The clinical microbiology reporting (CMR) for culture and antimicrobial susceptibility test (C and AST) is the most important investigation reported from a microbiology laboratory. However, majority of Indian microbiology laboratories generate a basic level C and AST report comprising of identification of the organism isolated with a list of antimicrobials and their susceptibility results, without any additional comments or messages. This leads to improper communication between the laboratory physicians and clinical physicians. This may further lead to irrational use of antimicrobials, improper specimen collection practices, inappropriate filing of requisition forms and poor infection control practices, which are mainly due to either unawareness or negligence of clinicians. Therefore, it is essential that the laboratory microbiologists of India should uplift themselves to clinical microbiologists and foster their CMR to higher standards by incorporating specific comments, suggestions and advices in the C and AST report, as recommended by the regulatory agencies such as Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing. The comments may be of several types which include report categories, in-progress reports, requisition form filling, specimen collection, footnotes in the AST table, infection control advices, antimicrobial agent-related suggestions, predicted susceptibility related and intrinsic resistance comments, etc. The use of comments will greatly help the clinicians to rationalise their antimicrobial practice, improvise practices of specimen collection, requisition form filling and finally instituting the appropriate infection control practices. These comments mentioned in this article are only author's recommendations; the end users may incorporate according their local practice and need.
Sastry AS, Deepashree R. Essentials of Hospital Infection Control. 1st ed. New Delhi, India: Jaypee Brothers Medical Publishers; 2019.
Bhattacharya S. Clinical microbiology: Should microbiology be a clinical or a laboratory speciality? Indian J Pathol Microbiol 2010;53:217.
CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 29th ed. CLSI Standard M100-S29. Wayne PA: Clinical and Laboratory Standards Institute; 2019.
EUCAST. Breakpoint Tables for Interpretation of MICs and Zone Diameters (Version 9.0, valid from 2019-01-01). Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_9.1-Breakpoint_Tables.pdf. [Last accessed on 2019 Dec 02].
CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests. 13th ed. CLSI Standard M02. Wayne, PA: Clinical and Laboratory Standards Institute; 2018.
Marcon MJ. “Value-added” reporting in clinical microbiology: Using computer-based textual reports and comments as an aid to communicating appropriate utilization and application of test results. Clin Microbiol Newsl 2003;25:25-31.
Musgrove MA, Kenney RM, Kendall RE, Peters M, Tibbetts R, Samuel L, et al. Microbiology comment nudge improves pneumonia prescribing. Open Forum Infect Dis 2018;5:ofy162.
Morency-Potvin P, Schwartz DN, Weinstein RA. Antimicrobial stewardship: How the microbiology laboratory can right the ship. Clin Microbiol Rev 2017;30:381-407.
Turner P, Fox-Lewis A, Shrestha P, Dance DA, Wangrangsimakul T, Cusack TP, et al. Microbiology Investigation Criteria for Reporting Objectively (MICRO): A framework for the reporting and interpretation of clinical microbiology data. BMC Med 2019;17:70.
Tille P. Bailey & Scott's Diagnostic Microbiology-E-Book. US/UK: Elsevier Health Sciences; 2015 Dec 28.
Humphries RM, Abbott AN, Hindler JA. Understanding and addressing CLSI breakpoint revisions: A primer for clinical laboratories. J Clin Microbiol 2019;57:e00203-19.
Kahlmeter G, Giske CG, Kirn TJ, Sharp SE. Point-counterpoint: Differences between the european committee on antimicrobial susceptibility testing and clinical and laboratory standards institute recommendations for reporting antimicrobial susceptibility results. J Clin Microbiol 2019;57:e01129-19.
Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J. In: Harrison's Principles of Internal Medicine. 20th ed. Fauci AS, editor. New York: Mcgraw-Hill; 2018.
Mahoney MT, Hirsch EB. What's New from the CLSI Subcommittee on Antimicrobial Susceptibility Testing. Society of Infectious Disease of Pharmacists; Oct 2019. Contagion ® website.
EUCAST. Intrinsic Resistance and Exceptional Phenotypes Tables (Version 3.1, valid from 2016-09-26). Available from: http://www.eucast.org/expert rules pdf. [Last accessed on 2019 Dec 02].