ArticleJournal of clinical microbiology2026
Diagnostic stewardship perceptions and practices among microbiology laboratories: a national survey from the American Society for Microbiology.
Article in Journal of clinical microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
7 authors.
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Abstract
Diagnostic stewardship (DxS) is a key activity for providing effective and efficient testing strategies for patient care. Complex test menus and result interpretation, high costs, limited reimbursements, and other factors necessitate DxS practices in clinical microbiology. We conducted a national survey of clinical microbiologists on their perceptions and practice of DxS in infectious diseases (ID) diagnostics. The 119 respondents (83 clinical directors, 33 operational leaders, and three trainees) indicated that DxS was practiced at their institution "some" (50.4%) or "most" (23.5%) of the time. Most respondents (>95%) had infection prevention and control and antimicrobial stewardship committees at their institutions. Academic medical center laboratories (AMCs) more often reported having microbiology consultation service, DxS/laboratory utilization committee, or official laboratory formulary than community hospital laboratories ( IMPORTANCE: At a time when microbiology test menus are expanding with costly molecular diagnostics while workforce shortages and reimbursement constraints persist, we conducted a national survey-based study of clinical microbiology professionals to capture their perceptions and practice of diagnostic stewardship. Results from 119 clinical microbiologists identified several common challenges as well as key differences between respondents from different institutional types as well as between respondents fulfilling different professional roles. The survey additionally identified diagnostic stewardship interventions regarded as most effective, factors most important in prioritization of stewardship efforts, and breadth of roles participating in diagnostic stewardship for microbiology tests. These unique observations into the state of diagnostic stewardship in clinical microbiology laboratories help establish a baseline for future research and guideline development in infectious disease testing.
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