Microbiology lab automation

Full automation has now become the gold standard for clinical laboratories. Without hospital microbiology labs, which according to the Centres for Disease Control deal with 1.7 million infections and 99,000 associated deaths annually in the US alone, the growing threat of community-acquired and nosocomial infections could prove insuperable.

Automated processes have gone well beyond changing outdated procedures. They minimise potentially dangerous practices, lower turnaround time, reduce errors, enhance quality control, improve specimen handling and boost accuracy.
Moreover, technologists in automated labs tend to embrace innovation more readily. Because automation largely circumvents repetitive manual processing, lab technicians find it easier to focus on complex tasks that require their specific skills.
It is therefore remarkable that, despite shortages of skilled personnel and increases in the volume of work, it has taken years for automation to become acceptable to microbiologists.
Microbiology has long been regarded as essentially manual because it is so complex. Its processes have therefore been seen as unsuited to automation, as well as costly to install.
Powerful challenges compel that to change. Chief among these are increasing numbers of patients with chronic illnesses (largely due to ageing populations), the prevalence of healthcare-associated infections, and drug resistance of bacteria. More samples and requests for analysis than ever are coming into the labs, especially since the swine flu pandemic is straining resources globally.
At the same time, microbiology is incorporating an increasingly diverse range of technologies such as immuno-assay and molecular diagnostics.
Identification of samples is swifter, susceptibility results more accurate. Time-consuming tasks e.g. plate streaking, which can lead to lab inefficiencies and slow response times, have been displaced by automation, so that time is better spent interpreting the results of identification and antibiotic-susceptibility testing – data essential for timely, accurate diagnosis.
A further advantage of automated labs is that, unlike manual processes, they enhance rather than curtail microbiologists’ clinical productivity. For example, 24 hours to culture a colony in a conventional lab means that a result can have no immediate effectiveness – the test’s only clinical value is as a confirmatory measure rather than a diagnostic tool.
However, automation significantly cuts the risks of misidentification or cross-contamination of specimens in microbiology labs. This is crucial because they handle a huge variety of specimens, volumes, containers and methodologies as well as many body fluids, fungal and wound-site collections, scrapings and tissue samples.
 A further plus for lab automation is that it promotes consistency and quality. Without automation, lab tasks that are necessarily repetitive can lead to inconsistent or inappropriate ways of work and, from there, to improper treatment, longer patient stays, medication errors and unwanted drug side-effects.
 Bar coding, robotics and computers that replace manual transcription significantly reduce data loss and errors. Automation also makes it less likely that plate information and patient identification will be duplicated or transposed.
Three trends will drive laboratory automation’s future: smaller, more-flexible analysers and automation based on next-generation technology, including microfluidics, easy-to-use, powerful software for centralised lab management, and internet-based real-time service for better up-time.
Report: David Loshak

01.09.2009

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