Clinical Microbiology and Infectious Diseases

Emerging Technologies for the Diagnosis of Microbial Infections

In today's clinical microbiology laboratory, automation is being introduced that will change the nature of how clinical specimens are processed and analyses. Over the last several years, many microbiology laboratories have implemented automation to process liquid specimens which have historically been inoculated to media manually. In some institutions, this automation has been able to free up staff to concentrate on other tasks and has resulted in increased efficiency in the laboratory setting. In addition to efficiency, there are ergonomic gains in the workplace due to the pre-analytical plating instruments since tasks that are manual such as de-capping and re-capping specimens are now performed by the automated processor. This functionality reduces the ergonomic impact of the manual task and improves the work place environment for the employee. This pre-analytical plating instrumentation is now being integrated within a suite of instruments referred to as Total Laboratory Automation, or TLA, which includes digital plate reading (DPR) and middleware technology applied to culture analysis. DPR and associated middleware allow the laboratory to analyse cultures in a new and innovative way. The inoculated media is imaged using a camera in the “smart incubator”, and the image presented to the technologist via the computer screen at the bench. The analysis of the culture occurs using the digital image. Further workup, such as picking a colony for mass spectrometry or automated identification, is being automated as well. This chapter will discuss the new and innovative automation solutions available for the clinical microbiology laboratory today.