Pharmacy OneSource Blog

New Clinical Microbiology Technologies and the Infection Preventionist

Posted on 11/19/15

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Does your infection prevention team work with your facility’s clinical microbiologists? What instrumentation does your laboratory employ to assist your department? Automation in the clinical microbiology laboratory (CML) has been overshadowed by automation seen in other labs such as chemistry and hematology. However, the CML has come a long way since relying so heavily on the gram stain (still important!) and cultures that could take up to a week to become positive. Now, the lab has continuous-monitoring blood culture systems, automated microbial identification, and automated antimicrobial susceptibility testing systems.1

Below are four topics presented at the September 2015 American Society of Microbiology’s and International Society of Chemotherapy’s International Congress of Chemotherapy and Infection Interscience Conference on Antimicrobial Agents and Chemotherapy that addressed rapid diagnostics and the relationship with infectious disease.
  • A novel technique that can analyze gaseous volatile organic compounds from samples of exhaled breath accurately detected tuberculosis among infected patients, according to a recent study.2

  • A rapid DNA sequencing device may effectively identify pathogens and antibiotic resistance in patients at high risk for urosepsis.3

  • A 20-minute diagnostic test used to identify Staphylococcus aureus in blood samples reduced hospital durations and eliminated unnecessary antibiotic treatment, according to recent study results.4

  • Researchers from Japan reported that they have invented an updated, more accurate version of a screening assay that detects tuberculosis infection.They found a new generation of QuantiFERON TB Gold In-Tube (Cellestis; QFT-GIT) assay that could replace the current QFT-GIT.

In addition, molecular testing can expedite respiratory infection diagnosis. Panels that use polymerase chain reaction (PCR) can detect seasonally common viruses, such as influenza A and B plus RSV, adenovirus, and enterovirus. PCRs are much more sensitive than rapid assays and are more reliable. Two immunoassays have been developed to enhance the sensitivity and specificity of detecting influenza viral antigens in respiratory specimens.6  These digital immunoassays (DIA) test for influenza A and B and eliminate the need for someone to interpret the results. Use of these and traditional rapid influenza diagnostic tests can improve patient outcomes and assist the infection preventionist (IP) by having a definitive diagnosis quickly, thereby facilitating isolation decisions.

We have these technologies, and many more currently available and soon to be available. The next question to answer will be: How do we pay for these products? CMLs are not normally significant revenue generators. Will administrators agree to allocating funds for new technology when there are so many other demands for resources?

Microbiologists and the technology they utilize are an inherent part of infection prevention and control. They can assist IPs by keeping abreast of current instrumentation, helping with antibiotic stewardship, assisting with targeted organism trending, and partnering in outbreak investigations.

Is your microbiologist part of your infection prevention team? Does your CML have automated instrumentation and new rapid diagnostic tests?

infection prevention and control

 

References:

  1. Bourbeau PP, Ledeboer NA. Automation in Clinical Microbiology. Journal of Clinical Microbiology. 2013. 51(6): 1658-1665.

  2. Sahota A, et al. Breath Analysis to Diagnose Pulmonary and Extra-pulmonary Tuberculosis Using Ion Mobility Spectrometry. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 17-21, 2015; San Diego. http://www.healio.com/infectious-disease/respiratory-infections/news/online/{7204e2a3-0325-4ed3-af13-2399fc79d1b1}/tb-breath-analysis-accurately-diagnoses-infected-patients

  3. Schmidt K, at al. Abstract D-714. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 17-21, 2015; San Diego. http://www.healio.com/infectious-disease/antimicrobials/news/online/%7B6b473f19-84a2-471c-8de6-0b34a96b4050%7D/rapid-dna-sequencing-device-identifies-uti-pathogens-resistance

  4. Candelaria WJ, et al. Abstract S-903. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 17-21, 2015; San Diego. http://www.healio.com/infectious-disease/practice-management/news/online/{d81d7687-f5dd-4ab3-a259-1114decd85fb}/20-minute-test-reduces-hospital-durations-unnecessary-treatments

  5. Candelaria WJ, et al. Abstract S-903. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 17-21, 2015; San Diego. http://www.healio.com/infectious-disease/practice-management/news/online/{d81d7687-f5dd-4ab3-a259-1114decd85fb}/20-minute-test-reduces-hospital-durations-unnecessary-treatments

  6. J. Dunn. The evolution of rapid influenza testing and the introduction of digital immunoassays. Infectious Disease News, January 2015. http://www.healio.com/infectious-disease/influenza/news/print/infectious-disease-news/%7B005788d9-dc21-4903-bdc5-d2d136763ff5%7D/the-evolution-of-rapid-influenza-testing-and-the-introduction-of-digital-immunoassays

Topics: Infection Prevention

About the Author

Eileen O'Rourke has been practicing hospital-based Infection Prevention since 1984 and served as a consultant with the ECRI Institute in 2014-2015. Eileen's background also includes experience in Microbiology and a Masters in Public Health. She is certified by CBIC and the American Society of Clinical Pathologists and has been active in the Delaware Valley Chapter of APIC (Association for Professionals in Infection Control and Epidemiology), serving as Education Chair and President. Her special interest is education and she has offered multiple infection prevention inservices, including webinars.