The RAH Microbiology Laboratory of SA Pathology services both private and public clients and processes approximately 30,000 specimens per month. Until late 2012 bacterial isolates from these specimens were identified and had antibiotic susceptibility testing performed using agar dilution. This methodology, although cost effective and flexible, was time consuming, and required specialised staff for test interpretation. With increasing workloads, budget cuts, reduction in skilled staff, pressure to maintain turn-around times and meet KPIs it was necessary to consider automation. In the second-half of 2012 the laboratory received two BD Phoenix analysers, a BD Phoenix AP, the EpiCenter software and a Bruker Maldi-Tof.

The challenges involved in the implementation of this new equipment included delays in equipment, IT interfacing & support, workflow changes, educating & training staff, communicating change, problems with the AST indicator and delays in manufacturing of custom panels and associated hardware and reagents. All of these challenges needed to be addressed whilst keeping the centralised antibiotic laboratory running and maintaining a 24/7 service to clients.

Although the implementation of this new equipment was plagued with challenges it has been achieved and movement over to automated identification and sensitivity testing has been very successful.