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Cross-contamination in cytology processing: a review of current practice
Janie Roberson1, Jacqueline M Cuda2, Antoinette D Davis Floyd1
1Department of Pathology, University of Alabama-Birmingham, Birmingham, Alabama.
Journal of the American Society of Cytopathology
|May 24, 2022
Summary
Cytopathology labs use fewer direct smears, but still need cross-contamination (CC) prevention. Alcohol-fixed smears are most at risk for CC, guiding labs to adopt risk-based policies.
Area of Science:
- Cytopathology
- Laboratory Medicine
- Quality Control
Background:
- Evolving cytopreparatory technologies favor liquid-based cytology over direct smears.
- Clinical Laboratory Improvement Amendments mandate cross-contamination (CC) prevention in cytopathology labs.
- The incidence and high-risk preparations for CC are not well-defined.
Purpose of the Study:
- To assess current practices for preventing cross-contamination (CC) in cytopathology laboratories.
- To identify specific preparation types with a high potential for CC.
- To understand laboratory policies related to CC, including rapid on-site evaluation.
Main Methods:
- A survey was distributed to members of the American Society of Cytopathology and American Society for Cytotechnology.
- The survey collected data on practice settings, CC policies, rapid on-site evaluation practices, and high-risk CC preparations.
- Data were collected from July 1 to August 14, 2020.
Main Results:
- Ninety-eight percent of laboratories have a written CC policy; 66.18% include rapid on-site evaluation CC procedures.
- Documented cases of cross-contamination (CC) were reported as rare.
- Alcohol-fixed, direct smears of Pap-stained fluids were identified as most susceptible to CC; 56.20% reported cell block contamination.
Conclusions:
- Shifting laboratory practices reduce the prevalence of high-risk CC preparations.
- A risk-based approach is recommended for defining and managing potential CC cases.
- Understanding current laboratory practices is crucial for refining CC policies and procedures.
