Effective use of the clinical microbiology laboratory

The clinician's expectations of the clinical microbiology laboratory, while valid, have not always been fulfilled. Major limitations in the accurate identification of an aetiological agent are imposed by cost considerations and poor communication between clinician and laboratory personnel. Other difficulties arise in the entire process of making use of a clinical microbiology laboratory, ranging from specimen collection to interpretation of results. These problems can be partially overcome by the use of guidelines for specimen collection which are designed to provide a sufficient amount of material and number of specimens for complete examination. Additional assistance to the clinician may be rendered by the current trends in clinical microbiology practice to limit the processing of inappropriate specimens and to develop rapid, economical procedures for the detection of pathogenic microorganisms. The clinician should not routinely request antibiotic susceptibility testing but rather base the decision to test on specimen source, type of organism isolated, whether the organisms was isolated in pure or mixed culture, and how predictable the susceptibility of the organism is to the drug of choice.