James H. Jorgensen, PhD 
Professor, Department of Pathology, Department of Medicine, Department of Microbiology, and Department of Clinical Laboratory Sciences, The University of Texas Health Science Center at San Antonio Director, Clinical Microbiology Laboratories, University Hospital

You started your career as a Research Associate at Shriners Hospital for Crippled Children, Burn Institute, Galveston Unit. Currently, you are the Professor, Department of Pathology, Department of Medicine, Department of Microbiology, and Department of Clinical Laboratory Sciences at the University of Texas Health Science Center at San Antonio, as well as Director, Clinical Microbiology Laboratories at University Hospital. Tell me about your work experience, and your other work in clinical microbiology.

I’ve been in my current job for over 30 years. It offers a nice balance for me, because my job is divided into three equal parts. This first part is being a Clinical Microbiologist and Laboratory Director. The second part is working in my research laboratory where we study antibiotic resistance mechanisms and discover new means of detecting resistance. The third part of my job is teaching. I teach medical students in the second, third, and fourth years; dental students; as well as pathology residents, infectious disease fellows, and clinical laboratory sciences students. My job involves all three areas in equal doses that provide a nice variety for me.

What specifically got you involved with Clinical Microbiology?

I got a Masters Degree in Microbiology. When I was trying to decide what to do next, I focused on the fact that I really enjoyed the medical microbiology courses that I had in college. So, I went to a medical school to get a degree in microbiology with the intention of being a clinical microbiologist. During the time I was in graduate school, I had a part-time job working at the Shriners Burn Institute as a clinical microbiologist. That got me involved and interested in this field.

Tell me about your involvement in professional societies outside CLSI.

My involvement has been focused primarily with the American Society for Microbiology (ASM). I have been a member of ASM throughout my career. I served as the Chairholder of the Clinical Microbiology Division of ASM. In addition, I was on the Program Committee for the Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) for several years. More recently, I have served as a Volume Editor for ASM’s Manual of Clinical Microbiology—both the 8th and 9th editions. We are currently working on the 10th edition, which is a two-volume text that is the most authoritative clinical microbiology manual in the world.

You have been involved in CLSI for over 20 years, currently serving as the Chairholder for the Working Group on Fastidious or Infrequently Isolated Bacteria, as well as Advisor to the Area Committee on Microbiology. Previously, you served as Vice-Chairholder and Chairholder. You also were Chairholder of the Area Committee on Microbiology and served on the CLSI Chairholders Council. In addition, since 2005, you have served as International Organization for Standardization (ISO) Technical Committee 212, Clinical laboratory testing and in vitro diagnostic test systems Convener of Working Group 4 focused on antibiotic testing. What first sparked your interest in CLSI?

I was recruited to serve as an advisor, then a member of the Subcommittee on Antimicrobial Susceptibility Testing. Once I got involved and continued to be involved, I eventually became the Vice-Chairholder and Chairholder of that committee, and later Chairholder of the Area Committee on Microbiology. As far as my involvement with ISO, CLSI has become a more global organization, and ISO is an extension of that global effort. It is an opportunity to codify methods and procedures on a global basis, including those countries that may not have their own professional groups.

From your extensive CLSI standards-development experiences, are there any notable documents or resolved consensus issues of which you are particularly proud?

I think the entire antimicrobial susceptibility testing collection of documents is very important in the United States, as well as globally. Performance Standards for Antimicrobial Disk Susceptibility Tests (M2),  Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically (M7), Performance Standards for Antimicrobial Susceptibility Testing (M100), Methods for Antimicrobial Susceptibility Testing of Anaerobic Bacteria (M11), and Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria (M45) are all antibacterial documents. There are also very important CLSI documents for antifungal, antimycobacterial, antiviral, and veterinary antimicrobial agents. I think the entire collection is a very important part of CLSI. These documents, in particular, are recognized globally. M2, M7, and M100 are especially critical in the everyday functioning of microbiology laboratories.

In your various leadership roles in the CLSI microbiology committees, what pressing or contemporary issues do you think need to be addressed?

There is an effort to streamline the process—to go from concept to final document much sooner than in the past. Issues like emerging antibiotic resistance present a fast moving target. CLSI needs to be responsive and come out with guidelines and standards within a relevant period of time. The continuing need for CLSI is to try to keep pace with emerging antibiotic resistance and to meet laboratories’ needs in terms of detection of those resistant organisms. I think knowledgeable clinical microbiologists have come to expect that M100 will come out every January. They obtain a copy of the supplement to find out what may have changed and to find out the latest recommendations. These documents are critical in the United States and a number of other areas, including Canada, South America, and, Asia, also rely on the updated guidelines from CLSI.

What continues to motivate you to devote your valuable time to the CLSI standards-development process?  

I have seen the positive contributions to clinical microbiology and clinical practice that these documents have made. There is no other source for this information. It is timely and reliable. Most of what I have seen as a laboratory director, as well as someone who participates in CLSI, is the very important contributions of CLSI documents to clinical practice. 

At the recently held 2008 CLSI Leadership Conference and To Your Good Health Workshop, you were presented with The John V. Bergen Award. What was your reaction to receiving this prestigious award?

First, I was surprised. I didn’t know I had been nominated. Once I had the chance to think about the award, I became proud to receive such a prestigious honor. Because I have been involved with CLSI for a long time, I knew John Bergen very well. I always looked up to him as being someone who represented the highest and most ethical standards, and encouraged all of us as volunteers and CLSI staff to do the same. I was very pleased to receive an award in his name. The award presentation at the Leadership Conference was very special. It was well-organized and ran smoothly. I think everyone that participated in the celebration enjoyed themselves.

Why do you feel volunteering for CLSI is important?

I think it gives you an opportunity to contribute to your professional field and to do something to improve clinical practice. You can join and contribute to other professional organizations. However, I think this one gives you an opportunity to see the very positive results of your contributions.

Do you recruit others in your professional field to participate in CLSI?

Yes, I have tried to identify up and coming microbiologists through ASM and other venues to serve on these CLSI committees. Most of the time, people are delighted to participate; however, initially they do not always understand what is involved. Once they have gone to a meeting or two, they get into the spirit of the process. They understand how working together can produce such useful results.

You have written and contributed to over 290 scientific publications and have received numerous honors and awards. Do you often find it important to reference CLSI documents in your presentations?

It is rare that I write anything or give any lecture without mentioning CLSI or pointing out the CLSI antimicrobial susceptibility testing standards in terms of their content and impact.

Why is it so important for clinical microbiologists to stay updated on the latest standards from CLSI?

Microbiology, in general, and antibiotic susceptibility, in particular, is a rapidly evolving discipline with lots of new emerging organisms. It is critically important for clinical microbiologists to have the latest documents to know what represents contemporary practice today.

What do you see as a path forward for CLSI? More specifically, do you have any particular suggestions for what you would like to see happen in the organization now or in the future? 

I have a few thoughts on a path forward for CLSI. One is CLSI needs to continue to recruit new volunteers to get capable people involved and to encourage them that this is an important way to contribute to their profession. This recruitment will keep CLSI growing and refreshed with new ideas. The second suggestion is CLSI needs to continue to find ways to disseminate the information more quickly than printed materials. Many laboratories have older documents, because they do not have the budget to buy the updated documents or do not know they exist. I realize it is a big challenge to produce high-quality materials and control costs. Lastly, I have the greatest respect for CLSI in that I have always found that the meetings are open, the process is transparent, and anyone that has something to say is given an opportunity to make whatever contribution they can. I think it is a very fair and open approach to develop consensus standards. Discussion, fact finding, and compromise are what lead to the final product. The consensus process is not done quickly; it is done with a great deal of deliberation.