Dr Rahul S Kamble
Consultant Microbiologist and Infection Control,
Lilavati Hospital & Research Centre

Exploring the unknown – The clinical microbiology revolution continues!

Despite manifold improvements in conventional methods (CM), the time that elapses until reporting the final result remains a limiting factor. Rapid microbiological testing is necessary. Increased use of automated and rapid microbiological tests in the healthcare system is expected to help provide quick disease management, enable administration of appropriate antimicrobial therapy, and reduce morbidity and mortality rates. Diagnostic microbiology is in the process of a much-needed shift from conventional methods to the molecular methods for rapid pathogen detection and identification. Several technological advances using simple molecular methods have become available in recent years, showing potential for cost benefits, specifically peptide nucleic acid fluorescent in situ hybridization (PNA-FISH) and targeted real-time PCR, such as GeneXpert assays. The molecular methods involve both genomics and proteomics in concert with bioinformatics.

The global clinical microbiology market was valued at USD 8.4 billion in 2015 and is projected to grow at a CAGR of 7.29 percent over the next decade. The high growth would be attributed to increasing demand for laboratory services in order to detect pathogen-based diseases coupled with escalating need for control measures for infectious disease spread.

With urbanization and globalization, all types of pollutions and health hazards are also taking grip. Spread of infectious diseases is witnessing sharp growth not only in developed countries but also in developing countries. Amongst all infections, respiratory infection diseases have high prevalence rate due to easy spread of contagious pathogens. Thus, the respiratory disease segments are expected to witness growth with a CAGR of 8.51 percent over the next decade.

The laboratory instruments products segment is expected to command the largest share of the global clinical microbiology instruments market. The laboratory instruments segment is expected to grow with a CAGR of 8.54 percent over the next decade. Factors such as continuous technological advancements in the field of microbiology testing instruments and the focus on laboratory automation (coupled with the integration of robotics with conventional microbiology instruments) are fueling the growth of clinical microbiology.

Challenges that need immediate attention of clinical microbiologists include emerging viral infections and global public health; biosafety, biosecurity, and bioterrorism; quality management; and antimicrobial resistance (AMR). Automation and informatics are critical to helping overcome the various challenges faced by microbiology labs. With technology advancement, a number of instruments and equipment used in laboratories are switching to automation. Lab automation is helping to transform the microbiology lab workflow by automating plate selection, barcoding, inoculation, streaking, transportation, incubation, and imaging. Diagnostic microbiology manufacturers are focusing on adoption of robotics used for specimen processing, plate reading, and organism identification in the near future. Digital images allow lab technicians and microbiologists to review plates anytime, anywhere, including remote locations and offer the ability to build algorithms that can automatically provide results without human intervention. Informatics tools also enable seamless connectivity between the laboratory information system (LIS) and other lab instruments. These tools help labs create an integrated workflow with a single-user interface, and provide laboratorians with access to real-time data and analytics. Cloud-based informatics systems also allow data to be aggregated across labs from the same network, helping with performance benchmarking, analysis, and standardization of protocols. Modern informatics systems also ensure that the latest data privacy and cyber security requirements are met while providing on-demand access to information, reports, and analytics which can improve lab productivity, reduce errors, and shorten time to results.

A combination of genomics and proteomics is the future of diagnostic microbiology. The next decade, and particularly the next few years, should prove intriguing as we strive to further impact clinical decision-making for infectious diseases by advances in clinical microbiology.

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