If you are in any way involved with clinical microbiology labs, you will be aware of the tsunami of interest in “complete” bacteriology  culture automation. Examples of such systems are Biomeurieux FMLA, BD Kiestra TLA and Copan Wasp, along with a host of others. One of them will be at a lab near you in the near future, if not already…

A lot of these systems claim “total” lab automation. They certainly represent progress, and there are a lot of quality benefits which I will go into in another post.

So where do the new systems fall short of “complete”. Let’s go through the process..

• Fetching the correct plates.
• Barcoding the plates.
• Uncapping the correct sample.
• Inoculating the plates.
• Taking the plates to the appropriate incubator.
• Incubating the plate for a certain amount of time.
• Imaging the plates.
• Interpreting the plates.
• Picking colonies off the plates for ID and susceptibility.
• Interfacing results to LIS.
• Validating the results.

The three areas highlighted in red are where these systems are not quite there yet….

Interpreting the plates: There is rapid development in software to aid scientists in interpreting agar plates. Good progress has been made in reading negative plates, reading chromogenic plates, and reading and interpreting susceptibilities. However there are still a lot of plates for which humans are still better than computers for reading. In 5 years time however, I would expect that the majority of plates will be read automatically.

Picking colonies off the plates for ID and susceptibility. At present these newer systems tend to return appropriate plates from the incubators to benches in order for the follow up work to be done. However colony pickers are being developed which will automatically pick marked colonies off plates. These picked colonies will then be used to automatically inoculate plates /broths for susceptibility testing and also a MALDI-TOF plate for identification. It is difficult to say when this technology will be commercialised, but I would guess within 5-10 years.

Validating the results: As information technology improves and the application of “logic” rules to the results becomes ever easier, I would anticipate that the vast majority of bacteriolgy culture results will eventually be released automatically, without human checking. Again I would anticipate this to happen in the next 5 years.

So there you have it. I think it is a little disingenuous for companies to claim that they already have “complete” bacteriology culture automation. Not yet, but it’s coming. I would predict by 2020 at least some samples will go through the whole bacterial culture process without being seen or touched by humans. It is a scary thought, but there is no point in denying that it is going to happen. Instead, embrace it and involve yourself with it. It is what the biochemists and haematologists have already been through in the past couple of decades….

Michael