Molecular Strep/Flu/RSV

We are in the process of implementing the Alere I for Flu and Strep, last year we had it for Flu only, I give my experience a 4/10.

Cons

1. We initially ordered 10 instruments last year, we got 8... then about mid February all reagents went on backorder preventing us from running any POC tests again until the end of March...

2. This instrument has a cross-contamination factor where if a user gets a positive(qc or patient) and then touches anywhere inside the instrument with their gloves they potentially will continue to get positives until they figure it out. (I honestly don't know how this instrument got its waiver...)

3. long test times for negative results, every test gives the instrument between a 10-20 minute downtime depending on the test.

Pros

1. Obviously, having a molecular flu and strep test is invaluable to providers and patient satisfaction. A strep A with no negative confirmation will save us big.

2. This year the Alere I 2.0 software changes reagent stability so everything is RT. they also added the early positive callout for flu.

3. QC requirements are relatively low. After initial assay validations (1 +&- QC of each assay) only shipment qc is required.

4. This year we are rolling it all the way out. We just ordered 65 instruments and the Alere team is assisting with training and validations.

All in all, I still give it a bad rating because of my nightmare experience last year but I can't deny it's  usefulness. If I could do it over I would invest money in Quidel and hope their platform gets it's waiver this year. theirs can batch up to 10 tests of any assay, tests times are lower and there is no cross contamination factor.

Hope this helps :) It was nice to vent!

Good points, Tyler!

I am not weighing in on a post with pros and cons from my experience because I just saw a presentation of someone who did not mention prior (or post) that they were going to slap on a response post that I sent in (not this listerve).  Because of that, you'll see far less of me 'weighing in' on any listserve. Yes, listserves are public but remember, there are 'members' of any listserve who may not be in the participant group and it's my personal opinion that if I'm going to copy anything that someone else presented or posted, I'm going to ask prior if it's OK out of respect for that professional.

ANYWAY - I do want to bring a point to this bullet because it changed how we chose to not engage the software change mentioned:

2. This year the Alere I 2.0 software changes reagent stability so everything is RT. they also added the early positive callout for flu.

The info we got verbally at the time an Alere tech did our software change was that if we chose the 'early positive callout for flu' then the 2nd flu result would not be disclosed. So if A came up +, then A+ was disclosed and the MD did not get to see the B result.

I'm not saying don't use that software change setting. I'm saying my suggestion from experience is to talk to your MDs before electing to make that change. For us the MDs would rather see both results than have the early call out.

Peggy

Would anyone have competency tests for Alere i Strep A 2 and Alere i Influenza A & B 2 that they would be willing to share? Also looking e-learning for this also.  Our ED have decided they want to run these.

Thank you,

Char

Does anyone here have experience with the LIAT by Roche?  Pros/Cons?

We are looking at implementing the Alerei for our clinics.  The manufacturer recommends 10% bleach or 70% ethanol for cleaning and disinfection.  10% bleach seems awfully strong and corrosive to me.  What are other labs using for cleaning?

We are currently rolling out the Alere i for Strep and Influenza in our ER Department.  Are we required to do correlation between our manual strep procedure that Alere i is replacing?  How many specimens should be done?  Our Alere i trainer said we could just clean our instruments with alcohol wipes.