Principles of molecular microbiology testing methods

Donna Wolk, S. Mitchell, R. Patel

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Molecular testing methods have the potential to replace many conventional microbiology laboratory assays. Recent refinements in technology have resulted in more user-friendly testing platforms. These platforms are automated and have lowered risks for contamination, decreased costs, and are faster than older platforms. The success of these technologies depends on their successful application to patient care. Quality issues include appropriate specimens for analysis, performance characteristics of different analytical methods, optimal specimen processing, the effects of PCR inhibitors, and false-positive results caused by contaminating nucleic acids. Quality control guidelines for molecular microbiologic diagnostic assays are in their infancy and require further development. Additionally, the problem of "too much" sensitivity (brought on by the extreme sensitivity of these techniques coupled with the potential presence of small numbers of pathogenic organisms in asymptomatic individuals) should be considered. Potential problems when monitoring therapy (because molecular detection techniques do not generally have the ability to determine whether an organism is dead or alive) can also occur. Cost-effective test use, pathogen- or disease-targeted algorithms, and standardized methods will be necessary for the true value of these technologies to be realized. This is especially important, because, unlike traditional culture methods, most molecular microbiology methods are pathogen-specific. Clinicians familiar with the reasons why "pan-culture" (i.e., requesting all culture possibilities at once) is inadvisable should not use the same irrational approach when requesting molecular tests. The clinical usefulness of molecular testing will be maximized as targeted algorithms are developed and an understanding of molecular test ordering patterns is realized. Laboratory technicians and physicians must continue to apply and combine theories of traditional microbiology, clinical chemistry, and general medicine to the understanding and application of molecular diagnostics.

Original languageEnglish (US)
Pages (from-to)1157-1204
Number of pages48
JournalInfectious Disease Clinics of North America
Volume15
Issue number4
DOIs
StatePublished - 2001
Externally publishedYes

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Microbiology
Molecular Pathology
Technology
Laboratory Personnel
Costs and Cost Analysis
Clinical Chemistry
Quality Control
Nucleic Acids
Patient Care
Medicine
Guidelines
Physicians
Polymerase Chain Reaction
Therapeutics

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Principles of molecular microbiology testing methods. / Wolk, Donna; Mitchell, S.; Patel, R.

In: Infectious Disease Clinics of North America, Vol. 15, No. 4, 2001, p. 1157-1204.

Research output: Contribution to journalArticle

Wolk, Donna ; Mitchell, S. ; Patel, R. / Principles of molecular microbiology testing methods. In: Infectious Disease Clinics of North America. 2001 ; Vol. 15, No. 4. pp. 1157-1204.
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