24 hours in the life of an Associate Practitioner in Microbiology

As an Associate Practitioner, my daily duties are varied. I work with staff members of all grades in the Microbiology lab to ensure that we are processing samples, performing the correct Quality Control checks, and supporting the smooth day-to-day running of the laboratory.

Specifically, I’m responsible for: Respiratory, COVID, and Norovirus PCR testing, pre-acceptance of new batches of test kits, weekly EUCAST testing of our QC organisms and antibiotic sensitivities, send-away specimens, isolate storage, and inoculating plates for all benches in the lab. I am usually assigned a section and list of jobs to look after each week, but I remain flexible in helping my colleagues and covering sections when needed.

Challenges in the lab

The biggest challenges I face are usually dependent on the number of samples we receive in the lab. In a hospital environment especially, we can’t predict what the workload for the day is going to be, and it can be a delicate balance to maintain. Examples of the balance being shifted can be down to factors out of our control, such as a lot of samples turning up to the lab at once, a phone call query that we need time to investigate, or sample processing issues (such as unlabelled or incorrectly collected specimens). Adaptability is always important in these scenarios. Different patients and service users will have different requirements, and we must always be prepared to expect the unexpected. The winter seasons also tend to be the most challenging for Microbiology due to the increased prominence of winter viruses and illnesses, and therefore an increased workload for our department.

The role of technology

Currently in my lab, we are in the process of evaluating Fecal PCR Filmarray testing with the hope of moving away from feces culture and allowing for in-house testing of toxins such as E. coli O157 and STEC (we currently send samples away to a reference lab for toxin testing). Feces culture can be more time-consuming in processing and awaiting results. So, the technology that this PCR platforming presents will allow us to save time in testing, and in diagnoses for the Medical Microbiologists and Infectious Diseases team in treating their patients.

My technology wish list

My wish list for our department would be to have an interface that can automatically link results from our PCR, MALDI-TOF, and Vitek platforms into our LIMS software. As we don’t currently have this, we manually transcribe these results, and the risk of transcription errors are therefore greater. An interface would allow more accuracy and reduced risk in this transcription process. Also, we currently refer most of our serology testing to reference labs, and this can be challenging when clinicians are waiting on results for these tests. I would therefore like to see more serology testing on-site, potentially via a shared analyser with Biochemistry, or the AFIAS-10 which can test for IGRA-TB.

Looking ahead

There is a new neonatal unit being built on-site, and I believe that our lab may see an increased workload with extra samples from this unit without guarantees of increased staffing levels. Technological solutions may be able to help in this scenario, as automated analysers or PCR platforms could reduce our culture workload and enable a quicker turnaround for results. That would not only reduce the pressures on our current workforce, but it would also allow a better service for our clinicians, and most importantly, our patients.

Published as part of the global CLINICAL24 conversation highlighting challenges facing clinical laboratories and exploring the technology solutions to overcome them. In partnership with Applied Microbiology International (AMI).