[en] Microbiology reference laboratories perform a crucial role within public health systems. This role was especially evident during the COVID-19 pandemic. In this Viewpoint, we emphasise the importance of microbiology reference laboratories and highlight the types of digital data and expertise they provide, which benefit national and international public health. We also highlight the value of surveillance initiatives among collaborative international partners, who work together to share, analyse, and interpret data, and then disseminate their findings in a timely manner. Microbiology reference laboratories have substantial impact at regional, national, and international levels, and sustained support for these laboratories is essential for public health in both pandemic and non-pandemic times.
Disciplines :
Laboratory medicine & medical technology
Author, co-author :
Shaw, David; Nuffield Department of Population Health, University of Oxford, Oxford, UK
Torreblanca, Raquel Abad; National Reference Laboratory for Meningococci, National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
Amin-Chowdhury, Zahin; Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
Bautista, Adriana; Grupo de Microbiologia-Instituto Nacional de Salud, Bogotá, Colombia
Bennett, Desiree; Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland
Broughton, Karen; Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
Casanova, Carlo; Swiss National Reference Centre for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
Choi, Eun Hwa; Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
Claus, Heike; German National Reference Center for Meningococci and Haemophilus influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
Corcoran, Mary; Department of Clinical Microbiology, The Royal College of Surgeons in Ireland, Dublin, Ireland, Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland
Cottrell, Simon; Public Health Wales, Cardiff, UK
Cunney, Robert; Department of Clinical Microbiology, The Royal College of Surgeons in Ireland, Dublin, Ireland, Department of Microbiology, Children's Health Ireland at Temple Street, Dublin, Ireland, Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland
Cuypers, Lize; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium, National Reference Centre for Invasive Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium
Dalby, Tine; Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
Davies, Heather; Meningococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New Zealand
de Gouveia, Linda; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
Deghmane, Ala-Eddine; Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Institut Pasteur, Paris, France
Desmet, Stefanie; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium, National Reference Centre for Invasive Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium
Domenech, Mirian; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain, Spanish Pneumococcal Reference Laboratory, National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
Drew, Richard; Clinical Innovation Unit, Rotunda, Dublin, Ireland, Department of Clinical Microbiology, The Royal College of Surgeons in Ireland, Dublin, Ireland, Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland
Plessis, Mignon du; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
Duarte, Carolina; Grupo de Microbiologia-Instituto Nacional de Salud, Bogotá, Colombia
Fuursted, Kurt; Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
Golden, Alyssa; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
Almeida, Samanta Cristine Grassi; National Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, Brazil
Henares, Desiree; CIBER de Epidemiología y Salud Públic, CIBERESP, Barcelona, Spain, Instituto de Recerca Pediatrica, Hospital Sant Joan de Deu, Barcelona, Spain
Henriques-Normark, Birgitta; Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
Hilty, Markus; Swiss National Reference Centre for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
Hoffmann, Steen; Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
Humphreys, Hilary; Department of Clinical Microbiology, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
Jacobsson, Susanne; National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Johnson, Christopher; Public Health Wales, Cardiff, UK
Jolley, Keith A; Department of Biology, University of Oxford, Oxford, UK
Kawabata, Aníbal; Department of Bacteriology and Mycology, Respiratory and Meningeal Diseases Section, Laboratorio Central de Salud Pública, Asunción, Paraguay
Kozakova, Jana; NRL for Streptococcal Infections, National Institute of Public Health, Prague, Czech Republic, Department of Air-Borne Bacterial Infections, National Institute of Public Health, Prague, Czech Republic, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
Kristinsson, Karl G; Department of Clinical Microbiology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
Krizova, Pavla; NRL for Meningococcal Infections, National Institute of Public Health, Prague, Czech Republic
Kuch, Alicja; National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
Ladhani, Shamez; Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
Lâm, Thiên-Trí; German National Reference Center for Meningococci and Haemophilus influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
Ayala, María Eugenia León; Department of Bacteriology and Mycology, Respiratory and Meningeal Diseases Section, Laboratorio Central de Salud Pública, Asunción, Paraguay
Lindholm, Laura; Department of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland
Litt, David; Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
Maiden, Martin C J; Department of Biology, University of Oxford, Oxford, UK
Martin, Irene; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
Martiny, Delphine ; Université de Mons - UMONS > Faculté de Médecine et de Pharmacie > Service du Doyen de la Faculté de Médecine et Pharmacie
Mattheus, Wesley; National Reference Centre for Neisseria meningitidis, Sciensano, Brussels, Belgium
McCarthy, Noel D; Trinity College Dublin, The University of Dublin, Dublin, Ireland
Meehan, Mary; Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland
Meiring, Susan; Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
Mölling, Paula; National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Morfeldt, Eva; Public Health Agency of Sweden, Solna, Sweden
Morgan, Julie; Streptococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New Zealand
Mulhall, Robert; Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland
Muñoz-Almagro, Carmen; CIBER de Epidemiología y Salud Públic, CIBERESP, Barcelona, Spain, Instituto de Recerca Pediatrica, Hospital Sant Joan de Deu, Barcelona, Spain, Medicine Department, Universitat Internacional de Catalunya, Barcelona, Spain
Murdoch, David; University of Otago, Christchurch, New Zealand
Musilek, Martin; NRL for Meningococcal Infections, National Institute of Public Health, Prague, Czech Republic
Novakova, Ludmila; NRL for Haemophilus Infections, National Institute of Public Health, Prague, Czech Republic
Oftadeh, Shahin; Institute of Clinical Pathology and Medical Research, NSW Health Pathology, NSW, Sydney, Australia
Perez-Arguello, Amaresh; Instituto de Recerca Pediatrica, Hospital Sant Joan de Deu, Barcelona, Spain
Pérez-Vázquez, Maria Dolores; National Centre of Microbiology and CIBER de enfermedades infecciosas, Instituto de Salud Carlos III, Madrid, Spain
Perrin, Monique; Laboratoire National de Sante, Dudelange, Luxembourg
Prevost, Benoit; Faculté de Médecine et Pharmacie Université de Mons (UMONS), Mons, Belgium, National Reference Centre for Haemophilus influenzae, Laboratoires des Hôpitaux Universitaires de Bruxelles-Universitaire Laboratorium Brussel, LHUB-ULB, Brussels, Belgium
Roberts, Maria; Public Health Wales, Cardiff, UK
Rokney, Assaf; Government Central Laboratories, Ministry of Health, Jerusalem, Israel
Ron, Merav; Government Central Laboratories, Ministry of Health, Jerusalem, Israel
Sanabria, Olga Marina; Grupo de Microbiologia-Instituto Nacional de Salud, Bogotá, Colombia
Scott, Kevin J; Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratory, Glasgow, UK
Sempere, Julio; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain, Spanish Pneumococcal Reference Laboratory, National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
Siira, Lotta; Department of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland
de Lemos, Ana Paula Silva; National Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, Brazil
Sintchenko, Vitali; Institute of Clinical Pathology and Medical Research, NSW Health Pathology, NSW, Sydney, Australia, Sydney Infectious Diseases Institute, University of Sydney, Sydney, NSW, Australia
Skoczyńska, Anna; National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
Slotved, Hans-Christian; Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
Smith, Andrew J; Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratory, Glasgow, UK, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
Taha, Muhamed-Kheir; Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Institut Pasteur, Paris, France
Toropainen, Maija; Department of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland
Tzanakaki, Georgina; National Meningitis Reference Laboratory, School of Public Health, University of West Attica, Athens, Greece
Vainio, Anni; Department of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland
van der Linden, Mark P G; Reference Laboratory for Streptococci, University Hospital RWTH Aachen, Aachen, Germany
van Sorge, Nina M; Department of Medical Microbiology and Infection Prevention and Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
Varon, Emmanuelle; Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, France
Moreno, Julio Vazquez; National Reference Laboratory for Meningococci, National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
Vohrnova, Sandra; NRL for Streptococcal Infections, National Institute of Public Health, Prague, Czech Republic
von Gottberg, Anne; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
Yuste, Jose; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain, Spanish Pneumococcal Reference Laboratory, National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
Brueggemann, Angela B; Nuffield Department of Population Health, University of Oxford, Oxford, UK. Electronic address: angela.brueggemann@ndph.ox.ac.uk
Sachs, JD, Karim, SSA, Aknin, L, et al. The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet 400 (2022), 1224–1280.
WHO. WHO COVID-19 dashboard. 2024, World Health Organization https://data.who.int/dashboards/covid19/cases. (Accessed 9 July 2024)
Consumers, Health and Food Executive Agency Unit. Study on cost-benefit analysis of reference laboratories for human pathogens—executive summary. 2016, Publications Office of the European Commission, Luxembourg.
Bajoriniene, A, Leitmeyer, KC, Struelens, MJ, Kokki, MH, Investing in public health microbiology laboratories in western Balkan countries enhances health security from communicable disease threats in Europe. Front Public Health, 7, 2019, 8.
WHO. Diagnostic stewardship: a guide to implementation in antimicrobial resistance surveillance sites. 2016, World Health Organization, Geneva.
Myers, MF, Rogers, DJ, Cox, J, Flahault, A, Hay, SI, Forecasting disease risk for increased epidemic preparedness in public health. Adv Parasitol 47 (2000), 309–330.
Ma, L, Caulfield, A, Dewan, KK, Harvill, ET, Pertactin-deficient Bordetella pertussis, vaccine-driven evolution, and reemergence of pertussis. Emerg Infect Dis 27 (2021), 1561–1566.
WHO. Global research and innovation for health emergencies. 2023, World Health Organization https://www.who.int/publications/m/item/global-research-and-innovation-for-health-emergencies. (Accessed 9 July 2024)
Bell, JA, Nuzzo, JB, Global health security index: advancing collective action and accountability amid global crisis. 2021, The Global Health Security Index https://ghsindex.org/. (Accessed 9 July 2024)
Messinger Cayetano, S, Crandall, L, Paradox of success and public perspective: COVID-19 and the perennial problem of prevention. J Epidemiol Community Health, 74, 2020, 679.
Oostdijk, C, Ferreira, JA, Ruijs, WLM, Mollema, L, Van Zoonen, K, Adolescent and parental decision-making for the MenACWY vaccination: influential predictors and parental-adolescent differences among households in the Netherlands. BMC Public Health, 23, 2023, 947.
Largeron, N, D'Agostino, P, Chapman, R, et al. Guiding principles for evaluating vaccines in joint health technology assessment in the European Union: preparing for the EU's regulation on HTA for vaccines. Value Health 27 (2024), 1318–1327.
House of Commons Health Committee. Public health post 2013, second report of session 2016–17. House of Commons. https://publications.parliament.uk/pa/cm201617/cmselect/cmhealth/140/140.pdf, 2016. (Accessed 9 July 2024)
Marmot, M, Health equity in England: the Marmot review 10 years on. BMJ, 368, 2020, m693.
Blazer, DG, Colenda, CC, Applegate, WB, Reifler, BV, The great health paradox: a call for increasing investment in public health. Acad Med 97 (2022), 484–486.
Masters, R, Anwar, E, Collins, B, Cookson, R, Capewell, S, Return on investment of public health interventions: a systematic review. J Epidemiol Community Health 71 (2017), 827–834.
Fu, C, Drake, T, Simangolwa, WM, et al. Understanding the costs and benefits of investing in laboratory systems in African countries. 2022, Center for Global Development https://www.cgdev.org/publication/understanding-costs-and-benefits-investing-laboratory-systems-african-countries. (Accessed 9 July 2024)
Africa Centres for Disease Control and Prevention. 3rd International Conference on Public Health in Africa (CPHIA 2023). Africa Centres for Disease Control and Prevention. https://africacdc.org/3rd-international-conference-on-public-health-in-africa-cphia-2023/. (Accessed 9 July 2024)
Brueggemann, AB, Jansen van Rensburg, MJ, Shaw, D, et al. Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: a prospective analysis of surveillance data. Lancet Digit Health 3 (2021), e360–e370.
Jolley, KA, Maiden, MC, BIGSdb: scalable analysis of bacterial genome variation at the population level. BMC Bioinformatics, 11, 2010, 595.
Shaw, D, Abad, R, Amin-Chowdhury, Z, et al. Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic: analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium. Lancet Digit Health 5 (2023), e582–e593.
WHO. Global genomic surveillance strategy for pathogens with pandemic and epidemic potential, 2022–2032. 2022, World Health Organization https://www.who.int/publications/i/item/9789240046979. (Accessed 9 July 2024)
Limb, M, Public health grants in England are “far too little, far too late,” says president of directors. BMJ, 380, 2023, 631.