Clinical Microbiology and Infectious Diseases

Automation

In a clinical microbiology laboratory, two areas depend on visual analysis or manual dexterity. First, the examination and recognition of specific characteristics of bacterial colonies growing on agar. This is a skill which requires pattern recognition and takes months, if not years, for a person to learn. Second, purifying organisms from a mixed growth by isolating individual bacterial colonies (picking colonies) requires high degrees of manual skill and hand-eye co-ordination. These skills, which are unique to clinical microbiology, take prolonged practice to perfect and depend on memorising a large body of information. A major part of the laboratory activity in bacteriology continues to depend on these processes. Third, microscopy is used for examination of a wide range of samples and tests. These include examination of: Gram stains of fresh clinical material or organisms isolated from specimens; stools for parasites; tissue culture cells for evidence of a cytopathic effect and performing cell counts on samples such as cerebrospinal fluid. Much of medical mycology is dependent on visual recognition. Electron microscopy is also available in some laboratories to aid viral diagnosis. These activities share much in common with other specialties of pathology such as histopathology, cytology and haematology which also utilise microscopy extensively. The results from these processes are largely dependent on producing a descriptive written report which, again, increases the complexity over those processes which can produce a numerical result. Therefore, full laboratory automation for performing these analyses and producing a test result will depend on highly sophisticated image analysis, advanced artificial intelligence and robotics.