The clinical microbiology laboratory. Utilization and cost-effectiveness.

Utilization of the microbiology laboratory is subject to limitations posed by the diversity of microbial agents causing infection, multiple and often poorly accessible sites of infection, contamination of specimens with indigenous flora, and failure of communication between clinician and microbiologist. Cost constraints increasingly limit the extent of microbiologic services available on-site and lead to decentralization of laboratory services and possible loss of quality control. Increased attention is being paid to process control of cultures, rapid screening and diagnostic tests as culture substitutes, and limitations on antibiotic susceptibility testing.