A clinical microbiologist is a specialised medical doctor responsible for diagnosing, managing, and preventing infectious diseases by examining microorganisms, like bacteria, viruses, and fungi, in lab settings. They play a crucial role in public health and infection control to ensure effective disease management and patient safety. Microbiologists are at the forefront of global epidemics like the flu and COVID-19, keeping the public safe. Dr Juliet Elvy, a clinical microbiologist and an Ambassador for Pathology Awareness Aotearoa, shares her insight into the role of a microbiologist.
What led you to pursue a career in microbiology, and how did your journey begin?
My interest began as a medical student at the University of Nottingham Medical School. I loved the microbiology modules as an undergraduate and opted for Microbiology as my BMedSci pathology discipline which we could intercalate with our medical degree in our 3rd year. My BMedSci research looked into HIV co-receptors and along with the research I had the opportunity to study microbiology in more depth, as well as become familiar with the medical microbiology laboratory at a very early stage in my medical career.
What are the most common misconceptions about the role of a clinical microbiologist?
The role of the clinical microbiologist is not well understood since we are not very visible in our day-to-day activities. Many people think we are technicians or scientists rather than doctors who specialise in clinical microbiology. They also do not realise the breadth of our work, which involves frequent clinical liaison with a wide range of clinical teams, from GPs to hospital specialists, midwives, nurses, and public health, from neonatal medicine specialists to elderly care. We are responsible for ensuring the quality and safety of the work performed in the microbiology laboratory, for innovation and introduction of new tests, managing testing budgets, performing ward rounds within our hospitals, guiding infection prevention and control, and antimicrobial and diagnostics stewardship activities. We are also actively involved in the education of our technical and scientific workforce, medical students and doctors in training, and a whole range of other healthcare professionals (nurses, midwives, pharmacists, etc).
How do you collaborate with other healthcare professionals in your daily work?
Collaboration and communication with other HCPs is at the core of what we do and can happen in a number of ways: communicating critical results for individual patients to their treating doctor, with advice on best management; advice on best tests to investigate for a particular problem or to answer a particular clinical question; on ward rounds and in multidisciplinary team meetings; by phone, email, on Teams, by text message! We also have the NZ Microbiology network to collaborate with other microbiologists across the country.
What role do you believe microbiologists play in public health?
Microbiologists work very closely with public health colleagues since testing for communicable diseases is the cornerstone of diagnosis and surveillance. We are also directly involved in pandemic preparedness planning and were key to the success of the COVID response in NZ, with test development and a huge increase in PCR testing capacity required for the COVID-19 elimination strategy. We are in regular contact with our public health colleagues at both a local and national planning/strategic level.
What is the most rewarding aspect of your work as a clinical microbiologist?
Our work is very varied; we get to discuss with colleagues from a wide range of different clinical specialties. Infectious diseases are full of surprises, and you never know when the next outbreak or pandemic of novel pathogens will arise.
What are your thoughts on the future of infectious disease management in New Zealand?
We have to be prepared and continuously scan the horizon for the next infectious disease threat. We also need to innovate and implement new diagnostic technologies as they become available. I believe antimicrobial resistance remains a significant concern. This impacts our ability to effectively treat infectious diseases and conduct modern healthcare, and we must find novel ways of treating diseases in a way that does not immediately lead to resistance developing. Pathogen genomics, phage therapy, precision medicine (with optimising antibiotic dosing for individual patients), increases in point-of-care testing, diagnostics at the bedside, and AI will all shape the future of infectious disease diagnostics and management.
How do you envision the role of clinical microbiologists evolving in the next decade?
We will need to be able to adapt to the constant changes and developments in the diagnostic landscape, including adoption of new technologies, particularly in the pathogen genomics space, automation and AI. These are exciting times to be a clinical microbiologist with such revolutionising technologies on the horizon!
Dr Juliet Elvy, is an Ambassador for Pathology Awareness Aotearoa and a Clinical Microbiologist at Awanui Labs.
