Background: Turnaround time (TAT) is a key performance indicator in clinical microbiology, particularly for urine cultures, which represent a high-volume workload and directly impact antimicrobial stewardship. Methods: This retrospective observational study compared urine culture TAT before (2023, manual workflow) and after (2025, total laboratory automation using WASPLab™) implementation in a high-volume reference laboratory. A total of 16,210 cultures in 2023 and 60,474 in 2025 were included. TAT was defined as the time from laboratory receipt to final report validation. Results: Implementation of total laboratory automation significantly reduced median TAT for both negative cultures (from 49.68 to 34.38 h) and positive cultures (from 50.42 to 34.62 h) (p < 0.001). In addition, variability in reporting times decreased, indicating improved consistency. Laboratory productivity increased from 2316 to 7559 cultures per full-time equivalent, representing a 3.26-fold improvement. Conclusions: Total laboratory automation significantly improved the speed and consistency of urine culture reporting, supporting enhanced laboratory efficiency and facilitating timely clinical decision-making.

We report a rare case of a 9-year-old Saudi girl with sickle-thalassemia who developed anti-f antibody—an uncommon finding in pediatric patients undergoing chronic transfusion therapy. Despite extensive exposure to blood transfusions, the presence of anti-f remains rare. This case highlights the clinical challenges associated with managing alloimmunization in sickle-thalassemia and emphasizes the importance of extended phenotype matching and vigilant antibody screening in such patients.

Background/Objectives: Iron deficiency anemia (IDA) remains the most prevalent nutritional deficiency worldwide and a leading cause of years lived with disability, particularly in low-income countries. In Egypt, the burden is substantial and compounded by regional socioeconomic, nutritional, and parasitic factors. Despite this, the predictors of diagnostic delay within the Egyptian healthcare system remain poorly characterized. This study aimed to quantify the extent of diagnostic delay among Egyptian patients with IDA and to identify the sociodemographic and clinical risk factors independently associated with prolonged time to diagnostic confirmation. Methods: A single-center retrospective cohort study was conducted at Al-Minia University Hospital, Egypt, between March and April 2026, enrolling 350 adults with confirmed IDA diagnosed between 2015 and 2025. “Diagnostic delay” was defined as the interval in days from the index date (the first documented abnormal complete blood count) to laboratory confirmation of iron deficiency by serum ferritin and/or transferrin saturation. Secondary outcomes included patient delay, system/testing delay, and etiology work-up delay. Time-to-event analysis was performed using Kaplan–Meier curves and Cox proportional hazards regression. All analyses were conducted in R version 4.4.0. Results: The cohort comprised 213 females (60.9%) and 137 males (39.1%), with a median age of 39 and 36 years, respectively. The median primary diagnostic delay was 76.0 days (IQR: 38.0, 182.8), with patient delay accounting for a median of 26.5 days and system/testing delay for 21.0 days. Overall, 155 patients (44.3%) experienced a diagnostic delay of more than 90 days. In the multivariable Cox model, urban residence (aHR = 0.69, 95% CI [0.53, 0.99], p = 0.045) was independently associated with a slower rate of diagnostic confirmation. Conclusions: Diagnostic delay in IDA is substantial in Egypt, driven by both patient-level symptom normalization and counterintuitive systemic bottlenecks. Urban residence was independently associated with prolonged time to diagnostic confirmation; ordering of iron studies at the first visit was associated with delay in bivariate analysis only and was not an independent predictor after multivariable adjustment. Targeted public health education, restructured primary care pathways, and improved laboratory turnaround times are essential to reduce this burden.