour turn-around for PCR Lab results (determined by sample receipt) for PCR reports
- Detection of Resistance Genes
Cost reduction and avoidance
- Reduced antibiotic utilization and better Antibiotic Stewardship
Increased Heal rates
- Increased patient satisfaction
- Greater clinical value - by reducing the subjectivity of identification associated with conventional culture technology
- Superior specificity of 99.9% microbes within an infection site
- Fast results in 3-5 business days (determined by sample receipt)
- Simultaneous identification of bacteria fungus, viruses, parasites, Candida and antibiotic resistance
- Detection of bacteria in the presence of antibiotics
- Increased sensitivity and specificity
- Simplicity of sample collection
We do not need to follow the same guidelines for transportation as culture samples, as DNA is not easily affected by time and temperature.
For Bacterial and fungal infections, Level I and II.
For Respiratory Viral and Bacterial infections:
- Respiratory Panel
- Gastrointestinal Panel
Rapid PCR Level 1 delivers detection of microbes on the chosen panel within 24 hours. Also, bacterial load and 8 gene resistances for immediate antibiotic therapy are delivered.
NGS Level 2 is delivered within 3-5 business days of receipt typically. The complex processing and verification associated with Next-Gen Sequencing typically takes 3-5 days. The superior data delivered in the Comprehensive report provides all the detected microbes within the sample and their relative abundances. With this next level of data, physicians can target therapy to over 25,000 major contributors of the disease state in great depth regardless of aerobic or anaerobic state.
No, however we do test for the following resistance genes:
We also provide the antimicrobial recommendation for each species detected. These recommendations are research based, similar to an antimicrobial guide reference. When a more typical bacteria is detected that is easily grown in the micro lab, like e-coli, your local antibiogram which tracks local resistance patterns should be referenced. This will only apply to 20-25 microbial species that are easily grown in culture.
FedEx® Shipping FAQs
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- Call FedEx at 1-800-GOFEDEX (1-800-463-3339) and give them the tracking number (12 digit number under the barcode). When calling say "agent" twice to speak to agent. Let them know it's biohazard prepaid pick-up.
Option to drop off at any FedEx/Kinkos location and drop inside at front of the store.
Clinical Diagnosis FAQs
Lab Report FAQs
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- Secure FAX
This sometimes happens when a strain of E coli or Kleb has a mutation at our primer binding site for our Level 1 assay. The mutation will cause it to not be detected by the Level 1. However, since Level 2, using a completely different site and technology, will be able to detected those strains.
Level 1 will be able to detect panel organisms at a lower concentration than level 2 (level 1 is more sensitive) However, Level 2 will detect numerous more organisms than Level 1.
Value of NGS over PCR is that we can still identify that’s had a strain mutation when the narrow range of PCR will not identify them.
Specimen Collection FAQs
Negative or Inconclusive Lab Report
5 reasons your sample may have been compromised
- Sample was collected from a site where there was no microbial species.
- Biocides or Lidocaine at 4% or higher was on the sample.
- Sample contained an overabundance of host DNA.
- Sample contained only non-viable material – ie, pus, mucus.
- In the case of urine an antibiotic active metabolite was in the sample vial and degraded the DNA. This can occur if the patient is on antibiotics.
Antibiotic Sensitivities & Viable vs Non-viable bacteria
- We do provide antibiotic resistance by detection of the resistant gene for the antibiotic classes.
- Culture sensitivities can only be performed if you can “grow” the microbe.
- Being able to culture “grow” a microbe is not the determining factor to verify if the species is a problem for the host.
- Only 1% of all known microorganisms can be grown in culture. Most physicians have only seen 30-50 species on C&S reports their entire medical career.
- We currently know the sequence codes for more than 50,000 species.
- You will not get from your micro lab the sensitivities of the more than 4,000 species we have detected in human samples.
- ECSMID guidelines make the point that antibiotic sensitivities have no clinical value when treating a biofilm infection.
- Breakpoints to determine S-I-R have been established for planktonic bacteria however, breakpoints haven’t been established for the biofilm or community of microorganisms.
Dead or Non Viable bacteria DNA degrades within 24 hours within the host environment.
Viable or Live bacteria once removed from the host environment it will take about 5 days for the DNA to die or degrade and become non-viable.
- If you refrigerate the sample it will be good for weeks. If you freeze the sample, the DNA will not degrade, and will be good forever.
- Due to the rapid degradation of DNA in dead bacterial cells it becomes extremely challenging for the technology to reach the threshold of DNA reads. If we don’t achieve enough DNA reads we can not detect the species.
- If the bacterial species is listed in our report it has met our criteria for DNA reads.
Detecting multiple species in a sample may be overwhelming, especially seeing species that you do not recognize. We are providing a complete picture of the microorganisms at the site the sample was taken from. If the sample was taken from an area of the host which has an established microbiome, (sinus cavity, mouth) interpretation can be more of a challenge. The following are points you should consider when reviewing our report.
- When treating a chronic infection you are dealing with biofilm phenotype.
- CDC and NIH “have estimated that biofilm infections now constitute 65% to 80% (respectively) of bacterial infections treated by physicians in the developed world.
- All bacteria / microorganisms will move to a biofilm phenotype.
- If we detect multiple species from a host site that is normally sterile, there is a high probability you are dealing with a Biofilm.
A: What do I treat?
Answer: Treatment decisions are based on multiple diagnostic criteria. Our report is not to be used in isolation. A common approach is to treat the dominant species when there is a concern for using multiple antimicrobials.
B. Is there a cut off of which species to treat?
Answer: No. Multiple species identified could be interpreted as a biofilm. In the case of biofilm infections the microorganisms are a “collaborative community” and are highly synergistic. When the sample is taken from a site other than the mouth, sinus cavity, gut, or areas in the body where we have an established microbiome, there are no commensal bacteria (Good Bacteria). Commensals need specific host related mechanisms and those host dependent processes are not possible in wounds, RTI, UTI, or joint infections.