Rapid diagnostics and AMR testing from the blood culture bench

Dr Neil Bentley OBE offers a personal reflection on the impact of rapid diagnostics and antimicrobial resistance testing from the blood culture bench.

Before I delve into rapid diagnostics and antimicrobial resistance testing (AST) in possible sepsis patients, I would like to indulge you a little into my world…

When I started my microbiology career back in the early 1980s, the thought of same-day microbiology was just a pipe dream. We struggled with hand lenses, Craigie tubes, sugar reactions and don’t mention Stokes AST plates. Back then the Gram stain was always the first point of call, and we couldn’t just stick it through the Maldi! The introduction of API’s and E-Test strips were mind blowing back then! Did we trust the ‘blood culture machine’ above the Castaneda method? Well, we learned to live with it. Ask someone with grey hair in the Microbiology laboratory if you don’t understand the terminology in the preceding text, and be prepared to pull up a sandbag, I bet they will still know the API 20E code for an E.coli

Same-day microbiology has been with us for some while now and is here to stay. With the advent of 24/7 working in some microbiology laboratories and automation solutions, we have been able to move from notional turnaround times (which were previously impacted on by the time and day of the week) to predictable turnaround times enabling timely patient care interventions. These same-day microbiology solutions have significantly improved patient care and outcomes in some cases, particularly in acute and emergency settings.  

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