Laboratory Turnaround Time Research Articles

Designing and Validating Autoverification Rules for Hematology Analysis in Sysmex XN-9000 Hematology System.

Hematology analysis is a common test among patients in hospital. However, manual verification of hematology analysis is time consuming and tedious, with variation between inter-individual laboratory workers. This study was to establish and validate a set of autoverification rules for hematology analysis in the department of laboratory medicine, Zhongshan Hospital of Sun Yatsen University. Hematology analysis was measured by a Sysmex XN-9000 hematology system in the Department of Laboratory Medicine, Zhongshan Hospital of Sun Yatsen University. SYSMEX Laboman EasyAccess 6.0 and the laboratory information system were used to construct the algorithm and design the autoverification rules of hematology analysis according to Clinical and Laboratory Standards Institute document Auto 10A and 41 rules of Hematology Review Criteria. The laboratory turnaround time (TAT), autoverification pass rates, false positive, false negative, and the average error rate were verified after implementing autoverification rules. Approximate 1,300 specimens were collected daily and transferred to our laboratory for hematology analysis; that is necessary to build a database and to design autoverification rules. The average autoverification passing rate was 81%; the false positive rate was 13.6%; the false negative rate and the average error rate was nearly zero, indicating that incorrect reports were almost eliminated. Moreover, since implementing autoverification, the TAT was reduced by 27.0% in in-patient reports, by 21.9% in out-patient reports, and by 39.0% in emergency reports, which enhanced the productivity in our laboratory. Our laboratory accelerated verification and decreased TAT and the odds of human review errors in the released results since implementing the autoverification. Thus, we can save more time and concentrate on verifying the abnormal results and processing emergency tests.

A Study of the Determinants of Laboratory Turnaround time in Tertiary Care Teaching Hospital in Bihar

A Study of the Determinants of Laboratory Turnaround time in Tertiary Care Teaching Hospital in Bihar

Switching from serum to plasma: Implementation of BD Vacutainer® Barricor™ Plasma Blood Collection Tubes improves sample quality and laboratory turnaround time

BackgroundFor blood, most 24/7 standard (immuno)chemistry parameters are either measured in serum or in lithium heparin plasma. Standard serum and plasma gel tubes have their shortcomings when timely analysis of high quality results is required. Serum requires clotting time and interference of gel globules in the plasma and adsorption of hydrophobic analytes into the gel layer potentially compromises high quality results from lithium heparin gel tubes. We sought to evaluate the impact of BD Vacutainer® Barricor™ Tube (Barricor™) on laboratory efficiency by measuring its effect on TAT and sample quality, as well as evaluate potential cost opportunities resulting from improved sample quality. MethodsTAT data and remediation activities were extracted and captured during two 6 months phases. Serum was used as the predominant matrix in the first phase and Barricor™ plasma was used in the second phase. ResultsBarricor™ significantly reduced the median TAT, especially for routine-priority samples during peak-hours. The TAT key-performance-indicator (percentage of results available within 90 ​min) improved to >90% for STAT as well as routine priority samples. Converting from serum gel, Barricor™ reduced fibrin-related remediation activities from 2.3% to 0.4%. This resulted in remediation-related cost reduction of €6.010,47 over the study period. ConclusionsBy implementing Barricor™, we saw a significant reduction in TAT and a reduction in fibrin-related remediation time and costs, when compared to a predominant serum workflow. The improved TAT opens up the possibility of consolidating to one single priority level, eliminating the need for the use of the STAT priority level.

Quality Improvement Initiatives to Improve Transfusion Safety and Efficiency for Patients Receiving Daratumumab

Introduction: Daratumumab is an IgG1k monoclonal antibody directed against CD38, a surface glycoprotein expressed on several cell types including erythrocytes and B lymphocytes at various stages in development, including bone marrow precursors and plasma cells. It was initially approved by the FDA in 2015 for the treatment of multiple myeloma and has since garnered additional approvals in other settings leading to a growing number of patients receiving daratumumab. Its anti-B lymphocyte properties are therapeutic in myeloma patients; however, it also binds CD38 on erythrocytes and circulates for up to six months after a dose. This creates a long-term problem when caring for these patients regarding transfusion needs and resources. In particular, daratumumab causes antibody screens to be panreactive, potentially masking the presence of clinically relevant antibodies. Mitigation of this effect requires specialized treatment with dithiothreitol (DTT)-treated reagent erythrocytes to release CD38 from the cell membrane. This step allows for more accurate detection of clinically relevant antibodies, with the noted exception of the Kell system as these antigens are also removed. Methods: When daratumumab was placed on formulary, we started weekly communication between the laboratory and clinical teams in order to establish best institutional practices. Additionally, a list of patients on daratumumab was created in order to track them across the institution and measure the impact of interventions on their care. These have prompted multiple interventions to improve the safety and efficiency of patients on daratumumab receiving transfusions. Results: As of January 2018, our laboratory began implementing in-house DTT testing and eliminated the need to send patient samples to a reference laboratory. Beginning in January 2019, DTT-antibody screens (ABSC) were captured in the electronic medical record (EMR). Over the next six months, 173 distinct DTT-ABSC were performed on 41 patients. Of these, 13 received at least one RBC transfusion for a total of 41 units, with 12 (29%) occurring as an outpatient and 29 (71%) as an inpatient. Importantly, all of these transfusions were on the same-day of the DTT-ABSC, reducing the burden of time and cost associated with travel, as well as the morbidities of delayed transfusion. This is a major step forward in patient care as there were previously no "same-day" transfusions when DTT-ABSC was sent to a reference laboratory. The previous reference laboratory turnaround time averaged 1165 minutes compared with 186 minutes for the in-house testing. These initiatives have also resulted in educational efforts, such as the creation of a daratumumab-specific transfusion consent form to be signed by the attending hematologist at the time of starting therapy, outlining the challenges associated with identifying blood for transfusion and documenting that the benefits of transfusion outweigh the potential risks. This form is valid indefinitely and has subverted previous clinical scenarios where inpatients on daratumumab required urgent/emergent transfusion without an in-house hematologist available to consent for the transfusion. Because DTT also eliminates Kell antigens, clinically relevant antibodies may go undetected in samples treated with DTT. Thus, it is our policy to use Kell-negative products for patients who are on daratumumab, unless the patient expresses the Kell antigen. Conclusions/Future Directions: Daratumumab therapy is becoming increasingly common in hematology practice. Awareness of the laboratory and clinical challenges that accompany its use and working to mitigate them will lead to safer and more timely patient care. In particular, in-house DTT-ABSC has led to same-day results and transfusion on the same outpatient visit. Next steps include additional educational efforts at an institutional level, establishing simple algorithms within the EMR linked with the order for daratumumab (e.g., automatic ABSC prior to administration), and refining our tracking system to better assess future interventions. Disclosures No relevant conflicts of interest to declare.

Reduction of turnaround time for non-tuberculous mycobacteria detection in heater–cooler units by propidium monoazide–real-time polymerase chain reaction

Invasive non-tuberculous mycobacteria (NTM) infections are emerging worldwide in patients undergoing open-chest cardiac bypass surgery exposed to contaminated heater-cooler units (HCUs). Although this outbreak has been investigated by culturing bacteria isolated from HCU aerosol and water samples, these conventional methods have low-analytic sensitivity, high rates of sample contamination, and long turnaround time. To develop a simple and effective method to detect NTM in HCUs by real-time polymerase chain reaction (PCR), with a short laboratory turnaround time and reliable culture results. A total of 281 water samples collected from various HCUs at seven Italian hospitals were simultaneously screened for NTM by a propidium monoazide (PMA)-PCR assay and by conventional culture testing. The results were analysed with culture testing as the reference method. (i) The agreement between culture testing and PMA-PCR was 85.0% with a cycle threshold (CT) cut-off value of <38 vs 80.0% with a CT of <43, with a moderate Cohen's κ-coefficient; (ii) the CT cut-off value of <42 was deemed more suitable for predicting positive specimens; (iii) given the low concentration of target DNA in water samples, the minimum volume to be tested was 1 L. The use of PMA-PCR for fast detection of NTM from environmental samples is highly recommended in order to ascertain whether HCUs may represent a potential source of human exposure to NTM. This reliable and simple method reduces laboratory turnaround time compared to conventional methods (one to two days vs eight weeks, respectively), thereby improving control strategies and effective management of HCUs.

Abstract 3976: “Fit-for-purpose” PIK3CA assays for patient stratification in breast cancer clinical trials

Abstract Background: Prospective clinical trials stratifying by PIK3CA genotype is necessary to determine if the mutation predicts for increased sensitivity to agents targeting the phosphoinositide 3-kinase (PI3K) pathway. It is crucial to select appropriate assays to optimize operational, scientific and timeline requirements for patient enrollment in a real world setting. Here we report application of three different PIK3CA mutation test methods during the course of a PI3K TKI development. Methods: We customized Sanger sequencing, cobas® assay and a proprietary investigational use only (IUO) assay to detect point mutations in PIK3CA in order to accommodate the development needs at the different stages of clinical development of PIK3CA TKIs. We performed method comparison studies to determine the most cost effective and “fit-for-purpose” assay for clinical trial testing. Specimen requirements, assay performance characteristics, turnaround-time (TAT) and valid result rates were assessed to select the best test method for patient stratification to meet the requirements of each stage of drug development. Results: PIK3CA test results can be obtained from a single, 5μm FFPE section with ≥0.1% and ≥10% tumor in the IUO and cobas® tests respectively. Sanger Sequencing requires longer processing time and ≥30% tumor content. The cobas® assays were validated in FFPE samples and can reliably detect PIK3CA mutations in exons 9 and 20 with ≥5% mutation level. The method comparison study showed that the concordance rate between Sanger sequencing and cobas® PIK3CA assay is 86% among the 360 samples tested while it is 96% between the cobas® assay and the IUO assay among 395 samples tested. The IUO assay is slightly more sensitive, and calls out the exact mutation while the cobas® assay may not. The Sanger sequencing demonstrated the lowest sensitivity and required more DNA input, which resulted in more samples failing to yield a valid result. The cobas® assay is a more user-friendly assay allowing better laboratory efficiency and TAT. Patients selected using the IUO assay showed a median progression-free survival nearly twice as long among those receiving a PI3K TKI compared to placebo. Conclusions: The most important factor in selecting a testing platform for clinical trial patient stratification is the assay performance characteristics. We employed the Sanger sequencing assay in the initial trial testing, then switched to the cobas® assay, and finally to the IUO assay to meet the requirements as the drug progressed through different stages of clinical development. The IUO assay has the performance characteristics that meet the regulatory requirements and a validated clinical utility in selecting patients for PI3K TKI treatment, thus on its way to a companion diagnostic submission. Citation Format: Hua C. Gong, Sharmila Manjeshwar, Violet Abraham, Shawn Rivera. “Fit-for-purpose” PIK3CA assays for patient stratification in breast cancer clinical trials [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3976.

Improved quality of samples and laboratory turnaround time using 3.5 mL low vacuum BD Vacutainer® Barricor tubes in the emergency department

BackgroundCentrifugation is a consuming time step which participates to increase the turnaround time (TAT) in laboratories, likewise hemolysis sample that needs a re-sampling could delay management of patients. Recently, it has been postulated that BD Barricor™ tube could allow to decrease the centrifugation time and prevent hemolysis, two key feature to ensure high-quality results.Aim of the study was to evaluate the impact of replacing 4 mL BD vacutainer heparin lithium tube by low vacuum 3.5 mL BD vacutainer Barricor™ tube in an emergency department (ED) on hemolysis rate and TAT. MethodsData of hemolysis index (HI) and TAT were compared between the first period of 15 days using 4 mL BD vacutainer heparin lithium tubes with 15 min at 2000xg as centrifugation setting and a second period of 15 days using BD vacutainer Barricor™ tube centrifuged 3 min at 4000xg. ResultsA significantly reduced time duration between reception of sample and available results in informatics lab system was observed with the reduction time of centrifugation allowed by use of Barricor™ tube compared to regular heparin lithium tubes (p < 0.001). A significative decrease in hemolysis rate also occurred in the second period as samples with HI < 10 reached from 52.5% in the first period to 68.5% (p < 0.001) in the second. ConclusionLow vacuum BarricorTM tubes allowing a higher speed of centrifugation improve lab TAT without impairment of sample quality as a significant reduction of hemolysis was observed, a double advantage which is of particular interest for ED.

A statistical analysis solution to measure the impact of sample processing methods on diagnostic laboratory turnaround time

A statistical analysis solution to measure the impact of sample processing methods on diagnostic laboratory turnaround time

The adaptation of AABACUS for quality improvement in laboratory workflow analysis ('L-AABACUS')

The ability to effectively monitor key indicators is important for continuous quality improvement in laboratory immunohistochemistry. This article deals specifically with laboratory turnaround time (TAT) as a key delivery indicator...

Exploring trade-offs between staffing levels and turnaround time in a pathology laboratory using discrete event simulation.

Many health delivery services have required performance targets. Typically, these targets are presented as percentiles of patients to be seen within specified timeframes. These targets present hospital administrators with a resourcing problem complicated by conflicting objectives: How to minimize costs while maximizing throughput to achieve the performance targets? In this paper, we describe the use of a simulation model to evaluate the effect of changes to staff levels in a cytology department, investigating the trade-off between staff levels and turnaround times in light of performance targets specified by government. Standard practice for determining staffing levels in a cytology department uses average workload estimates and does not take into account target performance measures, task variability, and the interruptive nature of the workload of pathologists. We develop a simulation model for pathologist workload within a cytology department in New Zealand. We describe the model construction process that follows the hierarchical control conceptual modeling (HCCM) framework. We use the resulting simulation model to examine the trade-offs between staffing levels (and associated rosters) and task turnaround time. The results indicate that consideration of variation in task arrivals is important when considering the effect of staffing levels on turnaround time. Furthermore, as the cytology department is required to meet performance targets that involve maximum service times for a percentile of patients, such an approach is necessary in order to estimate the performance level of a staffing roster.

A retrospective data analysis of Legionella pneumophila diagnostic procedures and their impact on patients' management: the experience of a rapid point-of-care test

We compare a conventional and a rapid point of care test (POCT) for the diagnosis of Legionella pneumophila, considering various performance criteria. We used data of patients with positive test for L. pneumophila (confirmed cases), registered by the microbiology laboratories of two hospitals in Crete, Greece. Hospital A adopts a conventional, indirect fluorescent-antibody technique and Hospital B uses a urinary antigen POCT. The mean laboratory turnaround time was 4.45 days for the conventional test and 0.11 days for POCT. A total of 24 laboratory positive cases (11 inpatients, 13 outpatients) were identified out of 905 samples taken from 751 people. The mean daily hospitalisation cost per inpatient was €79.86 for Hospital B and €127.45 for Hospital A; for the latter a much higher antibiotic treatment cost/patient was recorded. The analysis suggests that a rapid POCT for L. pneumophila could significantly decrease time to diagnosis, improve treatment and reduce hospitalisation charges.

A retrospective data analysis of Legionella pneumophila diagnostic procedures and their impact on patients' management: the experience of a rapid point-of-care test

We compare a conventional and a rapid point of care test (POCT) for the diagnosis of Legionella pneumophila, considering various performance criteria. We used data of patients with positive test for L. pneumophila (confirmed cases), registered by the microbiology laboratories of two hospitals in Crete, Greece. Hospital A adopts a conventional, indirect fluorescent-antibody technique and Hospital B uses a urinary antigen POCT. The mean laboratory turnaround time was 4.45 days for the conventional test and 0.11 days for POCT. A total of 24 laboratory positive cases (11 inpatients, 13 outpatients) were identified out of 905 samples taken from 751 people. The mean daily hospitalisation cost per inpatient was €79.86 for Hospital B and €127.45 for Hospital A; for the latter a much higher antibiotic treatment cost/patient was recorded. The analysis suggests that a rapid POCT for L. pneumophila could significantly decrease time to diagnosis, improve treatment and reduce hospitalisation charges.

Analysing Turnaround Time in Laboratory - A Key Performance Indicator

Background: Turnaround time (TAT) is one of the key indicators of performance of a laboratory. Laboratories define it as the time from the receipt of sample/ specimen to the reporting. A fast TAT helps clinicians in making early diagnosis. Aim: To determine the turnaround time (TAT) of the biochemistry laboratory with evaluation of the contribution of pre-analytical and analytical phase to the total TAT. Results: A total of 399 samples were analysed from three outpatient departments. Average pre-analytical turnaround time contribution was found to be higher as compared to the analytical time. Excess workload and delay in pneumatic shoot were the main causes of delay in pre-analytical phase. Conclusion: Improved turnaround time is the key to clinicians’ and patients’ better satisfaction with the laboratory. It can be attained by minimising the bottlenecks within the process.

Quantification of Methotrexate in Human Serum and Plasma by Liquid Chromatography Tandem Mass Spectrometry.

Mass spectrometry (MS) is a highly specific and sensitive technique that is used for the detection of many different analytes with diverse chemical characteristics. It has been adopted by clinical laboratories for the quantification of small molecules and, by extension, has been widely used for therapeutic drug monitoring. It is an attractive alternative to immunoassay methods, because it is not subject to the same interferences. A limitation of MS (relative to immunoassays) is the turnaround time. However, this can be addressed by workflow parallelization with other assays. Herein we describe a tandem LC-MS/MS method for the detection and quantification of methotrexate in human plasma with a lower limit of quantification of 0.01μM and within-assay and between-assay coefficients of variation of less than 15%. This method lacks interference from high-abundance metabolites and utilizes kindred chromatography to improve turnaround time in the therapeutic drug monitoring laboratory.

Reengineering Critical Laboratory Testing for Timely Chemotherapeutic Management.

Delivery of cytotoxic therapy is a complex multifaceted process that involves harmonized collaboration between all systems involved. Optimizing laboratory turnaround time (TAT) ensures timely delivery of chemotherapy, which potentially translates into improved patient outcomes and satisfaction. In this study, we aimed to reduce the laboratory TAT for key laboratory tests to optimize the timely administration of chemotherapy. TAT data for complete blood count (CBC) and comprehensive metabolic panel (CMP) included specimen collection to receipt (Col-Rcv), specimen receipt to result release (Rcv-Res), and the overall TAT from specimen collection to result release (Col-Res). Work flows were reconfigured to transport CBC specimens directly to the hematology laboratory after collection and to treat all CMP samples from chemotherapy clinics as urgent [i.e., shortest turnaround time (STAT)]. From the CMP, total bilirubin and creatinine-the 2 key analytes for liver and renal toxicity assessment before chemotherapy drug administration-were analyzed on ABL 800 whole blood analyzers to further improve the laboratory TAT. CBC showed a significant reduction in the median (Col-Res) TAT to 16 min (P < 0.0001). For CMP, by processing all specimens as STAT samples, the median (Col-Res) TAT was reduced from 74 min to 54 min (P < 0.0001), and it was further reduced to 9 min (P < 0.0001) for total bilirubin and creatinine. Careful work flow analysis and reengineering of preanalytical and analytical process for key laboratory tests significantly reduced median overall TAT to <20 min, which helped facilitate more timely delivery of chemotherapy, without necessitating the construction of a satellite laboratory.

Using laboratory data to categorise CD4 laboratory turn-around-time performance across a national programme.

Background and objectiveThe National Health Laboratory Service provides CD4 testing through an integrated tiered service delivery model with a target laboratory turn-around time (TAT) of 48 h. Mean TAT provides insight into national CD4 laboratory performance. However, it is not sensitive enough to identify inefficiencies of outlying laboratories or predict the percentage of samples meeting the TAT target. The aim of this study was to describe the use of the median, 75th percentile and percentage within target of laboratory TAT data to categorise laboratory performance.MethodsRetrospective CD4 laboratory data for 2015–2016 fiscal year were extracted from the corporate data warehouse. The laboratory TAT distribution and percentage of samples within the 48 h target were assessed. A scatter plot was used to categorise laboratory performance into four quadrants using both the percentage within target and 75th percentile TAT. The laboratory performance was labelled good, satisfactory or poor.ResultsTAT data reported a positive skew with a mode of 13 h and a median of 17 h and 75th percentile of 25 h. Overall, 93.2% of CD4 samples had a laboratory TAT of less than 48 h. 48 out of 52 laboratories reported good TAT performance, i.e. percentage within target > 85% and 75th percentile ≤ 48 h, with two categorised as satisfactory (one parameter met), and two as poor performing laboratories (failed both parameters).ConclusionThis study demonstrated the feasibility of utilising laboratory data to categorise laboratory performance. Using the quadrant approach for TAT data, laboratories that need interventions can be highlighted for root cause analysis assessment.

Correlation between Laboratory Turnaround Time in Pediatric Emergency Departement and Length of Stay

A quick and precise diagnosis is essential in hospital services, especially in the emergency department. In condition with high volume patients, perfomance of laboratory usually decreases. Studies which identify directly the delay of laboratory examinations in emergency department in relation to length of stay in wards have not been conducted. We did correlative study using secondary data obtained from medical records. Inclusion criteria was child, age range from 29 days to 12 years old who needed supporting laboratory examinations, directly admitted to wards or PICU after getting treatments in emergency department. Exclusion criteria was child with growth and developmental problem, malnutrition, immuncompromised condition, incomplete medical records data, and child died in the emergency department. Average patient in 2016 was 3,6 yeras old and in 2017 was 2 yeras old, mostly boys. Mostly with chief complaints of infections Analysis in 2017 showed correlation coefficient of 0.466 which means there was strong association between laboratory turnaround time and length of stay and statistically significant (p 0.03). multivariate analysis shown there was strong correlation between laboratory turnaround time and length of stay and if the predictive value increased by one unit, the length of stay would increase 6,5%.

Investigating the current skim milk powder inspection strategies for improvements in process optimisation

The production of skim milk powder (SMP) has increased among Irish Dairy processors in recent years. SMP has nutritional benefits and functional properties, including high calcium and potassium, a low fat content, excellent gelation, emulsification and foaming properties. As Irish dairy exports are increasing year on year, the requirement to intensify process optimisation is heightened. This study investigated the analytical test levels applicable to the regulatory requirements for the quality and safety assurance in the production of SMP across a 12 month period in two large Irish milk processing plants. The efficacy of the testing strategies and turnaround time for SMP for both plants were examined and compared. The results of this study demonstrate excess testing at 64% and 36% respectively, over the regulatory requirements for both companies. The sediment and density tests demonstrated the highest out of specification excess test results for each plant respectively. This is the first study to our knowledge on optimising sampling regimes in a dairy processing setting and the outcomes of this study propose an overview to the current SMP testing strategies for improvement in process optimisation for any milk product, focusing on the process in order to optimise overall production levels and to address analytical test levels, out of specification results and laboratory turn-around time (TAT).

Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study

BackgroundFailure in the timely follow-up of test results has been widely documented, contributing to delayed medical care. Yet, the impact of delay in reviewing test results on hospital length of stay (LOS) has not been studied. We examine the relationship between laboratory tests review time and hospital LOS.MethodsA retrospective cohort study of inpatients admitted to a metropolitan teaching hospital in Sydney, Australia, between 2011 and 2012 (n = 5804). Generalized linear models were developed to examine the relationship between hospital LOS and cumulative clinician read time (CRT), defined as the time taken by clinicians to review laboratory test results performed during an inpatient stay after they were reported in the computerized test reporting system. The models were adjusted for patients’ age, sex, and disease severity (measured by the Charlson Comorbidity index), the number of test panels performed, the number of unreviewed tests pre-discharge, and the cumulative laboratory turnaround time (LTAT) of tests performed during an inpatient stay.ResultsCumulative CRT is significantly associated with prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of prolonged LOS by 13.2% (p < 0.0001). Restricting the analysis to tests with abnormal results strengthened the relationship between cumulative CRT and prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of delayed discharge by 33.6% (p < 0.0001). Increasing age, disease severity and total number of tests were also significantly associated with prolonged LOS. Increasing number of unreviewed tests was negatively associated with prolonged LOS.ConclusionsReducing unnecessary hospital LOS has become a critical health policy goal as healthcare costs escalate. Preventing delay in reviewing test results represents an important opportunity to address potentially avoidable hospital stays and unnecessary resource utilization.

How can your microbiologist help you manage paediatric infection?

Abstract The presentation of a child to hospital with an acute illness is distressing for the child and his/her parents or carers. The clinical aim of the admitting paediatric team is to identify the cause of the illness, to treat it effectively and to discharge the child home quickly and safely. Multi-disciplinary care between the paediatric and the clinical microbiology team, who oversee and support the laboratory work of skilled scientists, is essential to manage paediatric infection. In this review, we will focus on current diagnostic methods for common paediatric microbiology consultations, with a focus on newer molecular technology to reduce laboratory turnaround time, and discuss the emergence of multi-drug resistant organisms that are impacting on antimicrobial prescribing practices. We will also highlight useful infection prevention and control advice that will be beneficial to the on-call paediatrician.