First, a decision to revise must take place. Some changes may be resisted because they do not make sense in the scheme of things. For example, Shigella is closely related to Escherichia, yet clinicians have historically maintained Shigella as a separate genus for clinical reasons.46
Implementation of changes is complex.
- Working with microbiology vendors (identification and susceptibility systems) is warranted to best understand how to make database changes and understand any product limitations.
- Microbiology staff (technicians, scientists) must be trained, and competencies performed after any standard operating procedure has been revised.
- Laboratory information system (LIS) staff, supervisors, administrators, pathologists, and medical directors must be informed and included in any SOP revisions and verifications of LIS updates.
- Quality control and management staff, as well as the microbiology staff and supervisors should review CAP (or other blind survey) results and any Final Critique documents describing changes in nomenclature.
Implications
- Timely notification of staff is necessary.
- Revisions in taxonomy/nomenclature must be accommodated.
- Resources to assist with the implementation of changes are available.
- Staff must be proactive, something that may be difficult to achieve when staffing levels are lower than expected.
46. Carroll, K. C., Munson, E., Butler-Wu, S. M., & Patrick, S. (2023). Point-Counterpoint: What’s in a name? Clinical microbiology laboratories should use nomenclature based on current taxonomy. Journal of Clinical Microbiology, 61(1). https://doi.org/10.1128/jcm.01732-22
