Medical Microbiology is a branch of medical science concerned with the prevention, diagnosis and treatment of infectious disease. The diagnostic microbiology laboratory is responsible for detecting and identifying disease-causing microbes in clinical samples. This includes the vast array of bacteria, viruses, fungi and parasites that are known to cause disease. Where appropriate, testing for susceptibility of the microbes to antimicrobial agents is carried out to advance treatment and recovery. Clinical samples commonly examined in the microbiology laboratory include urine, stool, culture swabs, sputum, cerebrospinal fluid, blood, and aspirates.
Microbiology services include:
- Cultural growth and identification techniques used to isolate bacteria and other infectious agents of medical significance.
- Laboratory practices and techniques involved in sterilisation, disinfection, decontamination, infection control, and biohazard containment.
- Processing of clinical specimens so as to interpret the resulting bacterial growth.
- Antibiotic susceptibility testing and its reporting for selected bacterial pathogens.
- Identifying by bacterial culture techniques the likely causes of infection in cases of septicaemia, meningitis, cellulitis, gastroenteritis and sexually transmitted diseases.
- The identification of common parasites, both internal and ectoparasites.
Resistance in Microbiology
Antimicrobial Resistance (AMR) has been the hot topic of Microbiology in recent years as its
rapidly growing threat to public health continues to alarm Pacific nations. Of concern amongst countries is the variation in laboratory capacity for AMR surveillance, regulated use of antibiotics, understanding and awareness of AMR within the regional networks, and the integrity of accurate laboratory detection and reporting.
The PPTC has worked alongside other NGO partners including DFAT Australia and WHO, to advance and improve testing methods and address laboratory reporting systems operating in lesser developed Pacific Island hospital facilities.
Key issues in laboratories include a shortage of specialised Microbiology staff and Infectious Disease experts, inadequate equipment and instrumentation, no laboratory information systems, poor delivery mechanisms for consumable supplies, and inconsistencies in standards of practice for AMR testing. Infection prevention and control (IPC) systems within health facilities throughout the Pacific are also underdeveloped and weakly linked to the laboratory and clinical services sector.
Staff at the PPTC have expertise in Microbiology testing methods, bacterial identification and antibiotic reporting specifications. They give lectures during our Wellington-based courses and regularly teach culture interpretation skills and management principles when visiting in-country national laboratories. Administering the EQA programme also has benefits for the PPTC in that they can pick up on underperformance issues shown in participating laboratories and respond to them with training and education sessions.
Recent Microbiology advances include:
- Introduction of automated Blood Culture machines.
- Introduction of CO2 incubator systems.
- Chromogenic Agar and Media developments.
- Automated ID and Antimicrobial susceptibility testing machines like Vitec and BD Phoenix.
- Maldi-TOF Identification units.
- Advancement and integration of Molecular PCR tests.
- GeneXpert PCR for TB testing and Resistance detection.
- Integrating Serology and Virology testing with Microbiology pathogens by detecting immune response antibodies.
- Fully automated 24/7 Microbiology Laboratory systems.
What PPTC Offers
PPTC’s focus is on improving quality and testing capacity in Pacific Island laboratories, where most do not have the means to provide essential tests, let alone critical tests, for their health care system. Microbiology diagnostic procedures are mostly performed manually in the Pacific region, with some automation in place with Blood Culture machines, AST analysers, and GeneXpert Machines.
The PPTC provides advice to Pacific Island laboratories on the purchase of equipment options that are appropriate and affordable in providing essential tests. The focus is also to improve testing capacity and quality locally. Advice and support is provided in the implementation of new equipment and the validation of the methods used in accordance with international standard requirements.
The PPTC is committed, to raising the quality and standard of Microbiology practiced across the countries participating in our EQA programme. Education in the appropriate interpretation of QC data, identification of pathogenic and commensal flora, performing sensitivity testing, identifying multi-drug-resistant bacteria, reporting or results to clinicians, providing interpretative comments, sending isolates for typing, and confirmatory testing to reference laboratory for surveillance purposes are paramount issues in raising the importance and understanding in Clinical Microbiology laboratories.
Blood Culture Machines, Automated ID, and susceptibility testing machines have recently been upgraded in Samoa and Solomon Islands under the guidance and direction of PPTC advisors.