The role of the microbiology laboratory in an era of increasing antibiotic resistance.
In medical institutions where antibiotic resistance is a problem, the situation can be likened to a state of warfare. Antibiotic-resistant bacteria are the enemy, the bodies of infected patients are the battlefield, and the health professionals are the "good guys." In this context, microbiology laboratories can be considered as an intelligence system that has the responsibility to detect the presence of the bacterial enemy, its strengths, its weaknesses (usually by antibiotic susceptibility testing), and any new weapons the enemy may have developed (especially new antibiotic-resistance mechanisms). It is fundamental that if the laboratory cannot provide prompt, accurate, and useful intelligence, it will be much harder to defeat the enemy. That is, without a good laboratory service it will be difficult to choose appropriate therapies for infected patients, and also to prevent the spread of pathogens that are resistant to multiple antibiotics. The laboratory role is critical. Thus, it is worthwhile to review the status of clinical microbiology laboratories for their ability to detect resistance, especially new types of resistance. Laboratories that cannot accurately detect antibiotic-resistant bacteria make it difficult for health professionals to make correct decisions and to respond appropriately.
Thomson
K S
KS
Center for Research in Anti-infectives and Biotechnology, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA. kstaac@creighton.edu
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology / Q000517:prevention & control; D019411:Clinical Laboratory Techniques; D004198:Disease Susceptibility; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D006801:Humans; D007753:Laboratories; D008826:Microbial Sensitivity Tests; D008828:Microbiological Techniques; D011159:Population Surveillance
D000900:Anti-Bacterial Agents