(719f) Innovations in Microbiology Imaging: Automated Gram Scanner

Background: The Gram stain is an essential test of pharmaceutical microbiology. With its swift and simple execution, the Gram stain serves as the first critical step in providing results to researchers regarding biocontamination during drug manufacturing. Even with escalating expenditures and a dwindling workforce, laboratories are still expected to meet this enhanced demand for rapid and accurate test results. Conversely, utilizing standard manual microscopy to assess Gram-stained slides is time-intensive, tedious work. This has led to the need for a more ergonomic and cost-effective solution of an automated microbial workflow.

To meet this challenge, we developed the Gram Scanner (GSC), an automated microscope scanning and imaging system. The aim of this study was to evaluate the amount of technician time as well as laboratory costs that the GSC can save a pharmaceutical microbiology lab. We hypothesized that automated scanning and image acquisition of gram-stained slides would be a faster process compared to the standard manual microscopy technique.

Methods: Gram-stained blood slides were scanned automatically with the Metafer Gram Scanner (MetaSystems Group Inc, Newton, MA) as well as evaluated manually through the oculars of a Zeiss AxioImager Z2 (Zeiss AS, Norway). For the manual workflow, 10 fields of view (FOVs) of each slide were first viewed under a 10X objective (pre-scan), and then each slide was analyzed under a 100X oil immersion objective (OIO), viewing 10, 20, 40 and 50 FOVs. Slide results were entered into Excel to mimic LIS data entry. For the automated workflow, 50 FOVs of each slide were first captured for the 10X pre-scan and then each slide was scanned under a 63X OIO, capturing 10, 20, 40, and 50 FOVs. Slides were evaluated by viewing the digitized images captured in the Metafer gallery, and results were entered into the scanning platform’s reporting tool (Neon). To determine the financial benefits of the GSC, we developed a return on investment (ROI) economic model based on known average wages and fringe benefit rates for medical technologists, the average number of slides processed daily in microbiology laboratories, and equipment cost including a service contract.

Results: Our overall findings confirmed that the GSC lessens the time as well as the financial burden for pharmaceutical microbiology laboratories. By reducing the amount of time that technologists are tethered to the microscope, the GSC saved ~85% of tech time in comparison to the manual method. When separating the automated workflow time into the time that a technologist is required to physically interact with the microscope or computer (hands-on time) and the time in which the machinery is independently performing a task (automation time), we found that the automated workflow was significantly comprised of only 17-20% hands-on time in comparison to 100% of hands-on time comprising the manual workflow. Additionally, linear regression analysis indicated that the amount of time for a technologist to review and score images generated by automated scanning only increased by 0.6 seconds with each 10 additional FOVs, while the review time increased 3.5 seconds for every additional 10 FOVs for slides reviewed manually. Lastly, ROI analysis revealed an estimated cost savings over 5 years for labs scanning an average of 3,000 slides monthly was over $1 million.

Conclusions: Using the GSC, pharmaceutical microbiologists can reduce microscope time significantly, increase overall lab efficiency through more cost-effective use of technician time, and thus aid in quickening the drug manufacturing process. With a breakeven in 1.3 years, the GSC is an ergonomic investment in full lab automation that permits labs to scale up production without increasing their labor force.