Present and future automation in bacteriology

Abstract

Clinical microbiology laboratories experience the same difficulties as other diagnostic services: an ever-increasing workload that is not matched by an increase in the number of technical staff to cope with it. Moreover, microbiological diagnosis frequently requires the combination of conventional and molecular methods that are time-consuming and expensive. Finally, microbiological sample analysis often provides the rationale for significant clinical decisions, and thus must have high reliability. Therefore, microbiology laboratories have to increase their productivity while still providing the highest quality of results. Since the middle of the last century, some real savings in technician time have been achieved with the employment of mechanical equipment that is not too expensive to be justified in a laboratory. This started with automatic bacterial counting using different technologies, such as direct cell counting and indirect measurement of physical, optical or chemical changes produced by bacterial growth, and counting of the colonies in solid medium after incubation [1]. These technologies are now widely utilized in blood culture systems with continuous monitoring, as well as in automated microbial identification and susceptibility testing systems. Instrumentation for microbial plating was also developed at the end of the last century. However, specimen processing and culture work-up, in particular, remain manual tasks, and few changes to the methods used to perform these tasks have been made in the recent past. Although some larger laboratories utilize urine plating instrumentation, most microbiology laboratories have no automation in their processing areas. The concentration of bacteriological benchwork in central laboratories prompt to equip them with plating instruments. For a long time microbiology plating instruments was uncommon, but during the 20th ECCMID in Vienna, different companies presented, in their showrooms, microbiology plating instruments, pointing out that time for automation for microbial plating had arrived. In alphabetical order, the companies were Beckton Dickinson/Dynacon with the Innova, bioMerieux with PREVI Isola, Copan Diagnostics with the Walk Away Specimen Processor, and Kiestra with the InoquIA Full Automatic. However, relevant information on the performance in routine laboratories of these different microbial plating instruments is scarce (only one manuscript in PubMed [2]), and it was almost impossible to convince microbiologist to write reviews on automation [3]. Therefore, we decided to solicit articles from companies involved in producing the microbiology plating instruments. Each of the five companies represented at the 20th ECCMID was invited to submit a manuscript on ‘the point of view (present and future) of their company on automation in bacteriology’ to the Journal. The first invitation was made during a meeting with the staff of the company present during the 20th ECCMID, and this was followed by four successive reminders by E-mail in the absence of a reply. Finally, only two companies submitted manuscripts. The authors extended the focus of the manuscripts to global automation in the clinical microbiology laboratory, from the clinical specimens to the results provided to the physicians [4,5]. As you will read, people writing about their own company have an intrinsically different perspective from those writing a typical scientific article. They write about short delays in processing, high-quality results, increased productivity of the laboratory, improved traceability and standardization of analysis, reduced costs, and increases in management quality. These manuscripts have strong marketing aim; however, it is interesting to collect the manufacturers’ perspectives to find out how companies see the future of the clinical microbiology laboratory.