A commentary on the role of molecular technology and automation in clinical diagnostics

Bioengineered. 2014 May-Jun;5(3):155-60. doi: 10.4161/bioe.28599. Epub 2014 Mar 21.

Abstract

Historically, the identification of bacterial or yeast isolates has been based on phenotypic characteristics such as growth on defined media, colony morphology, Gram stain, and various biochemical reactions, with significant delay in diagnosis. Clinical microbiology as a medical specialty has embraced advances in molecular technology for rapid species identification with broad-range 16S rDNA polymerase chain reaction (PCR) and matrix-assisted laser desorption and/or ionization time of flight (MALDI-TOF) mass spectrometry demonstrated as accurate, rapid, and cost-effective methods for the identification of most, but not all, bacteria and yeasts. Protracted conventional incubation times previously necessary to identify certain species have been mitigated, affording patients quicker diagnosis with associated reduction in exposure to empiric broad-spectrum antimicrobial therapy and shortened hospital stay. This short commentary details such molecular advances and their implications in the clinical microbiology setting.

Keywords: MALDI; PCR; clinical microbiology; impact; patient care.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Automation, Laboratory / instrumentation
  • Automation, Laboratory / methods*
  • Bacteria / genetics*
  • Bacteria / isolation & purification
  • Bacterial Infections / diagnosis*
  • Bacterial Infections / drug therapy
  • Bacterial Infections / microbiology
  • Bacterial Typing Techniques / instrumentation
  • Bacterial Typing Techniques / methods
  • Fungi / genetics*
  • Fungi / isolation & purification
  • Humans
  • Microbial Sensitivity Tests
  • Mycological Typing Techniques / instrumentation
  • Mycological Typing Techniques / methods
  • Mycoses / diagnosis*
  • Mycoses / drug therapy
  • Mycoses / microbiology
  • Polymerase Chain Reaction
  • RNA, Ribosomal, 16S / genetics*
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
  • Time Factors

Substances

  • Anti-Bacterial Agents
  • RNA, Ribosomal, 16S