Purpose of Review
To appraise the evidence and recommendations from published medical literature about the importance of clinical microbiology laboratory services in the prevention and control of infection in community and in the healthcare setting especially from the Indian perspective.
Effective infection prevention and control (IPC) is not possible without a functioning microbiology laboratory. Basic microbiology services in a biosafety level 2 facility consisting of light microscopy, blood culture, bacteriology, serology, and tests for certain fungus and mycobacteria (with standard facilities with regard to microscopy, culture) are essential for all tertiary care facilities providing IPC services. In primary and secondary healthcare facilities where microbiology laboratory services are not available in most low- and middle-income countries (LMICs), point of care tests and rapid diagnostic tests which are cost-effective have an important role in IPC and clinical care of patients. Quality assurance of all microbiology tests is important for clinical management and IPC.
Investment in the development of clinical microbiology laboratory infrastructure is essential for IPC and patient care. Surveillance data generated from clinical microbiology services may be used to monitor epidemiological trends of infectious diseases; formulate antimicrobial treatment or prophylactic policies; and assess impact of clinical, antimicrobial stewardship and IPC interventions.
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References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Cox JL, Simpson MD. Microbiology education and infection control competency: offering a new perspective. J Microbiol Biol Educ. 2018;19(2).
• Yusuf E, Hamers RL. What the WHO's list of essential diagnostics means for clinical microbiology laboratories and antimicrobial stewardship practice worldwide. Clin Microbiol Infect. 2019;25(1):6–9 Important source of information and commentary about World Health Organization’s Essential Diagnostics means for clinical microbiology laboratories.
Alp E, Cookson B, Erdem H, Rello J, Survey Group. Infection control bundles in intensive care: an international cross-sectional survey in low- and middle-income countries. J Hosp Infect. 2019;101(3):248–56.
Mathur P. Prevention of healthcare-associated infections in low- and middle-income countries: the 'bundle approach'. Indian J Med Microbiol. 2018;36(2):155–62.
Ramos R, Caceres DH, Perez M, Garcia N, Castillo W, Santiago E, et al. Emerging multidrug-resistant Candida duobushaemulonii infections in Panama Hospitals: importance of laboratory surveillance and accurate identification. J Clin Microbiol. 2018;56(7).
Kohlenberg A, Struelens MJ, Monnet DL, Plachouras D, The Candida auris Survey Collaborative Group. Candida auris: epidemiological situation, laboratory capacity and preparedness in European Union and European Economic Area countries, 2013 to 2017. Euro Surveill. 2018;23(13).
Nkengasong JN, Nsubuga P, Nwanyanwu O, Gershy-Damet GM, Roscigno G, Bulterys M, et al. Laboratory systems and services are critical in global health: time to end the neglect? Am J Clin Pathol. 2010;134(3):368–73.
• Diekema DJ. Rising stakes for health care-associated infection prevention: implications for the clinical microbiology laboratory. J Clin Microbiol. 2017;55(4):996–1001 This article would provide information about why clinical microbiology laboratory services are important for healthcare associated infection prevention.
•• Storr J, Twyman A, Zingg W, Damani N, Kilpatrick C, Reilly J, et al. Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations. Antimicrob Resist Infect Control. 2017;6:6 This article is fundamentally important for any infection control practitioner.
Walia K, Ohri VC. Strengthening surveillance key to addressing antimicrobial resistance. Indian J Med Microbiol. 2016;34:413–5.
Buehler SS, Madison B, Snyder SR, Derzon JH, Cornish NE, Saubolle MA, et al. Effectiveness of practices to increase timeliness of providing targeted therapy for inpatients with bloodstream infections: a laboratory medicine best practices systematic review and meta-analysis. Clin Microbiol Rev. 2016;29(1):59–103.
Kapil A. Accreditation of microbiology laboratories: a perspective. Indian J Med Microbiol. 2013;31:217–8.
Pfaller MA, Herwaldt LA. The clinical microbiology laboratory and infection control: emerging pathogens, antimicrobial resistance, and new technology. Clin Infect Dis. 1997;25(4):858–70.
• Ombelet S, Ronat JB, Walsh T, Yansouni CP, Cox J, Vlieghe E, et al. Clinical bacteriology in low-resource settings: today's solutions. Lancet Infect Dis. 2018;18(8):e248–58 This article would of interest to microbiologists working in LMICs.
•• Guidelines on Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level. Geneva: World Health Organization; 2016. https://www.ncbi.nlm.nih.gov/books/NBK401761/table/fm.s4.t1/. This article is fundamentally important for any infection control practitioner.
Kolmos HJ. Role of the clinical microbiology laboratory in infection control--a Danish perspective. J Hosp Infect. 2001;48(Suppl A):S50–4.
Conflict of Interest
Dr. Bhattacharya declares that he has no conflicts of interest.
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This article is part of the Topical Collection on Infection Prevention and Safety in Low and Middle Income Countries
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Cite this article
Bhattacharya, S. Improving Diagnostic and Laboratory Capacity Helps in Control of Infection: an Indian Perspective. Curr Treat Options Infect Dis 12, 112–121 (2020). https://doi.org/10.1007/s40506-020-00215-8
- Diagnostic services
- Clinical microbiology
- Infection prevention and control (IPC)
- Low- and middle-income countries (LMICs)