New laboratory techniques for hospital infection control.

The clinical microbiologist has important responsibilities in hospital infection control. Duties include participating in hospital-wide infection control activities (especially the infection control committee), recovering and identifying accurately the organisms responsible for nosocomial infection, characterizing antimicrobial susceptibility of many of these nosocomial pathogens, reporting in timely fashion laboratory data relevant to infection control, carrying out the few routine microbiologic studies of the hospital environment that are useful, supporting investigations of specific hospital infection problems as they arise, and providing special typing studies when necessary to establish similarity or difference of organisms. In the past decade, improvements in laboratory instrumentation and/or procedures have provided dramatic help to infection control efforts in several of these areas. Among these are new techniques for more rapid detection and differentiation of organisms and improved systems of reporting for both patient data and trend analysis. Perhaps the most dramatic advances have come in special procedures for examining (typing) hospital organisms for similarity or difference; here, molecular and other techniques have permitted more definitive examination of a wider range of organisms than previously was possible. With health care resources in the United States now at a premium, the current and future challenge for laboratories is to make their participation in infection control more efficient as well as effective. Establishing adequate quality control of methods and obtaining clinical data to allow correct interpretation will be crucial for efficient use of the new typing procedures. Deciding when these techniques are needed and whether they should be performed on site also will be an important part of this process.