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Indian Journal of Medical Microbiology, Vol. 27, No. 4, October-December, 2009, pp. 378-379 Correspondence Laboratory microbiology to clinical microbiology: Are we ready for a transition? K Kapila, *K Kaushik Department of Microbiology, Armed Forces Medical College, Pune - 411 040, India Correspondence Address:Department of Microbiology, Armed Forces Medical College, Pune - 411 040, India, mahakaroo@yahoo.com Date of Submission: 03-Jun-2009 Code Number: mb09109 PMID: 19736418 DOI: 10.4103/0255-0857.55448 Dear Editor, We read with interest the guest editorial in the April 2009 issue of IJMM. [1] The author has succinctly brought out the need for bridging the divide between clinical care and laboratory work in microbiology. We in India appear to be in a state of transition as we attempt to adopt this 'service delivery model'. The concept and approach, however, is not entirely unfamiliar to us. Through this letter we would like to share our experience in this regard. The department has undertaken an initiative to build a clinical association with physicians and intensive care experts in our hospital. As part of this effort, postgraduate students along with faculty members attend daily medical and surgical ICU rounds with the respective treating physicians. This approach revealed several benefits in a short span of time. For microbiologists - first hand patient information, clinical correlation, treatment trends and suggestions for additional / alternate tests were a few. For healthcare providers, direct liaison with laboratory personnel, guidelines on specimen collection, update on new findings (ESBLs / MBLs) and feedback on antibiotic susceptibility patterns proved invaluable. Subsequently, we also extended this service to the pediatric ward, Oncology and Hematology Units. Marked reduction in MRSA infections in the ICU, return of susceptibility patterns in certain Gram negative pathogens and investigation and source tracking of a nosocomial outbreak of neonatal septicemia were other notable benefits. Other proactive efforts included a study of the bacteriological profile of air in the ICU / Operating Units, up-to-date antibiotic policy recommendations and liaison with anesthetists, to resolve doubtful cases of ventilator associated pneumonia. Although the experience has proved to be mutually rewarding and educative, we continue to face certain challenges. Shortage of staff to cover all units and the ability to sustain the effort on a long-term basis are some of them. Suggestions for increasing the number of annual MD microbiology seats and reframing the curriculum to include clinical rotations may help overcome these challenges. [2] References
Copyright 2009 - Indian Journal of Medical Microbiology |
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