For Members
Reports Highlight the Evolving Role of Clinical Microbiology Laboratories
WASHINGTON, DC -- September 8, 2011 -- With the increasing availability of sophisticated
technologies to rapidly diagnose and treat infectious diseases, the duties and
the role of clinical laboratory microbiologists, who traditionally perform
these tests, could see significant changes in the next few years. That is one of the conclusions of a series of
reports published in a special supplement to the September 2011 Journal of Clinical Microbiology.
“This is a very exciting and dynamic period for clinical
microbiology: not only are we seeing changes in the way we practice, but we
also have a very sophisticated array of tools that are increasingly at our
disposal. These tools, and the changes
they impart, can substantially improve the quality and delivery of service
being provided for our patients,” writes Duane Newton of the University of
Michigan Medical School in one report on enhancing the function of clinical
microbiology laboratories.
The supplement is based on a symposium held in February 2011
to consider a number of issues facing clinical microbiologists today. Laboratory directors from across the United
States as well as a representative of the Food and Drug Administration and
individuals from eight companies currently active in the field of clinical
microbiology came together to plot a new way forward for the profession over
the next five years, encourage relationships between labs and industry and
develop plans to address important unanswered questions in the field.
Participants identified 19 different specific subjects
within five primary topic areas:
- Antimicrobial
susceptibility testing
- The
role of the clinical laboratory in the diagnosis of selected infectious
processes
- Conventional
versus molecular methods for pathogen detection and the role of clinical
microbiology in infection control
- Clinical
microbiology in the year 2015
- The
business of clinical microbiology
The supplement consists of reports from each of the 19
small-group discussions, written by the group facilitators.
“It is our sincere hope that the clinical microbiology
community will find the information presented herein to be insightful,
informative, and, in some cases, provocative.
We also hope that this information will serve as a stimulus for others
to begin to think about tangible ways of moving the discipline of clinical
microbiology forward,” writes Gary Doern, the journal’s editor-in-chief, in the
supplement’s introduction.
One of the reports focuses on new technology in clinical
microbiology, specifically the rapid diagnosis of bloodstream infections (BSIs)
and the associated condition known as sepsis.
A common complication of BSIs, sepsis ranks among the top 10 causes of
death in the
Since the risk of death from sepsis increases by over 7%
each hour that passes from the onset of shock to the start of targeted therapy,
rapid identification of the bacteria causing the infection is crucial to saving
the patient and containing healthcare costs.
Current laboratory standards rely on cultures for diagnosis, a method
that can take more than 3 to 5 days to produce results, a delay that has been
implicated as one reason for the high mortality and the emergence of
drug-resistant bacteria.
“Despite evidence showing that the rapid administration of
an effective antibiotic saves lives, tools in clinical microbiology are
primarily based on techniques that evolved 30 to 40 years ago,” write the
authors of the report. “Several technological advances using simple molecular
methods have become available in recent years and show potential for cost
benefit.”
Although implementation of these technologies in the health
care setting has been shown to reduce costs by $4,000 to over $21,000 per
patient, because of their cost and complexity they may be accessible only to
large reference or university-based diagnostic laboratories. The authors urge the development of platforms
that could have utility for hospitals regardless of their size.
“The enhancements desired for the engaged clinical
microbiology laboratory 5 years into the future will require us to be nimble,
innovative and connected. While this
path may not be familiar or comfortable, it will keep us professionally viable
and relevant,” writes
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The supplement can be accessed online at http://jcm.asm.org/content/vol49/9_Supplement/