Epidemiological/public health role of the clinical microbiology laboratory

Clinical microbiology laboratories process various specimens from patients, healthcare workers or elsewhere e.g. the environment. The results of their analyses can either contribute to the everyday diagnosis and management of infection in individual patients (the clinical role), or inform healthcare-associated infections (HAIs) infection prevention and control/hospital hygiene (IC) interventions or antimicrobial stewardship (AS) activities (the public health/the epidemiological role). However, as we will see, these two roles are interactive.

Clinical role of the microbiology laboratory.

1. Patient diagnosis and management.
2. Specific issues of HAIs.
3. The challenges of microbiological specimens.
4. Requirements of clinical specimens for microbiological analyses.
5. Quality assurance systems.
6. Microbiological laboratory methods.
7. The challenges of the consolidated microbiology laboratory.
8. Future developments.
9. Point of care (POC) tests.

Epidemiological/public health role of the clinical microbiology laboratory

1. Surveillance.
2. Outbreak investigations
3. Antimicrobial stewardship (AS).
4. More specialised IC-related services.
5. Participation in IC committee.
6. Education of IC, AS and clinical staff.

References:

• Baron EJ, Miller JM, Weinstein MP et al. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2013 recommendation by the Infectious diseases society of America (IDSA) and the American society for microbiology (ASM). Clin Infect Dis 2013;57:e22-e121.doi: 10.1093/cid/cit278.

• Diekema DJ, Saubolle MA. Clinical Microbiology and infection prevention. J Clin Microbiol 2011;49:S57-S60. doi:10.1128/JCM.00690-11.

• Kalenic S. the Role of Microbiology Laboratory. In: Basic Concepts of Infection Control, 3rd edition, International Federation of Infection Control, 2016. http://theific.org/wp-content/uploads/2016/04/7-micro_2016.pdf

• Murray PR. The clinician and the Microbiology Laboratory. In: Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases, 8th Ed., Bennett JE, Dolin R, Blaser MJ Editors, Elsevier Saunders, Philadelphia, 2015:191-223.

• Moore C. Point-of-care tests in infection control: should rapid testing be in the laboratory or at the front line? J Hosp Infect 2013;85(1):1-7. doi:10.1016/j.jhin.2013.06.005.

• Sautter LR, Thomson RB Jr. Consolidated clinical microbiology laboratories. J ClinMicrobiol 2015;53:1467-1472. doi:10.1128/JCM.02569-14.

• Stratton CW IV, Greene JN. Role of the Microbiology Laboratory and Molecular Epidemiology in Healthcare Epidemiology and Infection Control. In: Hospital Epidemiology and Infection Control, 4rd Ed., Mayhall CG, Editor, Lippincott, Williams & Wilkins, Philadelphia, 2012:1418-1431.

• Wolk DM, Dunne WM (2011) New technologies in clinical microbiology. J Clin Microbiol 49: S62–S67. doi:10.1128/JCM.00834-11.

• Niesters HG, Rossen JW, van der Avoort H, Baas D, Benschop K, Claas EC, et al. Laboratory-based surveillance in the molecular era: the TYPENED model, a joint data-sharing platform for clinical and public health laboratories. Euro Surveill.2013;18(4):pii=20387.

• Agodi A, Voulgari E, Barchitta M, Quattrocchi A, Bellocchi P, Poulou A, et al. A. Spread of carbapenem- and colistin-resistant Acinetobacter baumannii ST2 clonal strain causing outbreaks in two Sicilian hospitals. J Hosp Infect. 2014; 86(4): 260-6. doi: 10.1016/j.jhin.2014.02.001.

• Glenister H, Taylor L, Bartlett C, Cooke M, Sedgwick J, Leigh D. An assessment of selective surveillance methods for detecting hospital-acquired infection. Am J Med. 1991 Sep 16;91(3B):121S-124S.

==FEM PAGE CONTRIBUTORS

Contributors

Smilja Kalenic

Vladimir Prikazsky

Original contribution from

Smilja Kalenic,University of Zagreb School of Medicine

Barry Cookson, University College London