TABLE 3.
Essential, achievable, and aspirational antimicrobial stewardship activities for the microbiology laboratory
| Stewardship activity level | Descriptiona |
|---|---|
| Essential | Provide timely, reliable, and reproducible identification and antimicrobial susceptibility results |
| Actively participate in antimicrobial stewardship committee or work group | |
| Collaborate in educating local health care workers on microbiology issues that impact treatment and microbial resistance | |
| Promptly report unusual patterns of resistance, test supplementary agents, and provide advice on therapy for patients awaiting results | |
| Optimize communication of critical test result values and alert systems | |
| Provide, revise, and publicize annual CASR consistent with CLSI standards | |
| Provide guidance for adequate collection of microbiology specimens | |
| Develop alert systems for specific multidrug-resistant organisms | |
| Use cascade or selective reporting | |
| Collaborate with ID physicians and pharmacists on updating methods for susceptibility testing | |
| Achievable | Provide specific comments, drafted in collaboration with antimicrobial stewardship team, to guide therapy on microbiology reports |
| Participate in establishing protocols on biomarker use | |
| Use rapid diagnostic and antimicrobial susceptibility technologies for targeted critical specimen types | |
| Use rapid-detection platform for respiratory pathogens | |
| Guide optimal use of diagnostic assays for C. difficile | |
| Develop direct communication pathways with prescribers to help interpret RDT results and discrepant results | |
| Provide guidelines for the interpretation of microbiology test results | |
| Collaborate in audit and feedback of antimicrobial therapies for specific pathogens or syndromes where the role of lab test values is critical (e.g., C. difficile, bloodstream infections) | |
| Aspirational | Evaluate feasibility of and, where possible, perform testing for susceptibility to new drugs |
| Broaden use of validated rapid diagnostic and rapid antimicrobial susceptibility testing | |
| Participate in education of patients and local population on antimicrobial resistance | |
| Participate in national and regional surveillance systems | |
| Promote appropriate use of point-of-care microbiological tests, when available |
a
CLSI, Clinical and Laboratory Standards Institute; CASR, cumulative antimicrobial susceptibility report; RDT, rapid diagnostic test.