Clinical Microbiology Issues Update - February 2011

  • Update Regarding Physician Signature Issue
  • A Quick Guide to the Significance and Laboratory Identification of Cryptococcus gattii Posted
  • ASM Action Alert on Federal Funding for Science and Public Health Programs
  • Highlights of the President’s FY 2012 Budget


  • New from ASM Press
  • ASM Journal Articles of Interest
  • Cubist-ICAAC Award
  • ICAAC Young Investigator Awards
  • New Awards Deadline
  • ABMM Certification
  • Minority Microbiology Mentor Newsletter


  • MMWR Articles of Interest
  • FDA launches website to help regulated industries save time, resources


  • New Reports from IOM
  • CLSI-APHL Teleconferences
  • Clinical and Laboratory Standards Institute Guidelines
  • AACC Webinar
  • Articles of Interest


Update on Physician Signature Issue

The Centers for Medicare & Medicaid Services (CMS) will withdraw the rule that requires a physician’s signature on all paper requisitions for clinical diagnostic laboratory tests that are reimbursed by the Clinical Laboratory Fee Schedule (CLFS).  The ASM worked with the Clinical Laboratory Coalition (CLC) to have the rule revoked because the ramifications for clinical labs.  The ASM posted an alert on its web page asking members to contact their congressional delegation to sign onto a letter to CMS asking that the rule be revoked. Due to the efforts of ASM members and other CLC organization members the CMS announced on February 11, 2011 that the rule is unworkable and will work with the clinical laboratory community if a new rule is considered.  Copies of the House letter, which was signed by 89 representatives and the Senate letter, signed by 34 senators are available at:   ASM will continue to monitor the situation and keep members informed of any changes to the CLFS.


A Quick Guide to the Significance and Laboratory Identification of Cryptococcus gattii Posted
The PSAB Committee on Laboratory Practices has prepared A Quick Guide to the Significance and Laboratory Identification of Cryptococcus gattii.  C. gattii has emerged as an important cause of cryptococcosis in the Pacific Northwest region of the U.S.  This organism can not be differentiated from C. neoformans by conventional laboratory methods, and differences in clinical course and treatment outcomes have been suggested. This document outlines the epidemiological and clinical differences between C. gattii and C. neoformans, and indicates the laboratory tests that can be used for the differentiation of these two organisms.  The document was drafted by Susan Butler-Wu and Ajit Limaye and reviewed by the PSAB Committees on Laboratory Practices and Professional Affairs.  To download the guide go to:


ASM Action Alert on Federal Funding for Science and Public Health Programs

On February 15, the ASM Public and Scientific Affairs Board sent an action alert to the membership concerning proposed cuts to the FY 2011 federal agency budgets for science and public health programs. The alert was in response to the proposed cuts for science and public health programs in the House of Representatives’ bill (HR 1) to provide funding for the remainder of Fiscal Year 2011.  It is very important that members of Congress hear from their constituents about the adverse impacts of reducing federal funding for research and public health programs. The ASM action alert and information about the FY 2011 and FY 2012 budgets for research and public health programs is available on the ASM Public Affairs web site at


Highlights of the President’s FY 2012 Budget

The ASM has posted information about the President’s budget request for FY 2012, including highlights of the NIH, FDA, CDC, USDA, NSF, EPA and the DOE Office of Science.  The highlights are available at:




New from ASM Press


The Immune Response to Infection

Book ISBN or Item Number: 978-1-55581-514-1



Stefan H. E. Kaufmann, Max Planck Institute for Infection Biology

Barry T. Rouse, College of Veterinary Medicine, University of Tennessee

David L. Sacks, Laboratory of Parasitic Diseases, National Institutes of Health


About the Book

With an approach that covers the range from basic research to clinical applications, The Immune Response to Infection examines the mechanisms of both the innate and adaptive immune systems as they relate to infection and disease. The book not only explores the underlying mechanisms of immunity, but also the many sequelae of host-pathogen interactions, ranging from the sterile eradication of the invader, to controlled chronic infection, to pathologic corollaries of the host-pathogen crosstalk. It also explores the pathogenesis of certain autoimmune disorders and cancers that are induced by infectious agents but then become independent of the infection process.


Stable Isotope Probing and Related Technologies

Book ISBN or Item Number: 978-1-55581-537-0



J. Colin Murrell, University of Warwick, Warwick, United Kingdom

Andrew Whiteley, Centre for Ecology and Hydrology, Wallingford, United Kingdom


About the Book

The concept of using stable isotopes to label and track microbes and metabolites of interest is a very recent development in microbial ecology. This comprehensive, carefully edited book, featuring contributions from world leaders in the development and application of these technologies, is the first to present stable isotope probing (SIP) and its related technologies in a single volume.


Cryptococcus: From Human Pathogen to Model Yeast

Book ISBN or Item Number: 978-1-55581-501-1




Joseph Heitman, Duke University Medical Center

Thomas R. Kozel, University of Nevada School of Medicine

Kyung J. Kwon-Chung, National Institute of Allergy and Infectious Diseases, National Institutes of Health

John R. Perfect, Duke University Medical Center

Arturo Casadevall, Albert Einstein College of Medicine


About the Book

Since its first clinical appearance in an 1890s case report, Cryptococcus has dramatically advanced as a human fungal pathogen: it now infects approximately 1 million individuals per year, resulting in more than 600,000 annual mortalities, including one-third of all AIDS-associated deaths.


Featuring more than 100 expert authors from around the world, this book offers the full range of scientific and clinical perspectives needed to create this unique, comprehensive overview of Cryptococcus. It covers both the Cryptococcus neoformans and Cryptococcus gattii species, examining in detail the life cycle, pathophysiology, molecular biology, genetics, genomics, epidemiology, immunology, and clinical management of this encapsulated yeast. Among the 44 chapters, readers will find several in-depth discussions of the C. gattii outbreak that began on Vancouver Island in 1999 and then spread into the mainland of Canada and the United States, causing infections in both humans and animals.


To order books from ASM Press go to the ASM eStore at:


ASM Journal Articles of Interest

Prion Disease Spreads In Sheep Via Mother’s Milk
Journal of Virolog
y, January 2011

Transmission of prion brain diseases such as bovine spongiform enecephalopathy (BSE) – also known as mad cow disease – and human variant Creutzfeldt-Jakob disease (vCJD) is generally attributed to the consumption of the brain or organ meat of infected animals but new research demonstrates lambs exposed to milk from prion-infected sheep with inflamed mammary glands can develop prion disease as well. The research, which is published in the January 2011 issue of the Journal of Virology, has major implications for human and livestock health.


(C. Ligios, M.G. Cancedda, A. Carta, C. Santucciu, C. Maestrale, F. Demontis, M. Saba, C. Patta, J.C. DeMartini, A. Aguzzi, and C.J. Sigurdson, 2011. Sheep with Scrapie and Mastitis Transmit Infectious Prions through the Milk. J. Virol. 85:1136-1139.)

Novel Antibiotic Combinations Fight Resistance Genes
Antimicrobial Agents and Chemotherapy
, January 2011

The combination the antibiotic ceftazidime plus the compound NXL104 is active against bacterial pathogens containing genes that confer resistance to multiple carbapenems, according to two papers published in the January 2011 issue of the journal Antimicrobial Agents and Chemotherapy.


(D.M. Livermore, S. Mushtaq, M. Warner, J. Zhang, S. Maarjan, M. Doumith, and N. Woodford, 2011. Activities of NXL104 Combinations with Ceftazidime and Aztreonam against Carbapaenemase-Producing Enterobacteriaceae. Antim. Agents Chemother. 55:390-394.)

Nanoparticle Vaccine Protects Against Stomach Flu

Journal of Virology, January 2011

A new vaccine strategy using nanoparticles as carriers may be the key to developing a vaccine against norovirus, one of the most common causes of foodborne disease in the United States.  Researchers from the Cincinnati Children’s Hospital Medical Center report promising findings in the January 2011 isse of the Journal of Virology.


(D.M. Livermore, S. Mushtaq, M. Warner, J. Zhang, S. Maarjan, M. Doumith, and N. Woodford, 2011. Activities of NXL104 Combinations with Ceftazidime and Aztreonam against Carbapaenemase-Producing Enterobacteriaceae. Antim. Agents Chemother. 55:390-394.)


Cubist-ICAAC Award

The ASM is pleased to announce that Cubist Pharmaceuticals is the new sponsor of ASM's premier award honoring outstanding accomplishment in antimicrobial research, the Cubist-ICAAC Award.  This award was formerly known as the sanofi-aventis ICAAC Award.  This award is presented annually at ICAAC.  The laureate receives a cash prize of $10,000, a commemorative piece, and travel to ICAAC where he or she delivers the Cubist-ICAAC Award Lecture.  The nomination deadline is April 1, and award details and nominating instructions can be found at:


ICAAC Young Investigator Awards

Nominations for the ICAAC Young Investigator Awards are currently being accepted. The ICAAC Young Investigator Awards recognize and reward early career scientists for research excellence and potential in microbiology and infectious diseases, and are presented at ICAAC.   The award deadline is April 1, and details and nominating instructions can be found at:


New Awards Deadline
The deadline has changed for all awards that are presented at the ASM General Meeting. The new deadline for these awards is July 1.  ASM’s awards are your chance to honor your stellar students, colleagues, and mentors. ASM is committed to recognizing excellence and distinction. By nominating praiseworthy scientists, you are helping ASM ensure that deserving microbiologists are recognized for their exceptional achievements.  To view a full list of awards, as well as information about eligibility and the nomination process, visit: Please feel free to email with any questions.


ABMM Certification
Certification is a voluntary process in which individuals are recognized for demonstrating required skills and knowledge. It is achieved by demonstrating education and experience requirements and by passing a multiple-choice question exam. Many seek it to obtain a tangible and coveted credential that will set them apart from others who have similar education and experience. It gives employers a tool to help them make the right hire--a microbiologist who has been "tested" and "certified." 

The American Board of Medical Microbiology (ABMM) certifies the expertise of doctoral-level microbiologists seeking to direct public health or clinical microbiology laboratories. It is recognized by federal and state governmental agencies as a significant component toward meeting licensure requirements to direct laboratories engaged in the microbiological diagnosis of human disease. It is recognized under the Clinical Laboratory Improvement Amendments of 1988 final rule and in all 12 states that require licensure.

ABMM certification is achieved by passing an online multiple-choice exam that is offered daily in the month of June at testing centers worldwide. Visit  to learn more and apply online.

Deadline: April 1, 2011

Minority Microbiology Mentor Newsletter
The February issue of the Minority Mentor Newsletter has been published by the CMIIM.




MMWR Articles of Interest


The entire February 4, 2011 issue of the MMWR is available here:


FDA launches website to help regulated industries save time, resources

The U.S. Food and Drug Administration today introduced a new Web resource called FDA Basics for Industry ( to help companies and others save time and resources in their interactions with the agency.  The website includes basic information about the regulatory process, including information that is frequently requested by industry.  Part of the agency’s ongoing transparency initiative, the site is one of the 19 action items contained in a 46-page report titled “FDA Transparency Initiative: Improving Transparency to Regulated Industry.”




New Reports from IOM

Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel Update 2010

In 2009, the H1N1 influenza pandemic brought to the forefront the many unknowns about the virulence, spread, and nature of the virus, as well as questions regarding personal protective equipment (PPE) for healthcare personnel. In this report, the IOM assesses the progress of PPE research and identifies future directions for PPE for healthcare personnel. 


HIV Screening and Access to Care: Exploring the Impact of Policies on Access to and Provision of HIV Care

With the widespread use of highly active anti-retroviral treatment (HAART), HIV has become a chronic, rather than a fatal, disease. But for their treatment to succeed, patients require uninterrupted care from a health care provider and uninterrupted access to anti-HIV medications. The IOM identifies federal, state, and private health insurance policies that inhibit HIV-positive individuals from initiating or continuing their care.  To download the report go to:


CLSI-APHL Teleconferences

Using GP34 to Document Blood Collection Tube Performance in Your Lab (588-603-11)
February 17 • 1:00–2:00 PM Eastern (US) Time 

CQI: An Essential Building Block in a Quality Management System (588-609-11)
June 16 • 1:00–2:00 PM Eastern (US) Time

Clinical and Laboratory Standards Institute Guidelines

Performance Standards for Antimicrobial Susceptibility Testing: Twenty-First Edition


Quality Practices in Noninstrumented Point-of-Care Testing: An Instructional Manual and Resources for Health Care Workers; Approved Guideline
This instructional guideline delivers laboratory science concepts and activities with the goal of increasing knowledge and quality of laboratory testing for testing personnel with no laboratory background.


Validation and Verification of Tubes for Venous and Capillary Blood Specimen Collection; Approved Guideline
This document provides guidance for conducting validation and verification testing for venous and capillary blood collection tubes.


Tubes and Additives for Venous and Capillary Blood Specimen Collection; Approved Guideline–Sixth Edition
This standard contains requirements for the materials, manufacturing, and labeling of venous and capillary blood collection devices.


Development and Use of Quality Indicators for Process Improvement and Monitoring of Laboratory Quality; Approved Guideline
This document provides guidance on development of quality indicators and their use in the medical laboratory.


Clinical Laboratory Waste Management; Approved Guideline–Second Edition
Based on U.S. regulations, this document provides guidance on safe handling and disposal of chemical, infectious, radioactive, and multihazardous wastes generated in the clinical laboratory.


Quality Assurance for Design Control and Implementation of Immunohistochemistry Assays; Approved Guideline–Second Edition
This document provides guidelines for the development of validated diagnostic, prognostic, and predictive immunohistochemical assays.


AACC Webinar


Integrating Mass Spec in the Clinical Lab: What You Need to Know

Wednesday, March 16, 2011

2:00–3:30pm Eastern (US) time
Once employed mostly in pharma and basic science applications, mass spec-based test platforms are now an integral part of operations in a growing number of clinical labs. But how do you know whether mass spec can contribute to your lab’s growth plans? Which tests are the most likely candidates for migration to MS platforms? And how do you get a handle on all of the business issues that go into justifying mass spec?

Attend this webinar to find out if mass spec has a place in your lab, and learn how best to navigate the economic and operational decision points of successfully installing this technology.

The Experts:

James C. Ritchie, PhD (Moderator), Emory University School of Medicine and Emory University Hospital (Atlanta, GA)
Robert L. Fitzgerald, PhD, University of California-San Diego and VA Healthcare System (San Diego, CA)
James H. Nichols, PhD, Baystate Health and Tufts University School of Medicine (Springfield, MA)

Articles of Interest


Bacteria in the Gut May Influence Brain Development
February 1, 2011
A team of scientists from around the globe have found that gut bacteria may influence mammalian brain development and adult behavior.

Frisky bacteria war on drugs revealed
BBC News
January 28, 2011
Antibiotics are met by resistance from germs; so researchers develop new drugs and germs become resistant again. Now some scientists believe genetics will be the new weapon in the fight, with doctors consulting bacterial genomes when treating disease.

New Probiotic Combats Inflammatory Bowel Disease
February 1, 2011
You know the probiotics in your peach yogurt are healthful, but now it appears they may also be a powerful treatment for disease.

Controversy Erupts in French Classrooms over Permitting Teens to Genetically Modify Bacteria
Scientific American
January 31, 2011
A row has broken out in France over whether 15- and 16-year-olds should be allowed to create transgenic Escherichia coli bacteria in the classroom.

New Antibiotic Fights C. diff Infections
February 2, 2011
A new antibiotic, fidaxomicin, is as effective as vancomycin in curing C. diff (Clostridium difficile) infections and may be better at reducing recurrences, new research shows.

Bug to spider: I will control your offspring's sex
New Scientist
January 30, 2011
Famed for their ruthless reproductive strategies, female spiders are in fact mere puppets in the hands of a parasitic bug that kills off their embryonic sons.

Measles vaccine: Inhaled, not injected
February 2, 2011
A dry powder measles vaccine that is inhaled rather than injected could help protect children in developing countries where giving conventional vaccination safely is often difficult.

Plant prepares for pathogens at dawn
New Scientist
February 2, 2011
When flu season arrives, you might start eyeing citrus fruit closely or washing your hands with extra diligence. You're not alone. One species of plant, Arabidopsis thaliana, also anticipates an impending infection and guards itself against it.

Bacteria’s Genes Turn Against It
Laboratory Equipment Magazine
February 1, 2011
Researchers at Lawrence Livermore National Laboratory (LLNL) have discovered a new way to combat antibiotic resistant bacteria by using the bacteria's own genes.

Flu and You: Virus widespread in half the states
CNN Health
January 28, 2011
Half of the states have widespread flu activity, reports the Centers for Disease Control and Prevention.

For additional information about any items in this newsletter, please contact the Office of Public Affairs