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dc.contributor.authorOmbelet, Sen
dc.contributor.authorRonat, JBen
dc.contributor.authorWalsh, Ten
dc.contributor.authorYansouni, CPen
dc.contributor.authorCox, Jen
dc.contributor.authorVlieghe, Een
dc.contributor.authorMartiny, Den
dc.contributor.authorSemret, Men
dc.contributor.authorVandenberg, Oen
dc.contributor.authorJacobs, Jen
dc.date.accessioned2018-04-27T13:25:11Z
dc.date.available2018-04-27T13:25:11Z
dc.date.issued2018-03-05
dc.date.submitted2018-04-23
dc.identifier.citationClinical bacteriology in low-resource settings: today's solutions. 2018 Lancet Infect Disen
dc.identifier.issn1474-4457
dc.identifier.pmid29519767
dc.identifier.doi10.1016/S1473-3099(18)30093-8
dc.identifier.urihttp://hdl.handle.net/10144/619108
dc.description.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.
dc.language.isoenen
dc.publisherElsevieren
dc.rightsArchived with thanks to The Lancet. Infectious Diseasesen
dc.titleClinical bacteriology in low-resource settings: today's solutionsen
dc.identifier.journalThe Lancet. Infectious Diseasesen
refterms.dateFOA2019-03-04T13:48:36Z
html.description.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.


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