IDSA News - June/July 2013  (Plain Text Version)

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In this issue:
Patient Care and Science
•  New Guide for Laboratory Diagnosis of Infectious Diseases Now Available
•  ACIP: Evidence Doesn’t Support Second Dose of Tdap Vaccine for Adolescents and Adults
•  New Tools for Preventing Bloodstream Infections in Dialysis Patients
•  CDC Issues H3N2v Health Advisory with Updates for 2013
Clinical Practice Management
•  FDA Clarifies IND Requirement for Fecal Microbiota Transplantation
Science Speaks Blog
•  Advocates, Physicians Urge Company to Increase Access to New TB Drug
•  High Court Strikes Down “Anti-Prostitution Pledge” for Global AIDS Funding
•  Turning 10, PEPFAR Celebrates a Million Lifetimes of Birthdays to Come
Policy and Advocacy
•  Critical Antimicrobial Resistance Legislation Reintroduced in Congress
•  IDSA, PIDS Call for Broad Federal Response to Pertussis Outbreak
•  HHS Issues Organ Transplant Guidelines for Preventing Disease Transmission
Your Colleagues
•  In Memoriam: Alan D. Tice, MD, FIDSA (1943-2013)
•  Check Out “My IDSA” for Latest Member News
Education & Resources
•  Editor-in-Chief Applicants Sought for New IDSA/HIVMA Journal
•  Updated Journals App for iPhone, iPod Touch, or iPad
Top Stories
•  From the President: Diagnostic Advances Offer Great Promise for Patient Care, Public Health
•  All Baby Boomers Should Be Screened for HCV, U.S. Task Force Concludes
•  EIN Update: Asymptomatic Bacteriuria and Antimicrobial Stewardship
•  IDSA Journal Club


New Guide for Laboratory Diagnosis of Infectious Diseases Now Available

A new guide to help physicians appropriately and accurately use laboratory tests for the diagnosis of infectious disease is available online. Published in Clinical Infectious Diseases, the guide was developed by IDSA and the American Society for Microbiology.

“Getting the right diagnosis is contingent upon laboratory results that are accurate and clinically relevant,” said lead guide author Ellen Jo Baron, PhD, of Stanford University School of Medicine. “Physicians, their staff, and microbiologists must communicate and work together to ensure the best outcome for patients, and this guide aims to help facilitate this collaboration.”

Divided into sections on anatomic systems (including infections of the bloodstream, cardiovascular system, central nervous system, eyes, soft tissue of the head and neck, upper and lower respiratory system, gastrointestinal tract, abdomen, bone and joints, urinary tract, genitals, and skin and soft tissues) and etiologic agent groups (tickborne infections, viral syndromes, blood and tissue parasitic infections), the guide is designed help physicians decide what tests to request when they suspect specific agents are causing disease.

It also provides targeted recommendations and precautions regarding selecting and collecting specimens, and details what is required for various cultures and tests, as well as the appropriate collection device, temperature, and ideal transport time. The guide suggests 10 tenets of specimen management that everyone involved—from physician to nurse to laboratory scientist—should follow for good patient care:

  1. Specimens of poor quality must be rejected or results could be compromised.
  2. Physicians should not demand a report of “everything that grows” as this could result in an inaccurate diagnosis.
  3. Avoiding contamination of specimens is key, and careful collection is crucial.
  4. The laboratory requires a specimen, not a swab of a specimen, which may not hold enough infected material to ensure an accurate diagnosis and may be easily contaminated.
  5. The laboratory must follow its procedure manual or face legal challenges.
  6. A specimen should be collected prior to administration of antibiotics, the presence of which could lead to misleading results.
  7. Susceptibility testing should be performed on clinically significant isolates, not all microorganisms in the culture.
  8. Lab results should be accurate, significant, and clinically relevant.
  9. The laboratory – not the medical staff – should be allowed to set technical policy. Good communication and mutual respect will lead to collaborative policies.
  10. Specimens must be labeled accurately and completely (for example: dog bite wound, right forefinger).

Guide-related resources are being developed and will be available in the coming months. The new guide as well as IDSA clinical practice guidelines and related clinical tools can be accessed through the IDSA website, including a new Guidelines Discussion Forum, which allows members and others to comment on recently published IDSA practice guidelines.