Clinical Microbiology Newsletter最新文献

Neisseria meningitidis is a gram-negative organism primarily associated with invasive meningococcal disease. This case report presents a rare occurrence of Neisseria meningitidis pyelonephritis in a 24-year-old male with congenital urological abnormalities. We describe the diagnostic challenges and management of this unique case. Ultimately, the patient completed IV then oral antibiotics and recovered with no complications. This case emphasizes the importance of considering atypical pathogens in urinary tract infections and contributes valuable insights to diagnostic microbiology and clinical practice.

Assays that utilize nucleic acid amplification are prone to contamination from a variety of sources, including both target organisms and amplicon. Implementing effective systems for contamination monitoring as well as laboratory best practices are essential to any quality management system for molecular microbiology testing. A comprehensive contamination monitoring toolbox will be introduced here that includes guidance for environment swabbing, positivity rate monitoring, use of process controls, and monitoring complaints. As prevention of contamination is preferable, best practices for laboratory design, workflow, and personnel training will also be discussed. Lastly, a suggested plan for managing a contamination event will be proposed. The laboratory director should carefully assess the specific risks associated with testing performed in the laboratory and create a written plan for contamination monitoring, prevention, and management of contamination events.

Clinical microbiology laboratories support a range of services such as infectious disease diagnosis, infection prevention, and antimicrobial stewardship. The role of the clinical microbiology laboratory is more pivotal than ever as we face emerging pathogens, increases in healthcare-associated infections, antibiotic-resistant organisms, and rapidly advancing technologies. In the wake of these challenges, it is crucial for a clinical microbiology laboratory to be directed by medical microbiologists (i.e. laboratory directors) as they can provide accurate laboratory oversight and professional competence. Medical microbiologists can be found pursuing leadership roles in academic medical centers, diagnostic reference laboratories, public health institutions, and commercial entities such as diagnostic and pharmaceutical companies. Given the diverse career trajectories that medical microbiologists can have, the perspectives of these laboratory directors may be different even though they all strive to meet the common goal of providing diagnosis and management of infectious diseases.

This comprehensive review provides updates on the epidemiology, clinical presentations, and diagnostic methods for the most common Bartonella species causing human disease, including B. henselae, B. quintana, and B. bacilliformis. We highlight the distinctive transmission dynamics and clinical manifestations associated with each species, such as cat-scratch disease, trench fever, and Carrion's disease. The review also evaluates the advantages and limitations of serological and molecular diagnostic techniques, emphasizing the importance of integrating clinical evaluation with laboratory testing for accurate diagnosis and effective management of Bartonella infections.

Aminoglycoside antibiotics were historically a cornerstone of antimicrobial therapy for many bacterial infections but as the threat of antimicrobial resistance continues to rise, the once broad-spectrum activity of these agents grows smaller. They are also plagued with the potential for severe adverse events such as nephrotoxicity and ototoxicity, and emerging evidence suggests that these risks may outweigh their benefit in many cases. With the recent introduction of newer and likely safer broad-spectrum antibiotics, do aminoglycosides still have a place in therapy in modern medicine?

MALDI-ToF MS has become a cornerstone of the clinical microbiology laboratory. The reliability and ease-of-use of these instruments make them a popular choice of study to expand their applications and increase efficiency. The use of artificial intelligence has rapidly expanded in recent years and efforts are underway to integrate this technology into the clinical microbiology laboratory to expand the applications of MALDI-ToF MS and advance beyond current limitations in the identification of clinical isolates. At the same time as the rise of AI, clinical laboratories are facing pressure to increase efficiency due to the critical shortage of qualified laboratory personnel. Studies examining the performance of simplified testing workflows seek to help laboratorians do more with less. The improvement and creation of additional databases is also improving the rate of successful identifications. This review seeks to provide an update on recent developments around these topics.

The accurate diagnosis of ocular infections hinges on precise specimen collection, handling, communication, and strategic prioritization of testing methods. This review highlights the intricate eye anatomy clinical microbiologists should know to understand ocular collection techniques and diagnostic strategies. It explores limitations regarding specimen volume, offers insight into optimal ocular sample collection and processing, recommends optimal diagnostic strategies for a wide breadth of ocular pathogens, explores the utility of antimicrobial susceptibility testing, and emphasizes the necessity of robust collaboration between laboratory specialists and ocular healthcare providers to ensure superior ophthalmic care.