Cross-contamination in cytology processing: a review of current practice

• Published in: Journal of the American Society of Cytopathology JASC Vol. 11; no. 4; pp. 194 - 200
• Main Authors: Roberson, Janie, Cuda, Jacqueline M., Davis Floyd, Antoinette D., McGrath, Cindy M., Russell, Donna K., Wendel-Spiczka, Amy, VandenBussche, Christopher J., Reynolds, Jordan P.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2022
• Subjects: CLIA; Cross-contamination; Cytodiagnosis - methods; Cytological Techniques; Cytology preparation; Cytotechnologists; Humans; Inspection; Laboratories; Rapid on-site evaluation; Regulation; Surveys and Questionnaires; United States; United States; Cross-contamination; Rapid on-site evaluation; Cytology preparation; Inspection; Regulation; Cytotechnologists; CLIA
• ISSN: 2213-2945; 2213-2945
• DOI: 10.1016/j.jasc.2022.03.002

New cytopreparatory technologies decrease the need for direct smears in favor of an increased use of liquid-based cytology methods. Despite these practice changes, Clinical Laboratory Improvement Amendments continue to require that cytopathology laboratories have procedures to prevent cross-contamination (CC). While the incidence of CC is not well documented, specific cytologic preparations and specimens with a high potential for CC have not been generally defined by professional guidelines or consensus. The American Society of Cytopathology Clinical Practice Committee surveyed cytology practitioners to better understand current practice related to CC in cytology. The survey focused on four topics: (1) practice settings and demographic data; (2) current practice for meeting CC requirements; (3) practice for rapid on-site evaluation; and (4) preparation types considered high risk for CC. The survey was sent to all American Society of Cytopathology and American Society for Cytotechnology members from July 1 to August 14, 2020. Ninety-eight percent of laboratories had a written CC policy, with 66.18% of the policies addressing rapid on-site evaluation CC procedures. Documented cases of CC were rare. Alcohol-fixed, direct smears of Pap-stained fluids were deemed the most likely to be impacted by CC. Cell block contamination during the histologic processing were reported by 56.20% of respondents. Changes in practice has resulted in decreased preparation types associated with a high potential for CC. Laboratories should follow a risk-based approach to define these cases. Knowledge of practice patterns among laboratories can guide the development and refinement of policy and procedures. •This manuscript details the results of a survey sent nationally to cytotechnologists and supervisors regarding how they document their cross-contamination practices.•Documentation of preventative and maintenance practices pertaining to cross-contamination is varied across laboratories.•Use of liquid-based cytology methods and rapid on-site evaluation is practice based, and regulations should be guided as such.