Automation in the Clinical Microbiology Laboratory

Abstract

The clinical microbiology laboratory has historically been considered “low-tech,” especially when compared to the clinical chemistry laboratory. However, systems are emerging for the clinical microbiology laboratory with the potential to automate almost all areas of testing, including inoculation of primary culture plates, detection of growth on culture media, identification of microorganisms, susceptibility testing, and extraction and detection of nucleic acids in clinical samples. As a result, the workflow in the microbiology laboratory is changing at a rapid pace and microbiologists have the challenge of selecting the most appropriate, clinically useful, and cost-effective automation for their laboratories. We have asked 4 experts in this field, from clinical microbiology laboratories in the US and Europe, as well as from industry, to comment on the feasibility and impact of automation in the clinical microbiology laboratory. Are you currently using or do you anticipate using an automation platform in your microbiology laboratory? If yes, which sections of your laboratory are automated? Robin Patel: Mayo Clinic's clinical microbiology laboratory has been performing testing since 1911. Although select tests today resemble those performed a century ago, we have many examples of automated, state-of-the-art tests. These include blood cultures, infectious disease serologic platforms, and nucleic acid and proteomic diagnostics, to name a few. For over 2 decades, microbiology laboratories have been using automated blood culture instruments that “sense” microbial growth in blood culture bottles and “flag” positive bottles for immediate attention by laboratory technologists. Before the availability of such systems (in the not-so-distant past), laboratory technologists manually evaluated each blood culture bottle on multiple occasions. Technologists today could not fathom returning to the manual approach used a mere 3 decades ago. As with many chemistry tests, a myriad of infectious disease serologic tests are performed on automated platforms. Nucleic acid diagnostics, which have been used in our …