Flocked swabs combined with platforms to inoculate and streak specimens: a pre-analytical workstation for microbiology automation

Introduction. The bacteriology processes almost all the clinical specimens through manually performed cultures and therefore needs to evolve toward automated systems.We report our experience on the benefits of combination between liquid-based flocked swab transport systems (Copan Innovation) and platforms of plating and automatic streaking of agar plates.The main innovation is that, for the first time, the automation can be performed not only for urine and other few liquids materials, but also to most of other biological samples. Methods. Our considerations are based on more than one year of experience on the instrument InocuLAB® (Dynacon Inc.) in two Italian Hospitals, supplemented by theoretical knowledge of other marketed in Italy instruments.The three instruments currently available in Italy (A: InocuLAB® Copan, B:WASP® Copan and C: Previ-Isola bioMérieux®) can inoculate and streak liquid or eluated specimens from liquidbased flocked swab transport systems on any agar plate.The main differences are: streaking of already deposited material on plate (only A and B); choice among various protocols of streak and inoculate (only A and B); automatic opening and recapping of the specimen containers (only A and B); automatic choice of the plates (B: 9 columns and C: 5 columns); partition of the streaked plates in groups (B: up to 4 group s and C: up to 3); forced use of disposables devices (only instrument C). No instrument present problems of carryover and the quality of plated specimens is excellent. Conclusions. Although significantly different, all the platforms combined with flocked swabs represent a pre-analytical workstation for microbiology automation (inoculating, streaking, and bar-coding of liquid specimens). The main advantages can be seen in the operator’s production time, in safety and in quality of streak.The almost complete elution of the biological sample in liquid-based flocked swab transport systems is a standard base which allows to perform many diagnostic tests, including quantitative streaking for quantitative evaluation and multiple culture for additional investigation.