title: Rapid clinical bacteriology and its future impact.
abstract: Clinical microbiology has always been a slowly evolving and conservative science. The sub-field of bacteriology has been and still is dominated for over a century by culture-based technologies. The integration of serological and molecular methodologies during the seventies and eighties of the previous century took place relatively slowly and in a cumbersome fashion. When nucleic acid amplification technologies became available in the early nineties, the predicted "revolution" was again slow but in the end a real paradigm shift did take place. Several of the culture-based technologies were successfully replaced by tests aimed at nucleic acid detection. More recently a second revolution occurred. Mass spectrometry was introduced and broadly accepted as a new diagnostic gold standard for microbial species identification. Apparently, the diagnostic landscape is changing, albeit slowly, and the combination of newly identified infectious etiologies and the availability of innovative technologies has now opened new avenues for modernizing clinical microbiology. However, the improvement of microbial antibiotic susceptibility testing is still lagging behind. In this review we aim to sketch the most recent developments in laboratory-based clinical bacteriology and to provide an overview of emerging novel diagnostic approaches.
authors.affiliation: BioMérieux SA, Unit Microbiology, R&D Microbiology, La Balme Les Grottes, France.
authors.forename: Alex
authors.initials: A
authors.lastname: van Belkum
authors.forename: Géraldine
authors.initials: G
authors.lastname: Durand
authors.forename: Michel
authors.initials: M
authors.lastname: Peyret
authors.forename: Sonia
authors.initials: S
authors.lastname: Chatellier
authors.forename: Gilles
authors.initials: G
authors.lastname: Zambardi
authors.forename: Jacques
authors.initials: J
authors.lastname: Schrenzel
authors.forename: Dee
authors.initials: D
authors.lastname: Shortridge
authors.forename: Anette
authors.initials: A
authors.lastname: Engelhardt
authors.forename: William Michael
authors.initials: WM
authors.lastname: Dunne
mesh_terms: D001419:Bacteria / Q000235:genetics* / Q000302:isolation & purification / Q000378:metabolism; D001424:Bacterial Infections / Q000175:diagnosis / Q000382:microbiology*; D062609:Electronic Nose; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D013058:Mass Spectrometry; D025202:Molecular Diagnostic Techniques; D021141:Nucleic Acid Amplification Techniques
keywords: Antibiogram; Antibiotics; Antimicrobial susceptibility testing (AST); DNA testing; Drug resistance; Innovation; Laboratory automation; MALDI-TOF MS