b'Our goal is to test the right patients at the right time to ensureHow do the unique qualities of molecular testing, appropriate use of antibiotics. If we do a lot of testing on patientssuch as speed, affect how the lab collaborates with who are not having an infectious process, we get more chancesclinicians, nurses, and pharmacists?of a false positive, and then that patient is going to be treated forEvery time I do a lecture on ASP for microbiologists and something they dont have. technologists, I always emphasize that we need to collaborate with multidisciplinary clinical teams. To do that, we must spend How has COVID-19 affected ASP performance, andmore time outside of the laboratory and participate in different what have we learned for the future of ASPs? institutional committees designed to improve the care of COVID-19 impacted us a lot. At the beginning, we didnt havethe patient.reagents. Manufacturers dedicated all their resources to producing coronavirus tests. For other testssyndromic panels,We know exactly the testing that we can do, and whether there molecular testingwe didnt have enough reagents, or we didntare limitations to these tests. Typically, the pharmacists in my have the disposables needed to perform testing. We really hadprogram are the ones who understand that first. We usually do to prioritize when to use molecular testing for infections otherpreliminary studies with them when we want to implement a new than COVID-19. panel, then the ASP staff and I decide whether to use it. Next, we offer education to providers throughout the hospital.Later, COVID-19 impacted us due to how long patients were in the hospital. Some were hospitalized for a long time, in the ICUWe have education programs designed for medical students, and on ventilators. All these things are risk factors for getting anresidents, fellows, general practitioners, and specialistseach infection of a multi-drug resistant organism. If you look at theof those groups has unique needs. We educate the nurses, too, surge of COVID-19, that same curve is seen in prescription ofparticularly on the collection of samples, as we need a good antibiotics in the hospital. sample to provide the right answer for the patient.That made things more difficult for us and ASP. Remember, weDoes integrating molecular tests as part of ASP require didnt know a lot about COVID-19 at the time. different types of interpretation from the laboratory?We have been focused on communication with providers andClinicians, nurses, and pharmacists need to be educated about explaining how they can ensure appropriate use of antibiotics,the advantages and limitations of tests. To help with the selection and we are seeing significant improvement. We also know moreof the best treatment for a particular infection, the lab adds about COVID-19 and how it behaves. For example, after peoplecomments in the microbiology report to help other healthcare have a viral infection, they have a higher chance of getting aprofessionals understand results. It is difficult to educate bacterial infection because the virus can damage tissue andeverybody. We have a large number of clinicians throughout our interfere with the bodys defense mechanisms and with immunity.healthcare system. Physicians must continually learn about their This is true for other viruses as well as for the SARS-CoV-2 virus. own specialties. Theyre not going to be as focused on laboratory medicine, so we need to translate what the results for a specific So we still are in the process, now that we have learned moretest mean. Adding comments in the reports has allowed us to about the behavior of this virus, of educating our clinicians. provide education to a vast community of providers.This is particularly important for those molecular tests performed for patients in ambulatory care settings. I dont worry as much about interpretation for patients in the hospital, because I have my ASP group review results, especially for blood cultures, and provide consultation to the clinical team if needed.24 Molecular testing thermofisher.com/infectiousdisease Contents'