Developments and Clinical Applications in Diagnostic Molecular Microbiology

Abstract

Diagnostic Microbiology probably started in the late 17th century when the Dutch scientist Antoni van Leeuwenhoek made microorganisms visible for the first time. Since then, 3 major revolutions have taken place, all of which had a major impact on the field of clinical microbiology. The first revolution took place at the end of the 19th century after the development of solid culture media by Robert Koch. Bacterial culture, nowadays, still remains the cornerstone of clinical microbiology, although technical refinements have made available automated identification and antimicrobial susceptibility testing in most modern laboratories. The second revolution was the development of antigen/antibody detection in the sixties and seventies of the 20th century. Early antigen/antibody testing tended to lack some sensitivity and specificity, a problem which is nowadays largely resolved, however, most of these tests still show a window period before detectable antigen/antibody levels appea! r in the patient. The third and final revolution, the nucleic acid (NA)-based detection of microorganisms started some 25 year ago and is still ongoing. Molecular diagnostic testing has made its way from basic research to become a permanent asset for the clinical microbiology laboratory. In fact, in clinical virology it has nearly completely replaced viral culture as the primary means to detect active viral infection. However, in other fields in clinical microbiology, the use of molecular diagnostics