Medical laboratory Roles and Challenges in detection and reportingantimicrobial resistance

Background and Aim : Rising trend in bacterial resistance to antibiotics is recognized as a majorglobal threat to public health. It is estimated that antimicrobial resistance would account for ۱۰million deaths per year worldwide by ۲۰۵۰. In between Emergence of multidrug resistant bacteriathat may require new technologies for detection and reporting needs specific attention. This lectureis aimed to briefly explain the main roles of laboratory to strengthen antibiotic stewardshipactivities while mentioning some of the current challenges in detection of antimicrobial resistance.Methods : Understanding different processes related to patient management in a health carefacility and reviewing the impact of integration and involvement of laboratories in infectionprevention and control activities reveals important role of laboratory in achieving antibioticstewardship objectives.Results : Guidance and information provided by laboratories to determine local microbialsusceptibility pattern can help to generate appropriate surveillance data. On the other hand by usingnew rapid diagnostics, laboratories can decrease test turnaround time that not only shortens timeneeded for selecting most appropriate treatment but also help to avoid misuse or overuse ofantibiotics. Cascade or selective testing and reporting according to available formulary is anotherway that helps to provide appropriate guidance for updating empirical therapeutic algorithms.Main challenges that our facilities encounter include availability of quality diagnostic material todetect emerging resistant strains, access to updated standards and guidelines to generatecomprehensive institutional antibiogram profile and optimize empiric antimicrobial therapy andissues related to specimen collection and handling procedures.Conclusion : All these benefits could be achievable if laboratories are integrated in an organizedmultidisciplinary system with strong communication between clinicians, laboratory staff, andpharmacists that facilitate correct specimen collection, proper flow of necessary data andinformation as well as appropriate and standardized testing.