There are two aspects of clinical microbiology- the laboratory service and the clinical advice for treatment. The best practice in clinical microbiology laboratory provides the clinician with accurate and reliable laboratory diagnosis of infections to assist in the management of patients and choice of antimicrobial treatment.

It is the need of the hour for the microbiologist to move from agar plates to the clinical wards.

 MDRO or multidrug resistant organisms are those bacteria that have become resistant to certain antibiotics. For example: -

  1. MRSA
  2. VRE

MDRO infections have similar clinical manifestations as those of susceptible pathogens. But the problem stands in options of treatment which are narrowed. For example, until recently, only Vancomycin provided effective therapy for potentially life-threateningMRSA infections and during the 1990s there were virtually no antimicrobial agents to treat infections caused by VRE. Although antimicrobials are now available for treatment of MRSA and VRE infections, resistance to each new agent has already emerged in clinical isolates.

Increased lengths of stay, costs and mortality also have been associated with MDROs.

The reason behind the development of MDROs can be attributed to

1.Rampant use of antimicrobial agents.

2.Evolution of resistant strains.

3.Use of particular antibiotic poses selective pressure in bacterial population in turn promoting resistant bacteria to evolve and susceptible bacteria to die.

 

Resistant bacterial population flourish in areas of high antimicrobial use. These resistant bacterias in turn spread in the environment and transfer the genes coding for resistance to other unrelated bacteria.

It is the need of the hour to-

1.Promote infection control practices in healthcare centers.

2.Improve sanitary conditions and food handling techniques.

3.Over the counter sale of antibiotics should be controlled.

“As quoted by Louis Pasteur “Without laboratories men of science are soldiers without arms.”

Physicians should work in collaboration with microbiologists in choosing antibiotics. Thus, eliminating irrational use of antibiotics.

Preventing MDRO infections is part of creating a safe health care environment for patients, families and health care professionals. Such an environment also involves rounding together, huddling together and planning patient care together—that is, working together with one vision of creating a climate and culture of safety and quality.