The hidden profession that saves lives
Medical Laboratory Science (also called Clinical Laboratory Science) is one of the most under-recognized health professions – with excellent job prospects
By Rodney E. Rohde, PhD Posted on 11 February 2014
As an undergraduate microbiology major and MS student in virology, I envisioned a career in the clinical laboratory at some exciting hospital conducting microbiological testing to identify disease-causing microbes.
What is a Medical Laboratory Professional?
Medical Laboratory Scientists (MLS) and Medical Laboratory Technicians (MLT) — also known as Clinical Laboratory Scientists (CLS) — perform laboratory tests on patient samples to provide information needed to diagnose or monitor treatment. Examples of common laboratory tests include tests to detect anemia, diagnose diabetes and strep throat, and provide a transfusion to an accident victim.
Professional duties include:
- Operating computerized instruments
- Identifying abnormal cells
- Assuring safe transfusion of blood products
- Culturing and identifying bacteria and viruses
- Correlating test results with patient's condition
- Selecting and evaluating lab equipment
- Selecting, orienting and evaluating employees
- Monitoring the quality of testing
Source: NAACLS Standards for Accredited and Approved Programs
After graduating and starting my job search, I quickly learned that I was mistaken.
To conduct diagnostic laboratory testing in a clinical environment, like a hospital laboratory and most reference laboratories (which provide services for physicians), I needed to be certified or licensed as a medical laboratory scientist (MLS) or medical laboratory technician (MLT).
After learning that I would be unable to work in a hospital laboratory, I decided to go to work for the Texas Department of State Health Services (DSHS) in the Bureau of Laboratories as a public health microbiologist. I worked in a variety of areas, including newborn screening and virology.
Later, I was a molecular epidemiologist for the DSHS Zoonosis Control Division, where I became sort of a hybrid employee between the laboratory and in the field tracking zoonotic disease agents (for example, rabies, hantavirus and plague) as a molecular epidemiologist. It was a fantastic experience and provided a strong foundation for the span of my career. I was one of the original members of the successful Oral Rabies Vaccination Program in Texas that eliminated wildlife rabies from coyotes and foxes in the 1990s. I also worked with the Centers for Disease Control (CDC) to establish the DSHS Regional Rabies Typing Laboratory as the first state public health laboratory to provide rabies typing for other states and countries.
It was in the DSHS laboratory that I first became acquainted with a "med tech" and what his educational background and profession involved.
Medical laboratory science involves diagnostic laboratory testing from A to Z. These professionals do everything from providing your cancer testing results, to predicting the correct antibiotic to prescribe, to typing the correct blood for surgery. MLS professionals provide answers to life-and-death decisions every day.
I was fascinated – and disappointed – that I had not learned of this amazing career choice (and major) while I was in college. In fact, I was right across the street from an MLS program while I was obtaining my microbiology and virology degree.
This is an important thing to mention because MLS as a college major is often in an Allied Health program or the College of Health Professions, not in the College of Science where my microbiology courses were.
As MLS program chair, I have had so many students and alumni tell me: "If only I had known about the MLS major sooner."
In our program, about 40 percent to 50 percent of students who apply to our major already have a BS, or even an MS or PhD, in another major (such as microbiology, biology or biomedical studies), but they are either unable to find a job or they find out they can't work in a clinical laboratory without the degree and MLS certification.
In my case, I quickly became fascinated with the profession while working with so many wonderful medical lab scientists and medical lab technologists at DSHS. I learned that I could use my virology experience to get credit toward my certification, and went on to obtain my Specialty in Virology (SV) from the Board of Certification (BOC) of the American Society for Clinical Pathology (ASCP). The BOC is the primary certification agency for the medical laboratory profession. Eventually, after moving into academia, I acquired my Specialist in Microbiology (SM) and Molecular Biologist (MB) by the same route.
Have you ever wondered who conducts the detailed laboratory testing for your annual exam, such as cholesterol and glucose levels, and analyzes the results? Or who conducts specialized testing for genetic disorders like sickle cell disease? How about those who identify an antibiotic resistant infection like Methicillin Resistant Staphylococcus aureus (MRSA) and determine which antibiotic is required to save someone's life? Well, if you thought that it was your physician, or perhaps a nurse or someone else you see at your doctor's office or in the hospital, you would be incorrect.
MLS professionals provide up to 70 percent of patients' laboratory testing to physicians so they can provide an accurate diagnosis and treatment plan, according to a 2002 study in Clinical Leadership and Management Review titled "The Value of the Laboratory Professional in the Continuum of Care." In that study, author Rodney Forsman, Administrative Director Emeritus of the Mayo Clinic Medical Laboratories and President of the Clinical Laboratory Management Association, stated that 94 percent of the objective medical data in the patient record comes from the laboratory professionals.
Doctors rely on laboratory test results to make informed patient diagnoses. Patient history along with physical signs and symptoms are vital, but most diagnoses need confirmation that only laboratory tests can provide. The laboratory professionals also contribute to wellness testing, guiding treatment, and monitoring patient progress.
Video: 'A Life Saved'
This video by the American Society for Clinical Laboratory Science (ASCLS) tells the story of how medical laboratorians save lives by assisting with patient diagnosis and treatment:
Is this profession right for you?
Consider this profession if you:
- Have a strong interest in science
- Want a career in health care with minimal patient contact
- Like challenge and responsibility
- Like to solve problems
- Are a team player
- Work well under pressure
- Are self-motivated
- Enjoy working with computers
- Are detail-oriented
- Are willing to persevere to find the right answer
What are the job prospects?
The profession is growing "much faster than average," according to the US Bureau of Labor Statistics, with a 22 percent increase in employment projected from 2012 to 2022 – twice that of all other occupations. At Texas State University, the job placement rate for students has been 90 percent to 95 percent for the past decade, with most of the remaining students going to graduate school, according to Dr. Rohde. At the University of Delaware, Dr. McLane reports a similar scenario, with a job placement rate of 90 percent to 98 percent. They said students typically receive one or two job offers in their final semester while doing their clinical internships.
This situation is similar in may parts of the US, according to the American Society for Clinical Laboratory Science (ASCLS), which states: "Currently there is a shortage in many parts of the US,meaning that graduates can expect employment and higher salaries."
How much can you earn?
The salary for laboratory professionals varies according to their level and location. According to the American Society for Clinical Pathology (ASCP) 2013 Wage Survey of Clinical Laboratories in the United States, the staff level MT/MLS/CLS national average is $56,430 per year and $77,113 per year at the supervisory level. Salaries are higher for those who become lab directors or faculty members. The full ASCP report is here.
According to PayScale.com, which gathers its information from individual user reports: "A Mid-Career Medical/Clinical Laboratory Technologist earns an average of $22.40 per hour. The skills that increase pay for this job the most are PCR Analysis and Molecular Biology."
People often think their lab tests are done by their doctor, like it's done on House, or Dr. Kildare or Grey's Anatomy. In fact, you would probably not want your personal physician to do your lab tests because the specialized skills required are not an integral part of the medical school curriculum.
In a 2008 report in the Annals of Clinical Biochemistry, authors Victoria Khromova and Trevor Gray of Northern General Hospital in Sheffield, UK, reported that the junior doctors they surveyed were more confident in their knowledge of when to request tests than in their ability to interpret the results. In fact, 18 percent of them said they would order a lab test without knowing how to interpret the result. The authors concluded that the elimination of pathology and laboratory medicine from the curriculum in many medical schools is jeopardizing patient safety.
Ask your physician, nurse, pharmacist or biology graduate about Vitamin C acting as interference in glucose and triglyceride testing, or causes of false positives in pregnancy testing, or World Health Organization (WHO) classifications for Hodgkin disease and diagnostic criteria, or ways to test for swine flu (H1N1) and avian flu (H5N1), or genetic testing modalities for cystic fibrosis, or who is most likely to show antibodies to Kell during a STAT emergency test for life-saving blood in surgery, or any other critical laboratory test and its interpretation. These aspects of lab testing are generally not in the body of knowledge of any of these medical professionals, and yet it is completely in ours.
Formal coursework training in medical laboratory testing comprises a small portion of the curriculum for physicians, nurses, pharmacists, physical therapists, occupational therapists, and biology graduates. However, for MLS and MLT students, medical laboratory theory for all 1,000+ available lab tests, sources of interference, and connections between test results and diagnoses is the main focus of their studies.
My colleague Dr. Mary Ann McLane, Professor in the Medical Laboratory Sciences Department at the University of Delaware and Past President of the American Society for Clinical Laboratory Science (ASCLS), emphasized the value of their expertise to the patients:
Medical laboratory scientists are on the cutting edge of determining — by evidence-based practice — the most useful, time-efficient, safest, least costly diagnostic tests to be used for your health care. They are involved in the research needed to bring the best that science and technology can offer into the realm of diagnostic reality, all for the benefit of the patients we serve.
To that end, over 50 MLS professionals from ASCLS volunteer to answer questions daily about lab test results for both patients and clinicians through Lab Tests Online (labtestsonline.org), which has been has been run by the American Association for Clinical Chemistry (AACC) since it was launched in 2001.
Through this service, Dr. McLane said, "over 140,000 questions have been answered, saving many lives, relieving confusion about what such tests may mean, and offering follow-up questions for the next clinician visit."
"Lab Tests Online has given a public face to the practice of laboratory medicine," said Executive Producer George Linzer, "and with the support of ASCLS' consumer response network, it has begun to give more public recognition to the valuable work of the laboratory professional."
About 7.25 billion laboratory tests are conducted annually in the US, according to the Centers for Medicare & Medicaid Services. And yet most in the general public have no understanding about our profession and the critical services we provide daily.
You can learn more about our profession and its importance for patients on the ASCLS page Promote the Profession.
For patients, be an advocate for your own health and wellbeing by making sure your laboratory testing is being conducted by a qualified medical laboratory professional, by asking your health-care team about what your laboratory results mean and by visiting labtestsonline.org. You might just be surprised at how much you can learn by understanding your laboratory tests and the professionals who provides that expertise.
How do you become a Medical Laboratory Professional?
Medical laboratory scientists (also known as medical technologists or clinical laboratory scientists) must have a BS degree in medical technology or one of the life sciences.
Medical laboratory technicians must complete a two-year associate degree with similar courses and clinical practicum as the BS degree, but with less emphasis on highly complex laboratory techniques.
To work as either a medical laboratory scientist (MLS) or technician (MLT), you need to be certified by the Board of Certification (BOC) of the American Society for Clinical Pathology (ASCP) once you have a degree.
The best way to prepare for the certification exam is to complete an NAACLS accredited program or clinical internship in medical technology. These programs prepare students with a combination of lectures and clinical rotations in hematology, clinical chemistry, microbiology, mycology, parasitology, immunology, immunohematology (blood bank), and sometimes genetics. They are offered through hospitals and universities and take from two to four years to complete.
To work in some states (such as New York, Florida and California) you'll also need to be licensed. The license is usually obtained after sitting for the ASCP exam. Upon passing, you can then apply for the license. It's very important to understand the requirements of a particular state you will work in versus where you obtain your degree. For example, once students in our CLS program at Texas State University finish our degree and pass the MLS (ASCP) exam, they are able to work in any clinical laboratory in Texas. However, if our students move to California, there may be restrictions on their scope of work until they satisfy the state's requirements to work in a clinical laboratory.
There are various categorical and specialty certifications from ASCP (and other certification agencies) that will allow different "routes" to obtaining these credentials. ASCP has a free procedures booklet with information on the different routes to certification, how to register for certification, and how to maintain certification with continuing education. For a complete description of all the routes and requirements, visit the ASCP Board of Certification website.
You can learn about this profession and its importance for patients on the ASCLS page Promote the Profession.
Also, you can do a Web search for your area and "medical laboratory scientist" or "medical technologist" or contact the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS). It would also be helpful to visit with an advisor at a local medical laboratory or college.
Sources: National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) and American Society for Clinical Pathology (ASCP)
Elsevier Connect Contributor
Dr. Rodney E. Rohde is Professor, Research Dean and Program Chair and Director of the Clinical Laboratory Science program in the College of Health Professions of Texas State University, where he spends a great deal of time mentoring and coaching students in this sometimes mysterious and vague path.
Dr. Rohde's background is in public health and clinical microbiology, and his PhD dissertation at Texas State was aligned with his clinical background: MRSA knowledge, learning and adaptation. His research focuses on adult education and public health microbiology with respect to rabies virology, oral rabies wildlife vaccination, antibiotic resistant bacteria, and molecular diagnostics/biotechnology. He has published over 30 research articles, book chapters and abstracts and presented at more than 100 international, national and state conferences. He was awarded the 2012 Distinguished Author Award and the 2007 ASCLS Scientific Research Award for his work with MRSA. Learn more about his work here.
Elsevier's textbooks on Clinical Laboratory Science
Elsevier publishes many textbooks for Clinical Laboratory Science. Some of the most popular are:
- Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics (7th Edition coming in March), by Carl A. Burtis, PhD and David E. Bruns, MD
- Linne & Ringsrud's Clinical Laboratory Science: The Basics and Routine Techniques, 6th Edition, by Mary Louise Turgeon, EdD, MT(ASCP), CLS(NCA)
- Textbook of Diagnostic Microbiology, 4th Edition, by Connie R. Mahon, MS, MT(ASCP), CLS, Donald C. Lehman, EdD, MT(ASCP), SM(NRM) and George Manuselis Jr., MA, MT(ASCP)
- Hematology: Clinical Principles and Applications, 4th Edition, by Bernadette F. Rodak, MS, MLS, George A. Fritsma, MS, MLS and Elaine Keohane, PhD, MLS
See all of Elsevier's CLS textbooks.
- Eating our young in nursing … Are we full yet?
By Jennifer A. Brunworth, MSN, RN | Posted on 15 Oct 2015
Bullying is the profession’s “dirty little secret”; here’s how it works – and how we can change it
- 8 things you may not know about rabies – but should
By Pamela J. Wilson, LVT, MEd, and Rodney E. Rohde, PhD | Posted on 28 Sep 2015
For #WorldRabiesDay, two experts share less-known facts about rabies and how to prevent it
- Nurses unite on The View
By Chris Capot | Posted on 18 Sep 2015
In response to disparaging comments on the TV show, nurses will "show their stethoscopes" and the true work of the nursing profession
- For #NursesWeek, nurses at Elsevier reflect on changes and challenges in the profession
By Ian Evans | Posted on 06 May 2014
Colleagues talk about the expanding role of nurses – and how they're expected to do more with less
- C-SPAN: Q&A with Ibis Sánchez-Serrano—author of The World’s Health Care Crisis
By Alison Bert, Editor-in-Chief | Posted on 24 Mar 2014
He talks about how the high cost of medicine is fueling the market for fake prescription drugs and posing serious risks for world health
- 10 tips to finishing your PhD faster
By Rodney E. Rohde, PhD | Posted on 23 Oct 2013
What they don’t always tell you before you sign up for graduate school
- Training nurses means mastering a new technology
By Christopher Capot | Posted on 11 Dec 2012
With more hospitals adopting electronic health records, a simulated EHR system lets nurse educators give students hands-on experience
Medical microbiology , the large subset of microbiology that is applied to medicine, is a branch of medical science concerned with the prevention, diagnosis and treatment of infectious diseases. In addition, this field of science studies various clinical applications of microbes for the improvement of health. There are four kinds of microorganisms that cause infectious disease: bacteria, fungi, parasites and viruses, and one type of infectious protein called prion.
A medical microbiologist studies the characteristics of pathogens, their modes of transmission, mechanisms of infection and growth. Using this information, a treatment can be devised. Medical microbiologists often serve as consultants for physicians, providing identification of pathogens and suggesting treatment options. Other tasks may include the identification of potential health risks to the community or monitoring the evolution of potentially virulent or resistant strains of microbes, educating the community and assisting in the design of health practices. They may also assist in preventing or controlling epidemics and outbreaks of disease. Not all medical microbiologists study microbial pathology; some study common, non-pathogenic species to determine whether their properties can be used to develop antibiotics or other treatment methods.
Epidemiology, the study of the patterns, causes, and effects of health and disease conditions in populations, is an important part of medical microbiology, although the clinical aspect of the field primarily focuses on the presence and growth of microbial infections in individuals, their effects on the human body, and the methods of treating those infections. In this respect the entire field, as an applied science, can be conceptually subdivided into academic and clinical subspecialties, although in reality there is a fluid continuum between public health microbiology and clinical microbiology, just as the state of the art in clinical laboratories depends on continual improvements in academic medicine and research laboratories.
In 1676, Anton van Leeuwenhoek observed bacteria and other microorganisms, using a single-lens microscope of his own design.
In 1796, Edward Jenner developed a method using cowpox to successfully immunize a child against smallpox. The same principles are used for developing vaccines today.
Following on from this, in 1857 Louis Pasteur also designed vaccines against several diseases such as anthrax, fowl cholera and rabies as well as pasteurization for food preservation.
In 1867 Joseph Lister is considered to be the father of antiseptic surgery. By sterilizing the instruments with diluted carbolic acid and using it to clean wounds, post-operative infections were reduced, making surgery safer for patients.
In the years between 1876 and 1884 Robert Koch provided much insight into infectious diseases. He was one of the first scientists to focus on the isolation of bacteria in pure culture. This gave rise to the germ theory, a certain microorganism being responsible for a certain disease. He developed a series of criteria around this that have become known as the Koch's postulates.
A major milestone in medical microbiology is the Gram stain. In 1884 Hans Christian Gram developed the method of staining bacteria to make them more visible and differentiable under a microscope. This technique is widely used today.
In 1929 Alexander Fleming developed the most commonly used antibiotic substance both at the time and now: penicillin.
DNA sequencing, a method developed by Walter Gilbert and Frederick Sanger in 1977, caused a rapid change the development of vaccines, medical treatments and diagnostic methods. Some of these include synthetic insulin which was produced in 1979 using recombinant DNA and the first genetically engineered vaccine was created in 1986 for hepatitis B.
In 1995 a team at The Institute for Genomic Research sequenced the first bacterial genome; Haemophilus influenzae. A few months later, the first eukaryotic genome was completed. This would prove invaluable for diagnostic techniques.
Commonly treated infectious diseases
Causes and transmission of infectious diseases
See also: Infection
Infections may be caused by bacteria, viruses, fungi, and parasites. The pathogen that causes the disease may be exogenous (acquired from an external source; environmental, animal or other people, e.g. Influenza) or endogenous (from normal flora e.g. candidiasis).
The site at which a microbe enters the body is referred to as the portal of entry. These include the respiratory tract, gastrointestinal tract, genitourinary tract, skin, and mucous membranes. The portal of entry for a specific microbe is normally dependent on how it travels from its natural habitat to the host.
There are various ways in which disease can be transmitted between individuals. These include:
- Direct contact - Touching an infected host, including sexual contact
- Indirect contact - Touching a contaminated surface
- Droplet contact - Coughing or sneezing
- Fecal–oral route - Ingesting contaminated food or water sources
- Airborne transmission - Pathogen carrying spores
- Vector transmission - An organism that does not cause disease itself but transmits infection by conveying pathogens from one host to another
- Fomite transmission - An inanimate object or substance capable of carrying infectious germs or parasites
- Environmental - Hospital-acquired infection (Nosocomial infections)
Like other pathogens, viruses use these methods of transmission to enter the body, but viruses differ in that they must also enter into the host's actual cells. Once the virus has gained access to the host's cells, the virus' genetic material (RNA or DNA) must be introduced to the cell. Replication between viruses is greatly varied and depends on the type of genes involved in them. Most DNA viruses assemble in the nucleus while most RNA viruses develop solely in cytoplasm.
The mechanisms for infection, proliferation, and persistence of a virus in cells of the host are crucial for its survival. For example, some diseases such as measles employ a strategy whereby it must spread to a series of hosts. In these forms of viral infection, the illness is often treated by the body's own immune response, and therefore the virus is required to disperse to new hosts before it is destroyed by immunological resistance or host death. In contrast, some infectious agents such as the Feline leukemia virus, are able to withstand immune responses and are capable of achieving long-term residence within an individual host, whilst also retaining the ability to spread into successive hosts.
Main article: Diagnostic microbiology
Identification of an infectious agent for a minor illness can be as simple as clinical presentation; such as gastrointestinal disease and skin infections. In order to make an educated estimate as to which microbe could be causing the disease, epidemiological factors need to be considered; such as the patient's likelihood of exposure to the suspected organism and the presence and prevalence of a microbial strain in a community.
Diagnosis of infectious disease is nearly always initiated by consulting the patient's medical history and conducting a physical examination. More detailed identification techniques involve microbial culture, microscopy, biochemical tests and genotyping. Other less common techniques (such as X-rays, CAT scans, PET scans or NMR) are used to produce images of internal abnormalities resulting from the growth of an infectious agent.
Microbiological culture is the primary method used for isolating infectious disease for study in the laboratory. Tissue or fluid samples are tested for the presence of a specific pathogen, which is determined by growth in a selective or differential medium.
The 3 main types of media used for testing are:
- Solid culture: A solid surface is created using a mixture of nutrients, salts and agar. A single microbe on an agar plate can then grow into colonies (clones where cells are identical to each other) containing thousands of cells. These are primarily used to culture bacteria and fungi.
- Liquid culture: Cells are grown inside a liquid media. Microbial growth is determined by the time taken for the liquid to form a colloidal suspension. This technique is used for diagnosing parasites and detecting mycobacteria.
- Cell culture: Human or animal cell cultures are infected with the microbe of interest. These cultures are then observed to determine the effect the microbe has on the cells. This technique is used for identifying viruses.
Culture techniques will often use a microscopic examination to help in the identification of the microbe. Instruments such as compound light microscopes can be used to assess critical aspects of the organism. This can be performed immediately after the sample is taken from the patient and is used in conjunction with biochemical staining techniques, allowing for resolution of cellular features. Electron microscopes and fluorescence microscopes are also used for observing microbes in greater detail for research.
Fast and relatively simple biochemical tests can be used to identify infectious agents. For bacterial identification, the use of metabolic or enzymatic characteristics are common due to their ability to ferment carbohydrates in patterns characteristic of their genus and species. Acids, alcohols and gases are usually detected in these tests when bacteria are grown in selective liquid or solid media, as mentioned above. In order to perform these tests en masse, automated machines are used. These machines perform multiple biochemical tests simultaneously, using cards with several wells containing different dehydrated chemicals. The microbe of interest will react with each chemical in a specific way, aiding in its identification.
Serological methods are highly sensitive, specific and often extremely rapid laboratory tests used to identify different types of microorganisms. The tests are based upon the ability of an antibody to bind specifically to an antigen. The antigen (usually a protein or carbohydrate made by an infectious agent) is bound by the antibody, allowing this type of test to be used for organisms other than bacteria. This binding then sets off a chain of events that can be easily and definitively observed, depending on the test. More complex serological techniques are known as immunoassays. Using a similar basis as described above, immunoassays can detect or measure antigens from either infectious agents or the proteins generated by an infected host in response to the infection.
Polymerase chain reaction
Polymerase chain reaction (PCR) assays are the most commonly used molecular technique to detect and study microbes. As compared to other methods, sequencing and analysis is definitive, reliable, accurate, and fast. Today, quantitative PCR is the primary technique used, as this method provides faster data compared to a standard PCR assay. For instance, traditional PCR techniques require the use of gel electrophoresis to visualize amplified DNA molecules after the reaction has finished. quantitative PCR does not require this, as the detection system uses fluorescence and probes to detect the DNA molecules as they are being amplified. In addition to this, quantitative PCR also removes the risk of contamination that can occur during standard PCR procedures (carrying over PCR product into subsequent PCRs). Another advantage of using PCR to detect and study microbes is that the DNA sequences of newly discovered infectious microbes or strains can be compared to those already listed in databases, which in turn helps to increase understanding of which organism is causing the infectious disease and thus what possible methods of treatment could be used. This technique is the current standard for detecting viral infections such as AIDS and hepatitis.
Once an infection has been diagnosed and identified, suitable treatment options must be assessed by the physician and consulting medical microbiologists. Some infections can be dealt with by the body's own immune system, but more serious infections are treated with antimicrobial drugs. Bacterial infections are treated with antibacterials (often called antibiotics) whereas fungal and viral infections are treated with antifungals and antivirals respectively. A broad class of drugs known as antiparasitics are used to treat parasitic diseases.
Medical microbiologists often make treatment recommendations to the patient's physician based on the strain of microbe and its antibiotic resistances, the site of infection, the potential toxicity of antimicrobial drugs and any drug allergies the patient has.
In addition to drugs being specific to a certain kind of organism (bacteria, fungi, etc.), some drugs are specific to a certain genus or species of organism, and will not work on other organisms. Because of this specificity, medical microbiologists must consider the effectiveness of certain antimicrobial drugs when making recommendations. Additionally, strains of an organism may be resistant to a certain drug or class of drug, even when it is typically effective against the species. These strains, termed resistant strains, present a serious public health concern of growing importance to the medical industry as the spread of antibiotic resistance worsens. Antimicrobial resistance is an increasingly problematic issue that leads to millions of deaths every year.
Whilst drug resistance typically involves microbes chemically inactivating an antimicrobial drug or a cell mechanically stopping the uptake of a drug, another form of drug resistance can arise from the formation of biofilms. Some bacteria are able to form biofilms by adhering to surfaces on implanted devices such as catheters and prostheses and creating an extracellular matrix for other cells to adhere to. This provides them with a stable environment from which the bacteria can disperse and infect other parts of the host. Additionally, the extracellular matrix and dense outer layer of bacterial cells can protect the inner bacteria cells from antimicrobial drugs.
Medical microbiology is not only about diagnosing and treating disease, it also involves the study of beneficial microbes. Microbes have been shown to be helpful in combating infectious disease and promoting health. Treatments can be developed from microbes, as demonstrated by Alexander Fleming's discovery of penicillin as well as the development of new antibiotics from the bacterial genus Streptomyces among many others. Not only are microorganisms a source of antibiotics but some may also act as probiotics to provide health benefits to the host, such as providing better gastrointestinal health or inhibiting pathogens.
Notes and references
- ^Frank N. Egerton (2006). "A History of the Ecological Sciences, Part 19: Leeuwenhoek's Microscopic Natural History". Bulletin of the Ecological Society of America. 87: 47. doi:10.1890/0012-9623(2006)87[47:AHOTES]2.0.CO;2.
- ^Madigan M; Martinko J, eds. (2006). Brock Biology of Microorganisms (13th ed.). Pearson Education. p. 1096. ISBN 0-321-73551-X.
- ^Brock TD (1999). Robert Koch: a life in medicine and bacteriology. Washington DC: American Society of Microbiology Press. ISBN 1-55581-143-4.
- ^Sanger F, Nicklen S, Coulson AR (1977) DNA sequencing with chain-terminating inhibitors" Proceedings of the National Academy of Sciences 74:5463-5467.
- ^Fleischmann R, Adams M, White O, Clayton R, Kirkness E, Kerlavage A, Bult C, Tomb J, Dougherty B, Merrick J, al. e (1995) Whole-genome random sequencing and assembly of Haemophilus influenzae Rd" Science 269:496-512.
- ^Prescott LM, Harley JP, Klein DA (2005) Microbiology: McGraw-Hill Higher Education.
- ^Shaikh N; Leonard E; Martin JM (September 2010). "Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis". Pediatrics. 126 (3): 557–564. doi:10.1542/peds.2009-2648. PMID 20696723.
- ^Vos T; et al. (December 2012). "Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380: 2163–96. doi:10.1016/S0140-6736(12)61729-2. PMID 23245607.
- ^"Typhoid Fever". World Health Organization. Retrieved 2013-04-25.
- ^ ab"World Health Statistics 2012". World Health Organization. Retrieved 2013-04-25.
- ^Dennehy PH (2012). "Rotavirus infection: an update on management and prevention". Advances in Pediatrics. 59 (1): 47–74. doi:10.1016/j.yapd.2012.04.002. PMID 22789574.
- ^"Hepatitis C". World Health Organization. Retrieved 2013-04-25.
- ^Dunne EF; Unger ER; Sternberg, M (February 2007). "Prevalence of HPV infection among females in the United States". Journal of the American Medical Association. 297 (8): 813–9. doi:10.1001/jama.297.8.813. PMID 17327523.
- ^Kappus KD; Lundgren RG, Jr.; Juranek DD; Roberts JM; et al. (June 1994). "Intestinal parasitism in the United States: update on a continuing problem". American Society of Tropical Medicine and Hygiene. 50 (6): 705–13. PMID 8024063.
- ^"Toxoplasmosis". Centers for Disease Control and Prevention. Retrieved 2013-04-25.
- ^"Candidiasis". Centers for Disease Control and Prevention. Retrieved 2013-04-25.
- ^"Histoplasmosis". Centers for Disease Control and Prevention. Retrieved 2013-04-25.
- ^Washington, JA (1996). "10 Principles of Diagnosis". In Baron, S. Medical Microbiology (4th ed.). University of Texas Medical Branch at Galveston. ISBN 0-9631172-1-1.
- ^ abcSiebeling, RJ (1998). "Chapter 7 Principles of bacterial pathogenesis". In Bittar, Neville, E, B. Microbiology. Elsevier. p. 87. ISBN 1-55938-814-5.
- ^Rhinehart E; Friedman M (1999). Infection control in home care. Jones & Bartlett Learning. p. 11. ISBN 0-8342-1143-2.
- ^Roberts RJ, "Fish pathology, 3rd Edition", Elsevier Health Sciences, 2001.
- ^Roizman, B (1996). "42 Multiplication". In Baron, S. Medical Microbiology (4th ed.). University of Texas Medical Branch at Galveston. ISBN 0-9631172-1-1.
- ^Hilleman M (October 2004). "Strategies and mechanisms for host and pathogen survival in acute and persistent viral infections". Proceedings of the National Academy of Sciences of the United States of America. 101: 14560–14566. doi:10.1073/pnas.0404758101. PMC 521982. PMID 15297608.
- ^Greggs WM; Clouser CL; Patterson SE; Manksy LM (April 2012). "Discovery of drugs that possess activity against feline leukemia virus". Journal of General Virology. 93 (4): 900–905. doi:10.1099/vir.0.039909-0.
- ^ abNester E; Anderson D; Evans Roberts, C; Nester M (2009). Microbiology: A human perspective. McGraw Hill. pp. 336–337. ISBN 1-55938-814-5.
- ^Møller M; El Maghrabi R; Olesen N; Thomsen VØ (November 2004). "Safe inoculation of blood and bone marrow for liquid culture detection of mycobacteria". Occupational Medicine. 54 (8): 530–3. doi:10.1093/occmed/kqh106. PMID 15520021.
- ^Madigan MT (2009) Brock Biology of Microorganisms: Pearson/Benjamin Cummings.
- ^ abMackay I (2007). Real-time PCR in Microbiology: From Diagnosis to Characterisation. Horizon Scientific Press. pp. 1–25. ISBN 9781904455189.
- ^ abViljoen GJ; Nel LH; Crowther JR, eds. (2005). Molecular Diagnostic PCR Handbook. Springer. p. 58. ISBN 978-1-4020-3404-6.
- ^Tang YW; Persing DH (2009). Encyclopedia of Microbiology. Oxford Academic Press. pp. 308–320. ISBN 978-0-12-373944-5.
- ^WHO (April 2014). "Antimicrobial resistance: global report on surveillance 2014". WHO. WHO. Retrieved May 9, 2015.
- ^Vickery K, Hu H, Jacombs AS, Bradshaw DA, Deva AK (2013) A review of bacterial biofilms and their role in device-associated infection. Healthcare Infection .
- ^Stewart PS; Costerton JW (July 2001). "Antibiotic resistance of bacteria in biofilms". Lancet. 358 (9276): 135–8. doi:10.1016/S0140-6736(01)05321-1. PMID 11463434.
- ^Taguchi T, Yabe M, Odaki H, Shinozaki M, Metsä-Ketelä M, Arai T, Okamoto S, Ichinose K (2013) Biosynthetic Conclusions from the Functional Dissection of Oxygenases for Biosynthesis of Actinorhodin and Related Streptomyces Antibiotics. Chemistry & Biology 20:510-520.
- ^Williams NT (2010) Probiotics. American Journal of Health-System Pharmacy 67:449-458.