The emergence of new technology has a way of obscuring the lines between laboratory disciplines. The coupling of Matrix Assisted Laser Desorption with Time of Flight Mass Spectrometry (MALDI-TOF) has resulted in a tremendous shift in the field of clinical microbiology. But tried-and-true technologies have also played significant roles in discipline crossover, with infectious disease serologic testing finding a home on automated chemistry analyzers. Now more than ever, clinical chemists and clinical microbiologists must develop successful partnerships.

At yesterday’s symposium, “The Marriage of Clinical Microbiology and Clinical Chemistry: A Technological Exchange of Vows and Partnership,” Marc Couturier, PhD, Joely Straseski, PhD, and Carey-Ann Burnham, PhD demonstrated how a successful partnership between these two seemingly disparate disciplines is possible.

Rather than clinical chemists learning microbiology on the fly, or microbiologist attempting to understand the finer points of chemiluminescence and hook effects, the speakers showcased how experts can come together to leverage each other’s talents to “maximize testing efficiency and minimize redundancy.”

Couturier discussed his experience being a duck out of water (or better yet, a bacterium out of the culture plate) while navigating the unfamiliar world of clinical chemistry. Straseski highlighted the challenges that face a clinical chemist in the area of infectious disease serology and the difficulty encountered in applying a clinical chemistry mindset. Putting the final “I Do” to the disciplinary match made in heaven was Burnham, who discussed the use of mass spectrometry for microbial identification. Burnham emphasized the benefits of a unique partnership that is forming between two areas of laboratory medicine forever changed by the implementation of mass spectrometry.

Despite the natural growth of their analytical targets, Burnham noted the past lack of growth in the field of microbial identification and the proliferation of interest in MALDI-TOF analyses. Burnham touched on strengths and weakness of the MALDI-TOF workflow, and added an informative overview of how the technology works. Her discussion of unmet needs in the field provided a call to action for all laboratorians eager to have a positive impact in this fast-growing area of laboratory medicine.

Couturier and Straseski played off the marriage theme to further illustrate the unique partnership between clinical chemistry and microbiology by co-presenting their talks. Couturier spoke as a microbiology laboratory director looking for better analytical methods; Straseski, initially refusing to participate citing a headache, eventually joined in to discuss the analytical aspects of chemistry assays.

Blurring the lines between these two fields results in some striking insights. For example, that the highly automated processes commonplace in chemistry may be a welcome contrast to the highly trained but “difficult to automate eyeballs” noted by Straseski. The back and forth partnership was well illustrated with dueling explanations of the shared—but still different—laboratory concepts, such as cutoffs, reference intervals, test interpretation, and quality control. These underscored the remaining overall testing-related philosophical differences to testing in both fields. 

What became overwhelming clear from all three presentations yesterday morning is that continued success in laboratory medicine must go beyond the mere implementation of similar technologies: it must extend to the sharing lessons learned and successful approaches to testing workflows. But buyer beware, the relationship is not expected to be entirely smooth, as evidenced by Couturier’s initial reaction to monthly QC review in chemistry. He went on to spark a productive discussion about the growing need to analyze stool and the need to flush out the bugs before doing so with automated chemistry analyzers.

If you missed this symposium or want to know more about why MALDI-TOF may be coming to a laboratory near you soon, head over to the Brown Bag given by Melanie Yarbrough this morning, “The Proteomics Revolution in Clinical Microbiology: Understanding MALDI-TOF Mass Spectrometry.”