Clinical bacteriology in low-resource settings: today's solutions
MetadataShow full item record
JournalThe Lancet. Infectious Diseases
AbstractLow-resource settings are disproportionately burdened by infectious diseases and antimicrobial resistance. Good quality clinical bacteriology through a well functioning reference laboratory network is necessary for effective resistance control, but low-resource settings face infrastructural, technical, and behavioural challenges in the implementation of clinical bacteriology. In this Personal View, we explore what constitutes successful implementation of clinical bacteriology in low-resource settings and describe a framework for implementation that is suitable for general referral hospitals in low-income and middle-income countries with a moderate infrastructure. Most microbiological techniques and equipment are not developed for the specific needs of such settings. Pending the arrival of a new generation diagnostics for these settings, we suggest focus on improving, adapting, and implementing conventional, culture-based techniques. Priorities in low-resource settings include harmonised, quality assured, and tropicalised equipment, consumables, and techniques, and rationalised bacterial identification and testing for antimicrobial resistance. Diagnostics should be integrated into clinical care and patient management; clinically relevant specimens must be appropriately selected and prioritised. Open-access training materials and information management tools should be developed. Also important is the need for onsite validation and field adoption of diagnostics in low-resource settings, with considerable shortening of the time between development and implementation of diagnostics. We argue that the implementation of clinical bacteriology in low-resource settings improves patient management, provides valuable surveillance for local antibiotic treatment guidelines and national policies, and supports containment of antimicrobial resistance and the prevention and control of hospital-acquired infections.
- Implementation of quality management for clinical bacteriology in low-resource settings.
- Authors: Barbé B, Yansouni CP, Affolabi D, Jacobs J
- Issue date: 2017 Jul
- Point-of-care and point-of-'can': leveraging reference-laboratory capacity for integrated diagnosis of fever syndromes in the tropics.
- Authors: Semret M, Ndao M, Jacobs J, Yansouni CP
- Issue date: 2018 Aug
- Authors: Bloom BR, Atun R, Cohen T, Dye C, Fraser H, Gomez GB, Knight G, Murray M, Nardell E, Rubin E, Salomon J, Vassall A, Volchenkov G, White R, Wilson D, Yadav P, Holmes KK, Bertozzi S, Bloom BR, Jha P
- Issue date: 2017 Nov 3
- Tuberculosis bacteriology laboratory services and incremental protocols for developing countries.
- Authors: Laszlo A
- Issue date: 1996 Sep
- Antibiotic use and emerging resistance: how can resource-limited countries turn the tide?
- Authors: Bebell LM, Muiru AN
- Issue date: 2014 Sep