Editor’s Note: The 2024 Annual Academic Conference of the Clinical Microbiology Laboratory Committee (CCML 2024), organized by the Chinese Hospital Association and the Clinical Microbiology Laboratory Professional Committee, was held from September 6-8 in Beijing. With the theme "Standards as the Foundation, Technology as the Engine," the conference gathered renowned experts in microbiology and infectious diseases to deliver keynote lectures and discuss the latest developments in infectious disease diagnostics, clinical microbiology laboratory management, and more. The event aimed to provide a platform for clinical physicians, medical laboratory professionals, and related industries to exchange and learn. Infectious Disease Frontier invited Dr. Xiaoling Ma, Chair of the Clinical Microbiology Laboratory Committee of the Chinese Hospital Association and professor at Anhui Provincial Hospital, to discuss key features of the conference, the significance of releasing the "Quality and Technical Management Standards for Clinical Microbiology Laboratories," the impact of DRG/DIP payment reform on the discipline, and the breakthroughs and challenges in microbiological diagnosis.Infectious Disease Frontier: What do you think are the key highlights of this year’s CCML conference, and how do you believe they will positively influence clinical microbiology testing and infectious disease diagnosis?
Dr. Xiaoling Ma: The CCML conference is a specialized event focused on clinical microbiology testing. Compared to other broader diagnostic or infectious disease meetings, this conference is centered on the microbiology testing field. We delved into new technologies, detection methods for various pathogens, the latest domestic and international developments, and knowledge-sharing through scientific education and case discussions based on microbiological testing. This dedicated focus ensures that the conference content is more specialized and in-depth, offering a high-quality learning and exchange platform for clinical microbiology professionals. It undoubtedly contributes to advancing the field of clinical microbiology testing and improves the diagnosis and treatment of infectious diseases, ultimately benefiting patient care.
Infectious Disease Frontier: This conference officially launched the “Quality and Technical Management Standards for Clinical Microbiology Laboratories,” and you introduced the work of the Clinical Microbiology Laboratory Committee in standard development. How do you view the release of this “group standard,” and how will the “committee” promote improvements in clinical microbiology testing quality and technology?
Dr. Xiaoling Ma: The release of the “Quality and Technical Management Standards for Clinical Microbiology Laboratories” marks an important milestone in the standardization of the field. Although microbiology testing is just one branch of clinical diagnostics, it plays a critical role in national biosecurity and strategies to curb microbial resistance.
Considering the importance of microbiology testing and its rapid development, we’ve recognized the current lack of standardization. Historically, standardization relied primarily on government-led national or industry standards, but these standards often struggle to keep pace with the development of new technologies and methods, leading to a lag in practical application. Group standards serve as a valuable complement to national and industry standards. We aim to establish a more scientific, reasonable, and clinically relevant standardization system in the field of microbiology testing through the development of group standards. We also hope that through the promotion and implementation of these group standards, we can foster industry-wide collaboration and communication, advancing the progress and development of microbiology testing.
Infectious Disease Frontier: The DRG/DIP payment reform has had a direct impact on clinical practice. How does this reform relate to clinical microbiology diagnosis, and what effect does it have on the development of the field?
Dr. Xiaoling Ma: The reform of the DRG/DIP payment model shifts healthcare reimbursement from traditional fee-for-service to bundled payments based on diagnosis-related groups. This model requires hospitals and physicians to focus more on cost-effectiveness—ensuring high-quality care while managing medical costs. In terms of clinical microbiology diagnosis, it means we need to be more precise in selecting diagnostic tests, ensuring that each test provides valuable information for disease diagnosis and treatment. At the same time, we must continuously optimize testing processes and improve efficiency to reduce the financial burden on patients. This payment reform drives the field of clinical microbiology to focus more on the standardization and normalization of diagnosis and treatment, promoting ongoing development within the discipline.
Infectious Disease Frontier: At this conference, you also delivered an insightful presentation on “Advances and Challenges in the Diagnosis of Bloodstream Infections and Sepsis.” Could you share what you believe are the most important technological breakthroughs in microbiological diagnosis, and what challenges do we face?
Dr. Xiaoling Ma: In the diagnosis of bloodstream infections, we are witnessing unprecedented technological advancements. First, starting with traditional blood culture and identification processes, we aim to enhance both efficiency and accuracy, striving to deliver faster diagnostic results to clinicians. This involves dual optimization of culture technologies and workflows to significantly reduce wait times, making diagnoses more timely and effective.
Secondly, in the field of rapid identification and antibiotic susceptibility testing, we’ve implemented direct susceptibility testing and bacterial identification from positive blood culture bottles, simplifying and accelerating the diagnostic process. These technologies not only improve diagnostic accuracy but also provide valuable time for timely patient treatment.
Moreover, with the rapid development of molecular biology technologies such as digital polymerase chain reaction (PCR), gene amplification, multiplex PCR, and metagenomic next-generation sequencing (mNGS), we can now detect microorganisms directly from blood samples without relying on traditional cultures. This revolutionary advancement greatly broadens the scope of microbiological diagnostics, allowing us to identify pathogens that are otherwise difficult to detect using traditional methods.
However, alongside these technological advancements, we must also address the challenges in diagnosing sepsis. Sepsis is a dysregulated immune response to infection, and its diagnosis not only depends on accurate identification of the causative microorganism but also requires comprehensive assessment of the body’s response. Currently, we lack effective biomarkers to accurately reflect the body’s immune response, making sepsis diagnosis particularly complex and challenging.
Therefore, in future research, we need to focus more on understanding the mechanisms behind the body’s response to infection and invest in basic research to discover more sensitive and specific biomarkers. This will provide a more reliable basis for diagnosing sepsis. At the same time, we must continue to drive innovation in microbiological diagnostic technologies to provide more efficient and accurate diagnostic services for clinical practice.
