Letters to the Editor Future Role of the Microbiologist
Received November 11, 1974; accepted for publication November 11, 1974.
industry-wide standard for reporting cultures so that all laboratories report the same "quality" microbiology. At recent meetings of the American Society for Microbiology, Dr. Bartlett tried to get a concensus as to criteria for identification of organisms and for returning specimens to the physicians when they were unsatisfactory (for example, no pus in "sputum" specimens). Dr. Porres is also asking for assistance in establishing "ways to process specimens, number of specimens to be examined and numbers of colonies to be studied to ensure the recovery of all or most potential pathogens. These standards should include advice as to the use of 'normal flora' reports." Perhaps the American Society of Clinical Pathologists or the American Society for Microbiology or the Center for Disease Control, or a committee from the three organizations, should establish recommendations for "quality" microbiology. J. P. K I L B O U R N , P H . D .
Associate Director of Biology Services United Medical Laboratories, Inc. Portland, Oregon 97208 References 1. Bartlett RC: A plea for clinical relevance in medical microbiology. Am J Clin Pathol 61:867-872, 1974 2. Isenberg HD, Painter BG: Indigenous and pathogenic microorganisms of man, Manual of Clinical Microbiology. Second edition. Edited by EH Lennette, EH Spaulding, J P Truant. Washington, D.C., American Society for Microbiology, 1974, p p 4 5 - 5 8 3. Porres JM: Quality control in microbiology. Am J Clin Pathol 62:412-419, 1974
Dr. Bartlett's Reply To the Editor:—There is no question about the need for development of a consensus on clinical relevance in medical microbiology, as suggested by Dr. Kilbourn. A multidisciplinary committee has Received February 27, 1975; accepted for publication February 27, 1975. 142
been formed in Connecticut for this purpose, partly as a result of tight constraints on rising hospital costs imposed by a new state commission. Although there have been widespread acceptance and application of many of the principles I have recommended, 1 , 2 a storm of controversy and criticism has arisen, primarily from
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To the Editor:—There have been two recent articles discussing the future role of microbiologists in the American Journal of Clinical Pathology. They present opposing points of view as to the role microbiologists should take in medicine. A selective role was suggested by Bartlett, 1 of the Hartford Hospital. He feels that "criteria should be established to reduce unnecessary microbiologic effort in the evaluation of specimens . . ." Porres, of Miriam Hospital, argues for a general role, with examination of every organism in a specimen to see whether a potential pathogen is present. He states: "For the diagnosis of a bacterial infection, the causative microbe must be isolated and identified. . . T h e need to speciate microbial isolates has been stressed." 3 T h e new edition of the Manual of Clinical Microbiology (American Society of Microbiology) does not quite have the answer either. In chapter 5, "Indigenous and Pathogenic Microorganisms of Man," Isenberg and Painter 2 list the organisms in the respiratory tract, gastrointestinal tract, genitourinary tract, skin, ear, and eye. Following the organism name is the anatomic locale and the infectious disease process. Included as one of the "infectious disease processes" is the statement: "not determined unequivocally." What Drs. Bartlett, Porres, Isenberg, a n d P a i n t e r probably desire is an
Received November 11, 1974; accepted for publication November 11, 1974.
industry-wide standard for reporting cultures so that all laboratories report the same "quality" microbiology. At recent meetings of the American Society for Microbiology, Dr. Bartlett tried to get a concensus as to criteria for identification of organisms and for returning specimens to the physicians when they were unsatisfactory (for example, no pus in "sputum" specimens). Dr. Porres is also asking for assistance in establishing "ways to process specimens, number of specimens to be examined and numbers of colonies to be studied to ensure the recovery of all or most potential pathogens. These standards should include advice as to the use of 'normal flora' reports." Perhaps the American Society of Clinical Pathologists or the American Society for Microbiology or the Center for Disease Control, or a committee from the three organizations, should establish recommendations for "quality" microbiology. J. P. K I L B O U R N , P H . D .
Associate Director of Biology Services United Medical Laboratories, Inc. Portland, Oregon 97208 References 1. Bartlett RC: A plea for clinical relevance in medical microbiology. Am J Clin Pathol 61:867-872, 1974 2. Isenberg HD, Painter BG: Indigenous and pathogenic microorganisms of man, Manual of Clinical Microbiology. Second edition. Edited by EH Lennette, EH Spaulding, J P Truant. Washington, D.C., American Society for Microbiology, 1974, p p 4 5 - 5 8 3. Porres JM: Quality control in microbiology. Am J Clin Pathol 62:412-419, 1974
Dr. Bartlett's Reply To the Editor:—There is no question about the need for development of a consensus on clinical relevance in medical microbiology, as suggested by Dr. Kilbourn. A multidisciplinary committee has Received February 27, 1975; accepted for publication February 27, 1975. 142
been formed in Connecticut for this purpose, partly as a result of tight constraints on rising hospital costs imposed by a new state commission. Although there have been widespread acceptance and application of many of the principles I have recommended, 1 , 2 a storm of controversy and criticism has arisen, primarily from
Downloaded from http://ajcp.oxfordjournals.org/ by guest on June 5, 2016
To the Editor:—There have been two recent articles discussing the future role of microbiologists in the American Journal of Clinical Pathology. They present opposing points of view as to the role microbiologists should take in medicine. A selective role was suggested by Bartlett, 1 of the Hartford Hospital. He feels that "criteria should be established to reduce unnecessary microbiologic effort in the evaluation of specimens . . ." Porres, of Miriam Hospital, argues for a general role, with examination of every organism in a specimen to see whether a potential pathogen is present. He states: "For the diagnosis of a bacterial infection, the causative microbe must be isolated and identified. . . T h e need to speciate microbial isolates has been stressed." 3 T h e new edition of the Manual of Clinical Microbiology (American Society of Microbiology) does not quite have the answer either. In chapter 5, "Indigenous and Pathogenic Microorganisms of Man," Isenberg and Painter 2 list the organisms in the respiratory tract, gastrointestinal tract, genitourinary tract, skin, ear, and eye. Following the organism name is the anatomic locale and the infectious disease process. Included as one of the "infectious disease processes" is the statement: "not determined unequivocally." What Drs. Bartlett, Porres, Isenberg, a n d P a i n t e r probably desire is an
