title: Prevention and Control of Antimicrobial Resistant Healthcare-Associated Infections: The Microbiology Laboratory Rocks!
abstract: In Europe, each year, more than four milion patients acquire a healthcare-associated infection (HAI) and almost 40 thousand die as a direct consequence of it. Regardless of many stategies to prevent and control HAIs, they remain an important cause of morbidity and mortality worldwide with a significant economic impact: a recent estimate places it at the ten billion dollars/year. The control of HAIs requires a prompt and efficient identification of the etiological agent and a rapid communication with the clinician. The Microbiology Laboratory has a significant role in the prevention and control of these infections and is a key element of any Infection Control Program. The work of the Microbiology Laboratory covers microbial isolation and identification, determination of antimicrobial susceptibility patterns, epidemiological surveillance and outbreak detection, education, and report of quality assured results. In this paper we address the role and importance of the Microbiology Laboratory in the prevention and control of HAI and in Antibiotic Stewardship Programs and how it can be leveraged when combined with the use of information systems. Additionally, we critically review some challenges that the Microbiology Laboratory has to deal with, including the selection of analytic methods and the proper use of communication channels with other healthcare services.
authors.affiliation: Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon Portugal.
authors.forename: Alexandra S
authors.initials: AS
authors.lastname: Simões
authors.affiliation: Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Couto
authors.affiliation: Laboratório de Microbiologia Clínica e Biologia Molecular, Serviço de Patologia Clínica, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, LisbonPortugal; Centro de Estudos de Doenças Crónicas, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, LisbonPortugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Toscano
authors.affiliation: Laboratório de Microbiologia Clínica e Biologia Molecular, Serviço de Patologia Clínica, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, LisbonPortugal; Centro de Estudos de Doenças Crónicas, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, LisbonPortugal.
authors.forename: Elsa
authors.initials: E
authors.lastname: Gonçalves
authors.affiliation: Centro de Estudos de Doenças Crónicas, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, LisbonPortugal; Unidade de Cuidados Intensivos Polivalente, Hospital de São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, LisbonPortugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Póvoa
authors.affiliation: Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Viveiros
authors.affiliation: Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, LisbonPortugal; WHO Collaborating Center for Health Workforce Policy and Planning, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, LisbonPortugal.
authors.forename: Luís V
authors.initials: LV
authors.lastname: Lapão
keywords: antibiotic stewardship; antibiotics; communication; control; healthcare-associated infections; information systems; microbiology; prevention