title: A commentary on the role of molecular technology and automation in clinical diagnostics.
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.
authors.affiliation: Department of Clinical Microbiology; University Hospital Limerick; Limerick, Ireland; Centre for Interventions in Infection, Inflammation, and Immunity (4i) and Graduate Entry Medical School; University of Limerick; Limerick, Ireland.
authors.forename: Ciara
authors.initials: C
authors.lastname: O'Connor
authors.affiliation: Department of Clinical Microbiology; University Hospital Limerick; Limerick, Ireland.
authors.forename: Marie
authors.initials: M
authors.lastname: Fitzgibbon
authors.affiliation: Department of Clinical Microbiology; University Hospital Limerick; Limerick, Ireland.
authors.forename: James
authors.initials: J
authors.lastname: Powell
authors.affiliation: Department of Clinical Microbiology; University Hospital Limerick; Limerick, Ireland.
authors.forename: Denis
authors.initials: D
authors.lastname: Barron
authors.affiliation: Cork Institute of Technology; Cork, Ireland.
authors.forename: Jim
authors.initials: J
authors.lastname: O'Mahony
authors.affiliation: Department of Clinical Microbiology; University Hospital Limerick; Limerick, Ireland.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Power
authors.affiliation: Department of Clinical Microbiology; University Hospital Limerick; Limerick, Ireland; Centre for Interventions in Infection, Inflammation, and Immunity (4i) and Graduate Entry Medical School; University of Limerick; Limerick, Ireland.
authors.forename: Nuala H
authors.initials: NH
authors.lastname: O'Connell
authors.affiliation: Centre for Interventions in Infection, Inflammation, and Immunity (4i) and Graduate Entry Medical School; University of Limerick; Limerick, Ireland.
authors.forename: Colum
authors.initials: C
authors.lastname: Dunne
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D057205:Automation, Laboratory / Q000295:instrumentation / Q000379:methods*; D001419:Bacteria / Q000235:genetics* / Q000302:isolation & purification; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D015373:Bacterial Typing Techniques / Q000295:instrumentation / Q000379:methods; D005658:Fungi / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008826:Microbial Sensitivity Tests; D016533:Mycological Typing Techniques / Q000295:instrumentation / Q000379:methods; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016133:Polymerase Chain Reaction; D012336:RNA, Ribosomal, 16S / Q000235:genetics*; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D012336:RNA, Ribosomal, 16S
keywords: MALDI; PCR; clinical microbiology; impact; patient care