CLSI eNews - 1 July 2007  (Plain Text Version)

You have been at the UCLA Medical Center for over 29 years.  Tell me about the work you have done there, and your other work experience in clinical microbiology.

I have focused most of my career on the AST component of clinical microbiology.  I worked in the clinical laboratory at UCLA until 2000, at which time I was awarded a grant to work with the Centers for Disease Control and Prevention (CDC).  There my focus shifted to more of an educational component and I remained with the CDC until 2004.  Since then, I have continued to work part-time for UCLA Medical Center and I am also a consultant for the Association of Public Health Laboratories (APHL). 

One of your primary professional goals is to provide AST information to clinical laboratory scientists and clinicians. What has motivated you and sustained your interest in achieving this goal?

When I started in the 1970s, there was not much interest in the area of AST because we thought we had the “wonder drugs” we needed to control infectious disease.  We didn’t anticipate the drug resistance challenges that we now face.  From the evidence all around us, it is obvious that the demand for clinical microbiology testing, including AST will not subside anytime soon. 

How did you first become involved in the CLSI Subcommittee on AST?

I knew of CLSI through my involvement in AST. It was after I had begun doing some teaching and writing in this area that Jim Jorgensen invited me to participate in CLSI.  That was in the early 1990s and I have been actively involved, first as an advisor, then as a member, for over 12 years.

Tell me about your involvement in professional societies outside of CLSI.

First, let me tell you that I think it is important to find organizations that offers one an opportunity to make a real impact and a meaningful contribution to the field.  I have found my niche with the American Society for Microbiology (ASM) and CLSI.  I have recently become involved in ASM’s International Committee which addresses issues of global concern.  For example, we are looking to help clinical laboratories in Bolivia to improve their microbiology practices.  I believe in thinking globally and find myself attracted to projects with a global impact.

How does AST differ in various countries?

In developed countries, AST methods are similar to those used in the United States.  However in developing countries, laboratories face severe resource limitations, and so they’re in a constant struggle to equip themselves with supplies, manuals, and reference strains. Many of these laboratories do, however, find that the CLSI disk diffusion method works for them.  It is my understanding that CLSI AST standards are used in approximately 50 different countries, some of which are not as resource rich as the United States.  As we all know, antimicrobial resistance is a world-wide problem and resistant bacteria know no boundaries.  All laboratories performing AST must do their best to use reliable test methods and continually reassess the methods used to make certain they will detect new or “emerging” types of resistance. 

From your extensive involvement in CLSI subcommittee and working groups on AST, can you pinpoint any highlights or resolved consensus issues of which you are particularly proud?

Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data (M39) is one document of which I am particularly proud.  Many years ago I thought there was a need for developing recommendations for preparing a cumulative antibiogram and this topic was finally addressed in CLSI M39 in 2000. As we all know, it takes time to formulate an idea into a proposed project and then develop it through the consensus process. 

In January 2007, CLSI published Performance Standards for Antimicrobial Susceptibility Testing; Seventeenth Informational Supplement (M100-S17). Why is it so important for those who perform AST to use the new document?

Clinical microbiology, like many other disciplines in healthcare, is constantly changing. As new antimicrobial resistance is noted, the AST subcommittee addresses this through their consensus process. Often this leads to changes in recommendations for testing and reporting and these changes are reflected in the regular updates of the CLSI AST standards. Failure to follow the newest recommendations may compromise a laboratory’s ability to detect newly identified resistance.

In addition to the regular updates of the AST documents, clinical microbiologists can learn of newer developments, educational opportunities, etc. by visiting the CLSI webpage. Here, they can also view the AST committee’s mission; a list of members; all subcommittees and working groups; and projects currently in development.

While the webpage can keep us up to date on CLSI activities, I would encourage those who use CLSI documents to submit any suggestions they may have for CLSI or a specific document.  That feedback helps clarify and improve our materials and benefits everyone in the field.

From your continued teaching experience in AST, what role do you see for CLSI in education of AST?

CLSI is already a trusted resource for AST standards, so it makes sense that it would also provide valuable educational opportunities. I work with APHL which houses the National Laboratory Training Network (NLTN), and NLTN is very organized in their delivery of continuing education. I know CLSI is expanding its role as an educational resource.  I am very interested in exploring a partnership between NLTN and CLSI. 

How do CLSI AST documents tie into the presentations you make around the world?

Since many aspects of the procedures that most laboratories use for AST are based on CLSI documents, I refer to them often.

Do you have any recommendations you would like to see occur within CLSI, either in the area of clinical microbiology, or within the organization in general?

I think that strengthening the educational component of CLSI is vital, and I look forward to CLSI’s new plans to team up with partners to educate individuals involved in various aspects of healthcare.  We should also continue to rely on CLSI’s engaged volunteer network to make people aware of CLSI documents and promote their use throughout the world.