Need for better adherence to optimal incubation temperature for quality laboratory diagnostics and antibiotic resistance monitoring

In the omics era, incubation of human specimens and bacterial cultures continues to be the cornerstone for detection, identification and drug susceptibility testing (DST) of bacterial pathogens. Accurate results require bacterial incubation under optimal physicochemical conditions. Temperature is a key physicochemical factor that affects the bacterial environment, making incubators indispensable in clinical laboratories. Human pathogens generally multiply best at temperatures similar to those of the human host (35°C – 37°C). Biochemical tests for identification in pure isolates are recommended to be performed at 36°C ± 2°C, and DST at 35°C± 1°C.1,2,3,4 For Mycobacterium tuberculosis complex and most nontuberculous mycobacteria, the recommended temperature is 37°C in both cases. In a recent survey to determine the incubator requirements for clinical microbiology laboratories in resource-limited countries, we analysed several parameters including the temperatures used to incubate clinical specimens for primary bacterial isolation, replicating bacterial cultures and performing DST. The data were reported in a self-administered questionnaire conducted from April 2017 to June 2017 by 12 laboratories from three countries in Africa (Cameroon, Ivory Coast and Madagascar), three countries in the Americas (Haiti, Guyana and Bolivia) and one country in Asia (Bangladesh). The clinical specimens considered were sputum, pharyngeal or nasopharyngeal swabs, stools, urethral or vaginal swabs, skin, pus, urine, lymph nodes, blood, bone marrow, cerebrospinal fluid and other normally sterile body fluids. The analysed incubation temperatures referred to 26 pathogenic bacteria or pathogenic bacteria groups frequently isolated from clinical specimens...