The importance of the Clinical Microbiology lab
Jennifer Nguyen (11AM BIO230 lecture) found the following case study about how the Clinical Microbiology Lab saved the life of a sick toddler, and further demonstrates the essential need for rapid and accurate microbial identification.
Considering the growing population of people, current economical situation and demand for healthcare, the need for efficient and dynamic hospitals is abundant. The increase of quality of services and practices in the hospital must begin with microbiology. A powerful microbiology department in a hospital allows for the diagnosis of various illnesses to be documented correctly.
In the journal article, a 14-month old female toddler’s case of a painful and aggravated knee is diagnosed after a series of tests including X-rays and ultrasonography. The toddler was then diagnosed with purulent arthritis, taken into surgery and prescribed the antibiotic clindamycin. Meanwhile a microbiologist runs tests such as using molecular, DNA-based methods to detect the presence of Staphyloccocus aureus and Kingella kingae to verify the diagnosis and found that the patient was affirmative for Kingella kingae. DNA-based methods are used due to the fact that white blood cell counts are typically unreliable because of the variation among diagnosed patients. The original diagnosis was incorrect and the microbiologist altered the doctor’s treatment through the use of cefazolin. Cefazolin treats the bacterial infection of the skin caused by the presence of Kingella kingae in comparison to the drug clindamycin prescribed for the treatment of purulent arthritis. In this case, microbiology saved the patient and proved to be a very important role in the healthcare industry by serving as a definite verification for diagnosing sick patients. Without the microbiologists, the treatments ran on the child would have been performed in a manner of trial and error to confirm its effectiveness and correctness of the diagnosis.
There have been many tests developed to enforce the accuracy and promptness of results immediately after the health practitioner and patient meet. These tests include reflex testing of predetermined species, PCR testing, point of care testing which in the future will hopefully be used to test direct specimens, and fluorescent beacon probes which are used to detect Plasmodium spp. directly in blood at very low restrictions of time. Plasmodium spp. causes the disease malaria which is slowly becoming a concern for the U.S. as mosquitoes inhibit environments further north. The goal of these methods and the tests that are currently being developed is the punctuality that they deliver so patients do not have to wait an extended period of time to receive their results and health practitioners can help a large number of patients effectively and quickly.
With a team of microbiologists and clinicians, communication is essential in the success of delivering results of tests to ensure that the right diagnosis is given to patients. In the past, communication was very limited between microbiologists and clinicians due to the fact that they could only exchange information by personal interactions or by paper. In this day and age, the technology we have provides microbiologists and health practitioners the opportunity to communicate immediately through systems that show patient demographics, microbiology reports and hospital-specific antibiotic data. Not only do these systems produce a great tool for communication but they are also very cost-effective.
Through the use of high tech communication and effective tests, hospitals can save more people by diagnosing them faster. These factors are especially crucial in the emergency room due to the nature of the illnesses and their need for immediate attention. Also, these aspects greatly decrease the probability of failure in the hospital that could result in incorrect treatments or death. Although finding new methods to test with ease may not be cost-effective at the beginning, but in the end it would be more cost-effective due to the amount of patients treated correctly and instantaneously.
Citation: Beavers, T., & Wheeler, J. (2010). Collaborative medicine: Weaving the microbiology laboratory into clinical practice. MLO: Medical Laboratory Observer, 42(10), 20-22.