| Medical Microbiology | | | | mean and matters to be made clear and |
| Emerging Diagnostic Challenges | | | | understandable. The greatest communication gap |
| | | | between clinicians and microbiologists remain with |
| Medical Microbiology is a challenging profession deals | | | | terminology. |
| with all aspects of infection, through initial diagnosis, | | | | Molecular methods is diagnosis of Infectious diseases |
| to treatment. It includes hands on bench work in the | | | | |
| laboratory, which is often neglected and close | | | | The PCR is the most sensitive of the existing rapid |
| involvement with clinical staff in a variety of acute | | | | methods to detect microbial pathogens in clinical |
| and community settings to effectively manage | | | | specimens. In particular, when specific pathogens that |
| infections and ensure effective surveillance and | | | | are difficult to culture in vitro or require a long |
| infection prevention and control across the healthcare | | | | cultivation period are expected to be present in |
| community. | | | | specimens, the diagnostic value of PCR is known to |
| Unlike many other medical specialities the Microbiology | | | | be significant. However, the application of PCR to |
| departments are neglected by Governmental and | | | | clinical specimens has many potential pitfalls due to |
| several private Medical colleges. And our younger | | | | the susceptibility of PCR to inhibitors, contamination |
| generation of Microbiologists should adapt to the | | | | and experimental conditions. It is known that the |
| changing scenario to acquire their space in Medical | | | | sensitivity and specificity of a PCR assay is |
| Profession, which continues to be competetive and | | | | dependent on target genes, primer |
| driven by commercial interests as well. | | | | sequences, which are expensive. However molecular |
| Upcoming Microbiologists should realise that no day is | | | | methods are most talked, highly expensive and |
| the same in medical microbiology practice and each | | | | creating dedicated laboratories continues to be |
| day brings its own challenges and uncertainty. The | | | | difficult in our economy If modern methods of |
| goal of microbiologic evaluation is to provide accurate, | | | | molecular diagnostics are not implemented we will we |
| clinically pertinent results in a timely manner. | | | | out of scene in Modern Medicine. |
| However optimal utilization of the available resources | | | | Computer documentation with use of WHONET |
| is the need of the hour, which can be implemented | | | | |
| with dedicated practice which include - | | | | Continuous surveillance of local antimicrobial |
| 1. Scientific sterilization practises will certainly cut short | | | | susceptibility patterns is a must for combating |
| the rate of infection reduce the costs to the hospital | | | | emerging antimicrobial resistance.WHONET is an |
| and reduces morbidity and mortality. The recent | | | | effective computerized microbiology laboratory data |
| document on Sterilization released by CDC Atlanta | | | | management and analysis program that can provide |
| with title Guideline for Disinfection and Sterilization in | | | | guidance for empiric therapy of infections, alert |
| Healthcare Facilities, 2008 will clarify all the doubts of | | | | clinicians of trends of antimicrobial resistance, guide |
| practice, including the decreasing role of bio | | | | –the antibiotic policy decisions and preventive |
| hazardous chemical and use of environmentally safe | | | | measures. The program facilitates sharing of data |
| agents. Fumigation which we practice without | | | | amongst different hospitals by putting each |
| knowing its biohazards needs a rethinking. | | | | laboratory data into a common code and file format, |
| Microbiologists should learn more; educate the | | | | which can be merged for national or global |
| Paramedical and Nursing staffs who are our greater | | | | collaboration of antimicrobial resistance surveillance. All |
| partners in infection control. | | | | the documentation can be stored retrieved and |
| 2. Specimen collection and aseptic precautions in | | | | analysed with the freely avialble soft ware from |
| collection is a major concern to valid microbiology | | | | WHO, just needing computer The program supports |
| reporting, several life threatening septic complications | | | | routine entry of susceptibility test results performed |
| including blood cultures in bacterial infections are | | | | by disk diffusion, MIC, and/or Etest or by Hi comb |
| contaminated due to lapses in specimen collection. A | | | | method The majority of laboratories in the Armed |
| frequently contaminated blood culture reports losses | | | | forces use comparative disc diffusion techniques |
| the confidence of Physicians on Microbiology | | | | based on Stokes or Kirby Bauer method to |
| Departments. | | | | determine antibiotic sensitivity. Interpretation |
| Delayed reports due to ineffective, age old culture | | | | guidelines for most standardized testing |
| methods, certainly a concern to patients and treating | | | | methodologies are built into the system. |
| physician. | | | | WHONET working make you familiarise with optimal |
| 3. Bacteriology departments should be updated, as | | | | drug choice, zone sizes, easier to understand in |
| most of the life threatening infections are bacterial | | | | interpretation in precise reporting. |
| in developing world, effective early diagnosis reduce | | | | Tele diagnostic services in Infectious Diseases |
| the cost of antibacterial agents, on many occasions | | | | |
| are most costlier than hospital occupancy rates. | | | | When a laboratory would like assistance in identifying |
| However it is certainly need of the hour. | | | | a parasitic organism, or confirmation of a presumed |
| Bench work. | | | | diagnosis, and they have access to a digital camera, |
| Is the most important component of the Diagnostic | | | | they can use telediagnosis. Telediagnosis involves |
| Microbiology Typical tasks: include logs in sample or | | | | email transmission of data, such as digital images |
| specimen noting date, time, and tests to be | | | | captured from samples and clinical and travel history, |
| performed; based on quantitative growth patterns | | | | to CDC. Response to these inquiries can be provided |
| and effective reporting. A good control on the | | | | in a matter of minutes to hours. |
| bench work by Senior Microbiologists keeps | | | | If you are a Microbiologist or a Pathologist and want |
| everybody under check. | | | | to use telediagnosis assistance*, please visit the |
| All uncommon isolates should be studied to species | | | | Diagnostic Assistance section on the DPDx Web site. |
| level with extended biochemical testing, and will be a | | | | Caring for self is equally important |
| boon to publish case reports in good academic | | | | Our health and disease is a concern to us and family |
| journals. | | | | member apart from the society. All Bio hazardous |
| All uncommon isolates should not be reported without | | | | micro-organisms and materials to be handled with |
| the wisdom of the senior Microbiologists. | | | | caution. Be a champion to promote the “Universal |
| All upcoming Microbiologists should seek the help of | | | | Precautions” make the best contributions in |
| reference centres for assistance and guidance as all | | | | prevention of infection in your own working arena. |
| we think may not be correct. | | | | Publishing your work |
| 4. The diagnostic work on Mycobacteriology and | | | | Always publish your genuine work in Journals and |
| Mycology lags the advances to the growing needs of | | | | periodicals; do not get disappointed if you cannot |
| the physicians. Tuberculosis being a major health | | | | publish in a reputed journal. Now there are good |
| problem in the country, yet no dedicated laboratories | | | | quality on line Microbiology Journals (e-Journals) and |
| to diagnose the disease beyond smear examination, | | | | periodicals which are indexed and available for your |
| and increasing drug resistant tuberculosis is a | | | | rescue. Every attempt to publish an article makes |
| concern to the treating physician. The attention and | | | | you realise where we have to improve and by going |
| dedicated work of the young Microbiologists will | | | | through good references we can certainly improve |
| certainly supported by every one. However we | | | | ourselves. |
| certainly need new generation of Microbiologists to | | | | Internet and e-learning. |
| take up the Tuberculosis related work. | | | | All young and senior professionals should refer the |
| 5. The anaerobic culture work remains least | | | | good potential of information high way, the Internet |
| attempted and younger generation of Microbiologists | | | | and get the best out it. E-learning should be our next |
| should explore this division of bacteriology as many | | | | option to know what the world is thinking about. I |
| anaerobes are developing drug resitance. | | | | consider it is the best emerging option for improving |
| Reporting the Microbiology Results | | | | our knowledge in Microbiology. |
| Reporting the results should be done with caution as | | | | * Dr.T.V. |
| the Physicians are not familiar with what really we | | | | |