WHY CLINICAL MICROBIOLOGY IS IMPORTANT IN SAVING LIVES?

Dr.T.V.Rao MD

Clinical microbiology is different from other sections of the laboratory sciences because it deals with live microorganisms that multiply rapidly, are vulnerable to unscientific collection of desired specimens and inappropriate handling, which contaminates the specimens, between the patient and the laboratory, many inexperienced and ill qualified laboratories report commensals as pathogens and give the wrong signals to treat with Newer generation of Antibiotics, Sterile equipment and media should be used to transfer and culture micro-organisms. Aseptic technique should be observed whenever micro-organisms are transferred from one container to another. however the true pathogens are able to evolve resistance to therapeutic regimens, and can disrupt the public health through devastating local, regional, national, and worldwide outbreaks. Many organisms isolated in the laboratory are clinically unimportant under normal circumstances and clinically significant in others, in particularly immune suppressed patients. Skilled clinical microbiologists help to make those determinations, the results of which often direct therapeutic decision-making optimal. It would be advantageous to rapidly characterize both phenotypic and molecular traits of microorganisms to improve the care provided to patients. Unfortunately most of these analyses are currently beyond the capabilities of majority of clinical microbiology laboratories. In spite of India’s rapid advances in many super and sub specialties, majority of Diagnostic Microbiology laboratories are in poor state of Health. The India’s policies on restricting Antibiotic use to contain Antibiotic resistance and creation of super bugs has not taken a true shape. The physicians find the Antibiotics are ultimate solutions to the practice of Medicine. Clinical microbiology laboratories are often ill-equipped to cope with diagnosing new or forgotten infectious agents, named as emerging and re-emerging infectious diseases, especially when pathogen detection requires phenotypic or genotype tests that are not widely available. Clinical microbiologists could play a role in developing diagnostic capabilities, but in many instances there is little incentive offered by their employers to conduct the necessary research. Where opportunities do exist, progress may be stymied by the bureaucratic requirements of institutional Auditing, and accountability to patients. In many developing countries it is expected the ultimate solutions of life and death is in the hands physicians prescriptions, which in turn created the present crisis of Antibiotic Misuse and related consequences. One of the most important problems facing clinical microbiology laboratories is lack of the laboratory workforce. Thoroughly trained, highly skilled workers are a vanishing breed. A number of studies have shown that there are more laboratory workers today leaving the workplace than are entering the workplace, many women take to the laboratory technology in the early part of their career and leave the profession with domestic concerns and poor pay structure. If we deeply analyse the matters, the majority of postgraduates join to fill the gap in the career to get a Job in a Medical colleges and Institution’s to become a faculty, with least interest on matters of Diagnostic Microbiology. In spite of equal proportion of Microbiologists when compared with other specialties many lack the will to work and improve the specialty; however there is least support from many administrators. The capable private laboratories cannot survive without kickbacks which has become a work culture in our country it is ultimately the helpless patients pay the price with money and life. The creation of super bugs is also attributed to practice of Medicine with unscientific spirit, associated with lack of realization of emerging threat from Multidrug, and Pan resistant Microbes. All diagnostic microbiology laboratories should strive to improve the standards as Good laboratory practices, and

consist of activities that depend on several principles: aseptic technique, control of media, control of test strains, control of equipment, diligent recording and evaluation of data, and training of the laboratory staff. Because of the known variability in microbiology data, reliability and reproducibility are dependent on the use of accepted methods and adherence to good laboratory practices. I feel that is important to realize that if we analyse the diagnostic reports, we are getting majority of samples from elderly and geriatric patients, who are in majority of cases are at the mercy of social support, and are at every risk to get infected both is community and Hospitals, and senior Microbiologists should take responsibility to solve the diagnostic problems of the elderly patients. It is good that we should invest a little of Hospital resources in Microbiology Departments for better care of our Patients.

Dr.T.V.Rao MD – Professor of Microbiology – A freelance writer