You are Regional Director of Microbiology, Department of Pathology, Regional Laboratory, Kaiser Permanente Northwest. What are your duties like as Regional Director of Microbiology?
I oversee the daily operations of the microbiology laboratory. I consult on daily basis with clinicians regarding test ordering and interpretation of lab data, and I do laboratory rounds with the technologists on difficult cases. I also serve on the infection control committee for the hospital as well as the antibiotic utilization subcommittee and the laboratory compliance committee.
Your work with Clostridium difficile testing helps to serve as the basis for multi-step testing for C. difficile toxin currently used in many clinical microbiology labs. Can you describe the steps in testing? Why do we need so many steps?
The first step is a screening test. It’s called the GDH screen – glutamate dehydrogenase, or GDH, is a common antigen of C. difficile and can be used in many facilities as a sensitive screen. That test can be combined with or followed by a test looking for the toxin. If both tests are positive then no further testing is necessary. However, due to the lack of sensitivity in the toxin test, if the GDH screen is positive and the toxin test is negative, additional testing is necessary. Most labs are using a molecular assay to look for the genes associated with production of one the C. difficile toxins. As molecular testing can be expensive, it’s cost-effective to use a less expensive screening test first.
What are some of the biggest scientific challenges facing clinical labs these days?
How to incorporate new technologies in a clinically useful and cost-effective manner faces all of us. In addition, dealing with mounting governmental regulations in health care and cost cutting is a challenge. It will be important to determine how the clinical laboratory can assist in reducing healthcare costs.
You’re obviously well acquainted with the capabilities of a clinical microbiology laboratory. How does it feel to watch movies and television shows in which the hero identifies a pathogen in no time flat?
We’re not that far away from that actually being reality. Between molecular diagnostics and new mass spectrometry, we’re performing more and more very rapid identifications of organisms.
Where do you see your field in 10 years?
I see clinical microbiology being more ‘chemistry’ based, by which I mean with methods like molecular diagnostics and mass spectrometry we’re getting down to the level of the chemistry of the organism, which would include analysis of proteins and nucleic acids rather than just biochemical testing for organisms’ reactions.
If you had to change careers today and you could do anything, what would you do?
I would probably be a journalist. I’d like to be based in Washington DC and be a political reporter.
What’s your favorite science book?
My favorite science fiction book is The Stand, by Stephen King.
What is something about you that most people don’t know?
I’m married to Howard Stern. Actually, my husband is a year older than the shock-jock Howard Stern. I was also a paid professional musician while I was in college. I played the horn – either baritone or trumpet.