Establishing diagnostic microbiology laboratory

1. Establishing diagnostic microbiologylaboratory Dr.T.V.Rao MD Dr.T.V.Rao MD

2. What is Medical Microbiology • Medical Microbiology may overlap with parasitology, generally considered the Studyof Diseases caused by multi-cellular parasites, where a parasite is defined as an organism that derives its nutrients from another living organisms, often but not always to the detriments of its host. Microbes are continually probing our defenses and commensals that get into the "wrong" place can do untold damage. A very small Minority of microbes are primary pathogens. These are capable of infecting individuals and causing disease. Dr.T.V.Rao MD

3. Challenges in Medical Microbiology • Medical Microbiology is a challenging profession deals with all aspects of infection, through initial diagnosis, to treatment. It includes hands on bench work in the laboratory, which is often neglected and close involvement with clinical staff in a variety of acute and community settings to effectively manage infections and ensure effective surveillance and infection prevention and control across the healthcare community. Dr.T.V.Rao MD

4. Know what you are doing • Laboratory medicine in general and microbiology in particular is presently subject to rapid evolution. • •Do we know where we are going? • •What are the driving forces? • •Is it good, bad or just plain necessary? • •Who is gaining and who is losing? Dr.T.V.Rao MD

5. Components of diagnostic microbiology • It is the analysis ofa sample, the synthesis ofresults (of several samples) and the clinical consultation. Together these form the basis for • -diagnosis, • -therapy, • -infection control • -advice on and surveillance of antimicrobial resistance and several other ”Public health” issues on a national and European level. Dr.T.V.Rao MD

6. Role of clinical microbiologists • Clinical microbiologists are engaged in the field of diagnostic microbiology to determine whether pathogenic microorganisms are present in clinical specimens collected from patients with suspected infections. If microorganisms are found, these are identified and susceptibility profiles, when indicated, are determined. Dr.T.V.Rao MD

7. Coping with progress in diagnostic microbiology • During the past two decades, technical advances in the field of diagnostic microbiology have made constant and enormous progress in various areas, including bacteriology, mycology, mycobacteriology, parasitology, and virology. The diagnostic capabilities of modern clinical microbiology laboratories have improved rapidly and have expanded greatly due to a technological revolution in molecular aspects of microbiology and immunology. In particular, rapid techniques for nucleic acid amplification and characterization combined with automation and user-friendly software have significantly broadened the diagnostic arsenal for the clinical microbiologist. Dr.T.V.Rao MD

8. Conventional diagnostic microbiology • The conventional diagnostic model for clinical microbiology has been labor-intensive and frequently required days to weeks before test results were available. Moreover, due to the complexity and length of such testing, this service was usually directed at the hospitalized patient population. Dr.T.V.Rao MD

9. Design the laboratory to suit the circumstances – and work load Dr.T.V.Rao MD

10. Establish the biosafety in microbiology laboratory Over the past two decades, Biosafety in Microbiological and Biomedical Laboratories (BMBL) has become the code of practice for biosafety—the discipline addressing the safe handling and containment of infectious microorganisms and hazardous biological materials. Dr.T.V.Rao MD

11. Biosafety level 1 • Biosafety level 1 (BSL-1) is the basic level of protection and is appropriate for agents that are not known to cause disease in normal, healthy humans Dr.T.V.Rao MD

12. Biosafety level 2 • Biosafety level 2 (BSL-2) is appropriate for handling moderate-risk agents that cause human disease of varying severity by ingestion or through percutaneous or mucous membrane exposure Dr.T.V.Rao MD

13. Biosafety level 3 • Biosafety level 3 (BSL-3) is appropriate for agents with a known potential for aerosol transmission, for agents that may cause serious and potentially lethal infections and that are indigenous or exotic in origin. Dr.T.V.Rao MD

14. biosafety level 4 • Exotic agents that pose a high individual risk of life-threatening disease by infectious aerosols and for which no treatment is available are restricted to high containment laboratories that meet biosafety level 4 (BSL-4) standards Dr.T.V.Rao MD

15. optimal utilization of the available resources Dr.T.V.Rao MD

16. Be familiar with sterilization Practices • Scientific sterilization practices will certainly cut short the rate of infection reduce the costs to the hospital and reduces morbidity and mortality. The recent document on Sterilization released by CDC Atlanta with title Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008will clarify all the doubts of practice, including the decreasing role of bio hazardous chemical and use of environmentally safe agents. Fumigation which we practice without knowing its biohazards needs a rethinking. Microbiologists should learn more; educate the Paramedical and Nursing staffs who are our greater partners in infection control. Dr.T.V.Rao MD

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