Hot Topics in Clinical Laboratory Science

Hot Topics in Clinical Laboratory Science


 
Antibiotic Resistance: The Ongoing Battle to Combat the Crisis in Bacterial Drug Resistance

     Since the first use of penicillin, bacteria have waged a war of joining together, recombining their DNA structures and exhibiting more disease causing problems for patients and their physicians. Pharmaceutical companies became distraught in finding new pathways to develop new anti-microbial agents to combat former non-lethal strains of pathogenic organisms, who now struck up a new line of defense.

     Genetic manipulation occurring in nature and in hospital situations of overuse and indiscreet dosing of antibiotics led to this challenge. One finding proved that the FDA (US Food and Drug Administration) from 1983 to 2010 only approved 1 new antibiotic therapy per year, where formerly 4 per year were destined for the market.¹ Couple this with the issue of companies find their rate of investment return on drug protocol research, development and marketing became zero. Better money was made in developing drugs for continuous consumption for cardiovascular problems, psychosis, diabetes and overall rheumatologic conditions.

     Meanwhile as the 21^st century has continued on, laboratories must deal with a growing patient load that brings in community acquired MRSA (Methicillin Resistant Staph aureus), resistant Tuberculosis strains to prior treatments, and a growing group of resistant septic causing organisms which left patients with very little option for drug therapy treatment. The CDC (Centers for Disease Control), the WHO ( World Health Organization , and other international organizations and governments are tackling this issue head on. I would expand on this even further if this topic is chosen. 


Vaccinations: An Ounce of Prevention? Controversy over the DTP and MMR vaccines and Autism

     These issues revolve around parents' refusal to have their children immunized with the DTP vaccine, particularly against "Whooping Cough" (Pertussis). This led to urgent cares and emergency rooms seeing infants and small children with respiratory difficulties which presented the need to culture their nasal cavities for the causative agent Bordetella pertussis. My own laboratory in Riverside, California,(Southern California), has seen several positive cases of this respiratory organism seen in non-innoculated children. So insurgent was this situation that local school districts here have required vaccinations of "Tdap' now for 7^th-12^th graders prior to registration in schools. One article that spawned this situation came from Mark Geier and the Wakefield study, which when taken to court was proved to be ridden with ethics violations and false study data. The court concluded that there was no creditable link between the vaccine MMR( Measles, Mumps, and Rubella), and the occurrence of autism in vaccinated children.²


Automation in the Lab & Clinical Laboratory Scientist Shortage

     This problem brewed out of the shortage of trained, degree earned personnel in the laboratory. Now automation and robotic analyzers take care of more volume, quality control features, and maintenance issues than ever before. Quicker, more accurate, and more cost effective, more volume and variety of tests are routinely done in this decade than ever before. One example is ARUP laboratories who is working on a system that optically guarantees and verifies specimen labels and the quality of the specimen. As Charles Hawker of ARUP labs notes," So much automation may lead to as much as 80% of labs will be automated during the 2010s."³


 
Works Cited

1. Bartlett, John G., MD. Antibiotic Resistance, Top 10 Infectious Diseases 2010-2011 http://www.medscape.com/viewarticle/735126_print 11 Oct 2011
   
2. Pertussis Vaccine now required for School Entry @http://www.eastbaypediatrics.com/hot_topics.php 11 Oct 2011
   
3. Rollins, G. What Will the Coming Decade Bring? January 2010 Clinical Laboratory News: Lab Medicine Outlook Vol 36, Number 1 @ http://www.aacc.org/publications/cln/2010/January