Medical & Diagnostic Microbiology: A Guide in Resources Constrained Laboratories

In low and middle income countries (LMICs), the emerging threat of antimicrobial resistant bacteria causing diseases is a major concern. LMICs face many challenges when implementing laboratory medicine, given the scarcity of diagnostic bacteriology laboratories and availability of limited options of effective antibiotic therapy for resistant pathogens. Consequently increasing morbidity and mortality among patients especially in intensive care units (ICUs) and limiting the availability of data on antimicrobial resistance. Medical Bacteriology is defined as the study of diseases causing bacteria. It covers host-parasite interactions including host defense mechanisms and bacterial virulence factors, a critical step in understanding of bacterial pathogenicity. Diagnostic Bacteriology is the study of isolation and identification of diseases causing bacteria. Different culture media, depending on the purpose, are used for the isolation of diseases causing bacteria from clinical specimens (e.g., blood, urine and pus). The isolated bacteria are then speciated to possible Genera and/or species by biochemical identification tests. Further, isolates (bacteria) are subjected to in vitro antibiotic susceptibility testing to determine their susceptibility patterns towards different antibiotic agents for the purpose of guiding rational antibiotic therapy. All diagnostic procedures in Bacteriology Laboratories are centered to quality assurances which ensures the reproducibility and reliability of the produced results. In all stages, quality check should be maintained and documented in accordance to local and international laboratory standards. Moreover, results should be reported within turn-around-time (TAT) for timely initiation of rational antibiotic therapy.