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Clin Infect Dis. 2018 Aug 31;67(6):813-816. doi: 10.1093/cid/ciy584.

A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology.

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Microbiology Technical Services, LLC, Dunwoody, Georgia.
Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
Yale University School of Medicine, New Haven, Connecticut.
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Department of Pathology, Rhode Island Hospital, Providence.
Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill.
Department of Pathology, Children's Healthcare of Atlanta, Georgia.
Medical College of Wisconsin, Milwaukee.
Department of Laboratory Medicine, Cleveland Clinic, Ohio.
Department of Pathology and Laboratory Medicine, Beaumont Health, Royal Oak, Michigan.
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Department of Pathology and Laboratory Medicine, University of Louisville, Kentucky.
Department of Infectious Disease and Global Health, Tufts University, North Grafton, Massachusetts.
Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois.
Departments of Medicine and Pathology & Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.


The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician/advanced practice provider and the microbiologists who provide enormous value to the healthcare team. This document, developed by experts in laboratory and adult and pediatric clinical medicine, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. This document presents a system-based approach rather than specimen-based approach, and includes bloodstream and cardiovascular system infections, central nervous system infections, ocular infections, soft tissue infections of the head and neck, upper and lower respiratory infections, infections of the gastrointestinal tract, intra-abdominal infections, bone and joint infections, urinary tract infections, genital infections, and other skin and soft tissue infections; or into etiologic agent groups, including arthropod-borne infections, viral syndromes, and blood and tissue parasite infections. Each section contains introductory concepts, a summary of key points, and detailed tables that list suspected agents; the most reliable tests to order; the samples (and volumes) to collect in order of preference; specimen transport devices, procedures, times, and temperatures; and detailed notes on specific issues regarding the test methods, such as when tests are likely to require a specialized laboratory or have prolonged turnaround times. In addition, the pediatric needs of specimen management are also emphasized. There is intentional redundancy among the tables and sections, as many agents and assay choices overlap. The document is intended to serve as a guidance for physicians in choosing tests that will aid them to quickly and accurately diagnose infectious diseases in their patients.


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