The impact of changes in Clinical Microbiology Laboratory location and ownership on the practice of Infectious Diseases
Weinstein, Melvin P.
Beekmann, Susan E.
Polgreen, Philip M.
Ellison, Richard T. III
UMass Chan AffiliationsDepartment of Medicine, Division of Infectious Diseases and Immunology
Document TypeAccepted Manuscript
clinical microbiology laboratories
Analytical, Diagnostic and Therapeutic Techniques and Equipment
Health and Medical Administration
Health Services Administration
Immunology and Infectious Disease
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AbstractThe number of onsite clinical microbiology laboratories in hospitals is decreasing, likely related to the business model for laboratory consolidation and labor shortages, and this impacts a variety of clinical practices including banking isolates for clinical or epidemiologic purposes. To determine the impact of these trends, infectious disease (ID) physicians were surveyed regarding their perceptions of offsite services. Clinical microbiology practices for retention of clinical isolates for future use were also determined. Surveys were sent to members of the Infectious Diseases Society of America's (IDSA) Emerging Infections Network (EIN). The EIN is a sentinel network of ID physicians who care for adult and/or pediatric patients in North America and who are members of IDSA. The response rate was 763 (45%) of 1,680 potential respondents. Five hundred forty (81%) respondents reported interacting with the clinical microbiology laboratory. Eighty-six percent of respondents thought an onsite laboratory very important for timely diagnostic reporting and ongoing communication with the clinical microbiologist. Thirty-five percent practiced in institutions where the core microbiology laboratory has been moved offsite, and an additional 7% (N=38) reported that movement of core laboratory functions offsite was being considered. The respondents reported that only 24% of laboratories banked all isolates with the majority saving isolates for less than 30 days. Based on these results, the trend towards centralized core laboratories negatively impacts the practice of ID physicians, potentially delays effective implementation of prompt and targeted care for patients with serious infections, and similarly adversely impacts infection control epidemiologic investigations.
Pentella M, Weinstein MP, Beekmann SE, Polgreen PM, Ellison RT 3rd. The impact of changes in Clinical Microbiology Laboratory location and ownership on the practice of Infectious Diseases. J Clin Microbiol. 2020 Feb 19:JCM.01508-19. doi: 10.1128/JCM.01508-19. Epub ahead of print. PMID: 32075902. Link to article on publisher's site