Asst Prof Lab Med; Director, Clinical Microbiology Laboratory, YNHH; Director, Virology Reference Laboratory, VACT; Director, Medical Microbiology Fellowship Program
Clinical Microbiology Laboratory
The Clinical Microbiology Laboratory is certified by the American College of Pathology as an Extent 4 [highest] in the following areas: Bacteriology; Mycology; Mycobacteriology; and Parasitology. Extent 4 means that the Laboratory has passes periodic proficiency tests and unannounced inspections so that it is licensed to perform the most complex diagnosis in these areas. The Clinical Virology Laboratory is likewise certified.
Each of the sections of the Laboratory has its own space, with the combined clinical sections comprising approximately 3500 sq feet. In addition, the Clinical Fellows have a research laboratory of 350 sq feet.
The Laboratory utilizes a mixture of molecular diagnostic and agar-based techniques. Its “theme” has, and is, “rapid” (less than 4 hour) diagnostic methods. It has an extensive publication history concerning these methods, which are now used world-wide. Approximately 85% of pathogenic bacteria are identified from an agar plate within 4 hours of colony observation.
Routine molecular techniques directly from patient specimens include genetic amplification for M. tuberculosis, Neisseria gonorrhoeae, Chlamydia, and Group B Streptococcus. Recently the Laboratory introduced a Real Time PCR method for the rapid detection of MRSA, both from nose surveillance and also from positive blood cultures.
Routine rapid Antigen tests include Giardia, Cryptosporidium, H. pyori, Campylobacter, E. coli SLT (Shiga-like toxin), and Galactomanin.
The Laboratory routinely sequences from 16s ribosomal bacterial DNA for identification. It has, with the Molecular Diagnostics Laboratory, an ABS sequences and a proprietary data base, to which it adds. In addition, the Laboratory is developing an RNAse polymerase PCR assay for the identification of Mycobacterium and a sequence assay for the identification of fungi.
Clinical Infectious Diseases Rounds are held in the Microbiology Laboratory on Monday, Tuesday, Thursday and Friday. A faculty member conducts the rounds in conjunction with the Clinical Microbiology Fellow and Laboratory Medicine Resident. Rounds include patient case histories followed by a discussion of the laboratory methods and results. Didactic sessions on specific topics may also be presented.