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IDSA, ASM update lab diagnosis guide
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The Infectious Disease Society of America and the American Society for Microbiology released an updated guide designed to help health care providers use the microbiology laboratory to diagnose infectious diseases.
The guide was published today in Clinical Infectious Diseases.
“Diagnostic technology is advancing at a tremendous rate; this new guide reflects the new diagnostic methods available for infections,” J. Michael Miller, PhD, director of Microbiology Technical Services in Dunwoody, Georgia, told Infectious Disease News. “More importantly, it details the needs of the microbiology laboratory in terms of selecting, collecting, transporting and storing specimens submitted for analysis that are taken from each body system.”
Advances in molecular testing mean infectious diseases can be diagnosed in minutes or hours and patients can receive appropriate treatment sooner, the IDSA and ASM noted. They said the guide, which updates recommendations published in 2013, will help health care providers know the proper tests to order and when to order them.
The guide underscores the correct way to collect and manage blood, urine, skin or other tissue specimens. In it, the authors list “10 points of importance,” including:
- poor quality specimens must be rejected;
- laboratories require specimens, such as actual tissue, aspirates and fluids, and not a swab of a specimen;
- specimens should be collected before antibiotics are administered; and
- specimens must have accurate and complete labeling.
Specimen management should include specific labeling of where the specimen came from, such as “top of right ear” vs. “skin,” according to the IDSA and ASM. This helps microbiologists eliminate the possibility of microbes in the culture that would not normally reside in certain areas of the body.
The authors noted that a contaminated or inadequate tissue specimen could lead to wrong diagnoses, harmful treatment and costly hospital stays.
The guide is broken down into 15 types of infections, including bloodstream infections and infections of the cardiovascular system, central nervous system infections, ocular infections, soft tissue infections of the head and neck, upper respiratory tract bacterial and fungal infections, lower respiratory tract infections, infections of the gastrointestinal tract, intra-abdominal infections, bone and joint infections, urinary tract infections, general infections, skin and soft tissue infections, arthropod-borne infections, viral syndromes, and blood and tissue parasite infections.
Expanded information on pediatric needs, including testing for tick-borne diseases, also is included in the guide. As is information on advancements in diagnostics, including nucleic acid amplification tests.
“Instead of using a shotgun approach and prescribing broad-spectrum antibiotics, these new rapid diagnostic tests can help health care providers target the specific organism causing the infection much sooner than traditional microbiologic tests,” Melvin P. Weinstein, MD, FIDSA, chief of infectious diseases, allergy and immunology at Rutgers Robert Wood Johnson Medical School, said in a news release.
The guide also promotes a collaborative, multidisciplinary approach to treatment, according to the IDSA and ASM.
“ID physicians are microbiologists’ closest colleagues in supporting the need for a high-quality diagnostic process,” Miller said in the release. “They understand the microbiology component and can serve as liaisons between the lab and other health care providers, as can board-certified microbiologists.” – by Bruce Thiel
Disclosures: Miller reports receiving royalties from ASM for his 1999 book, A Guide to Specimen Management in Clinical Microbiology, and serving on the board of directors of BioFire Defense. Weinstein reports receiving royalties from UpToDate, payment for consultancies from Rempex, Accelerate Diagnostics and PDL Biopharma, and that his institution has received payment for his consultancies with Pfizer and has received grants/pending grants from JMI Labs, BD Diagnostics, Siemens, and bioMérieux that are all outside the submitted work. Please see the study for all other authors’ relevant financial disclosures.
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