Communication between Clinicians and the Hospital-based Microbiology Laboratory: Strategies for 2018 and Beyond

Abstract

Treatment of infections in the hospital poses some unique issues in comparison with treatment of other equally sick inpatients without infections. The diversity of potential pathogens for a given infected site (e.g., pneumonia) and the changing spectrum of antimicrobial susceptibilities are variables generally not encountered with other diseases. Infectious diseases may also have distinctly geographical and/ or travel-related aspects as shown by inhaled fungal infections such as coccidioidosmycosis from the southwestern United States or Ebola virus disease in West Africa. Communicable diseases due to specific infectious agents (e.g., influenza virus, methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum beta-lactamase-producing gram-negative rod bacteria (ESBL-GNR’s), and many other examples) also pose challenges in timely diagnosis, infection control, and patient-familycolleague education. In the case of Ebola virus, the presence of only a few infected individuals in the United States in 2014 caused nationwide concern among healthcare workers and the public. Clinicians, infection control staff and the hospitalbased microbiology laboratory all received many inquiries about potential routes of transmission, diagnostic testing, and personal protective strategies.