The Department of Clinical Microbiology comprises bacteriology, mycology, mycobacteriology, serology, infectious molecular biology, infectious disease surveillance department both in the hospital and in the community. The Department of Microbiology at MMM is an NABL-accredited lab working 24 x 7 all through the year with state-of-the-art quality and lab management systems that cater to the needs of its users–the multi-specialty hospital with clinicians and walk-in patients. The department is continuously striving to develop and update the antimicrobial usage policy and support the infection control program with routine surveillance, outbreak detection and management, antibiotic stewardship and increasing awareness among healthcare-associated staff.
The past year has been a year of arduous work for the laboratory both in terms of disease surveillance and academic achievements. From the time the laboratory received approval for doing the RT–PCR test for Covid-19 in 2020, more than 1 lakh samples have been processed. The turnaround times have reduced significantly to as low as 20 minutes for emergency request and down to 1 hour for routine ones.
The laboratory offers a wide array of tests in routine bacteriology, mycology and mycobacteriology that include staining to visualize bacteria, fungi, parasites and Mycobacterium tuberculosis, culture, speciation and other specialized tests. The serology section uses immunological principles like antigen-antibody reactions to identify diseases and the stage of the disease (acute vs convalescent). The range of tests being offered newly in molecular biology include Covod-19, Dengue/ Chikungunya PCR, Leptospira PCR, Malaria (PF/PV) PCR, Human Papilloma Virus (HPV) PCR, HIV viral load, HBV viral load, H1N1 PCR, and MTB PCR among others.
The department provides top-class facilities such as automated blood culture with the BacT/Alert system from bioMerieux which detects culture positives in as few as 4–6 hours. We have automated identification systems, Vitek Compact II, that identify growth in 4-6 hours and also provide automated sensitivity reports with Minimum Inhibitory Concentrations (MIC). We are also equipped with a carbon dioxide incubator for bacteriology and do anaerobic cultures with identification. Safety is our key concern, especially when handling organisms like Mycobacterium tuberculosis and some highly pathogenic fungi for which we have a level III biosafety cabinet. We are the proud owners of a fluorescent microscope which finds application in auramine-based screening of Mycobacterium tuberculosis and calcoflour white-based detection of fungi. Most serology tests are run on a Fluorescent Enzyme Immunoassay equipment–Mini Vidas, bioMerieux, France, which runs the TORCH assays, Procalcitonin (results in 25 min), Hepatitis A IgM, and Clostridium difficile toxin production among others.
The laboratory is also involved in extensive surveillance of air, water and food in the hospital environment. It is instrumental in outbreak investigation and environmental sampling that helps in reducing hospital-acquired infections and their spread.
Continuous monitoring of infections has led to overall improved patient care and a reduction in hospital-acquired infections. Included in the monitoring is the assessment of multidrug-resistant microbes and protocols have been developed to tackle it within the hospital. With regard to research and development, the laboratory has received a grant from the Government of India for a multicentric study on “Bacteriophages and their products for the control of biofilms of drug resistant Klebsiella pneumoniae”.
It is planned to develop the department further over the coming years in terms of increasing research activities through national and international grants and increasing the depth and range of tests being done.