I had the opportunity to visit a food microbiology laboratory a few weeks ago. It was clearly a good laboratory with excellent quality assurance measures, but it was interesting to visit a microbiology lab that did not have a MALDI-TOF platform in place. The lab still relied very much on traditional identification techniques for identification such as colonial morphology, Gram stain, oxidase, catalase, and of course the API biochemical strips!
This made me reminisce about my training days in microbiology in Glasgow back at the turn of the century, when we still used Kohn’s tubes for Salmonella & Shigella identification, X and V discs were used for Haemophilus influenzae, and the CAMP and Reverse CAMP test were used for Streptococcus agalactiae and Clostridium perfringens respectively.
Nowadays, in most clinical diagnostic microbiology labs, everything just gets “thrown” on to the MALDI-TOF platform and an ID is usually forthcoming. In the rare occasions that a “Maldi” ID is not obtainable, one can always send the isolate for 16s/18s RNA sequencing.
It is a changed world, and all the mystery has disappeared..
There are of course very good reasons for clinical microbiology labs to move to MALDI-TOF identification. It is fast, mostly accurate and cost-efficient when utilised in a mid to large sized laboratory. It is also probably safer in terms of risk of laboratory-acquired infections.
But it is a little bit dull, tedious even. I do miss the old-fashioned methods, their variety and their idiosyncrasies. It also gave staff a good grounding in the basic principles of microbiology and bacterial identification. Most new staff that start in medical microbiology laboratories these days will be unfamiliar with anything else apart from MALDI-TOF.
Traditional diagnostic microbiology is a dying art, and the labs that still practice it are becoming fewer by the year.
I am by no means a luddite, and I am all for progress, but I don’t think the recent technological advances have necessarily made us better microbiologists, or made the job more enjoyable…
Michael
Totally agree, I think most of the older group would miss the thrill of identifying unusual isolates, that’s what makes micro so interesting. The morphology of a colony, or the characteristic aroma. But as we are well aware, progress is the name of the game & an interesting job is flung out the window so to speak.
No one can argue against progress.. But in some cases, a simple direct microscopic examination is all you need (trichomonas, gardnerella vaginalis, neisseria gonorrhea etc)..
Absolutely agree – the joy of identifying an unusual organism, the really basic principles are lost on the newer staff. Progress and technology are imperative but it is important to not lose sight of the basics in our teaching and training. This gap becomes quite clear when the MALDI is “down” and staff have to resort back to basics to get identifications out.
I really miss the traditional microbiology methods. The CAMP test fascinates me and I marvel at the shapes made with the haemolytic.I loved guessing the ID as I set up the tests them arriving at work the next morning to see if I was right…. the good old days🙂
It fascinated me as well. I am sure the CAMP test came up in my microbiology exams!
I’m only 38 years old and was still trained the “old” way. The world is changing at incredible speed. It’s hard to imagine what my kids will grow up to be… thanks for the thoughts and reminders Michael 🙂
38 is still quite young really Nienke. The average age of the staff at my lab has decreased by about 20 years over the past 6 months due to lots of new grads starting. My cut-off for an “old microbiologist” is now 40!
Very true observation and concern particularly about the new staff in the Microbiology labs. They will be unfamiliar with the fast, accurate and cost effective basic conventional techniques which is important for resource limited situations. Technical progress is imperative but basics are very important.
It a lot for the young microbiologists to learn, what with the traditional methodology, the new methods, and also how to operate the automated platforms. I don’t envy the trainees these days…