Pathogens Never Sleep – Should Clinical Microbiology Laboratories?

Dr. Campos’ presentation and question & answer session have been archived.

ASM’s December hot topic discussion, “Pathogens Never Sleep – Should Clinical Microbiology Laboratories?” is presented by Joseph M. Campos, Ph.D., D(ABMM), F(AAM), Director, Microbiology Laboratory, Molecular Diagnostics Laboratory, and Laboratory Informatics, Children’s National Medical Center, and Professor, Departments of Pediatrics, Pathology, and Microbiology/Immunology/Tropical Medicine, George Washington University Medical Center.

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  1. What is the impact on a key partner with clinical microbiology-infection prevention and control-of this impressive transformation?
    Is there increased communication with infection prevention and control?
    Are isolation precautions instituted more quickly, more frequently or less frequently?
    Are there improvements in HAI rates and reductions in transmission with better data sooner?
    Thank you for a great model!

    • Joseph M. Campos, Ph.D., D(ABMM), F(AAM)

      Thank you for your important questions. The impact of our 24 hour Microbiology Laboratory on the infection prevention and control efforts at Children’s National Medical Center have been noteworthy. Of course the reduced turnaround times for positive cultures identify patients who are either colonized or infected with multiply drug-resistant organisms on a more timely basis. Hospitalized patients can be moved into (or out of) precautions sooner than in the past.

      The most dramatic effect has been on our MRSA active surveillance program. We assume that all patients admitted to our neonatal intensive care unit (NICU) are colonized with MRSA and they are automatically placed on contact precautions. With nasal swab testing now performed round-the-clock by real-time PCR on new admissions to our NICU, we are able to notify Infection Control and nurses/physicians on that unit of MRSA status of new patients. When patients are found to be MRSA-free by this testing, they are moved out of contact precautions within 90 minutes of admission, simplifying the care of these patients.

      Our Infection Control group is still looking at the impact of the above program on transmission of MRSA from patient to patient. What we already know is that this rate was significantly reduced once we converted from culture-based to PCR-based surveillance.

  2. I like the concept of the 24hr lab, but was quite upset when I heard you are paying for immigration expenses to get techs from the Phillipines, when the unemployment rate in this country is out of control. CLIA regulations allow anyone with a bachelor’s degree in biological sciences to perform high complexity testing under the direction of a qualified medical director. Our lab has had a shortage of bachelor’s degree medical technologists and an abundant supply of assoc. degree MLTs. We wanted to strengthen our technologist base, and have hired 4 techs in the past year with degrees in Chemistry or Biology. We are able to pick from numerous very qualified applicants – superb transcripts. They have made excellent employees. With our country in the state it is in, I cannot understand the need to pay for the immigration of “ex-patriots” – who as you admitted send their paychecks back to relatives in the Phillipines.

    • Joseph M. Campos, Ph.D., D(ABMM), F(AAM)

      Thank you for your comments. We do advertise the occasional positions we have in our Microbiology Laboratory both internally and externally, prior to recruiting from the Phillipines. We have been unable to attract qualified medical technologists who are willing to work evening and night shifts in our laboratory. Thus, we have followed the same path as our Department of Nursing colleagues have in advertising our openings in the Phillipines with great success.

      Like you, I wish we could find individuals in the U.S. who are willing to work these shifts. When we are unable to do so, then we turn to alternative sources like the Phillipines.