Low D E, McGeer A
Department of Microbiology, Mount Sinai and Princess Margaret Hospitals, University of Toronto, ON, Canada.
New Horiz. 1995 May;3(2):161-9.
Clinical microbiologists and hospital epidemiologists have traditionally been concerned with the isolation and identification of organisms for diagnosis in individual patients, and the detection of transmission of such organisms from patient to patient. The use of molecular biology techniques, such as nucleic acid probing and amplification, provides the potential for revolutionizing how we diagnose infecting pathogens and determining the relation between nosocomial isolates. In clinical microbiology, this means that we will be able to detect smaller amounts of DNA or RNA of pathogens than is currently possible, that the time required to identify and determine the antimicrobial susceptibility of slow-growing pathogens will be dramatically reduced, and that the diagnosis of nonculturable organisms will become possible. In hospital epidemiology, the use of such techniques has already provided tests with exceptional discriminatory power. Molecular techniques allow more efficient typing of all pathogens, and permit discrimination between strains of organisms that were previously phenotypically identical or uncharacterizable. Currently, cost and complexity limit the applicability of these techniques; however, they are likely to be developed for routine laboratory use in the next decade, and their impact will be considerable.
临床微生物学家和医院流行病学家传统上关注的是分离和鉴定用于个体患者诊断的微生物，以及检测此类微生物在患者之间的传播。分子生物学技术的应用，如核酸探针和扩增技术，为彻底改变我们诊断感染病原体的方式以及确定医院分离株之间的关系提供了潜力。在临床微生物学中，这意味着我们将能够检测到比目前更少的病原体DNA或RNA，鉴定和确定生长缓慢的病原体对抗菌药物敏感性所需的时间将大幅减少，并且不可培养微生物的诊断将成为可能。在医院流行病学中，此类技术的应用已经提供了具有卓越鉴别力的检测方法。分子技术能更高效地对所有病原体进行分型，并能区分以前表型相同或无法分型的微生物菌株。目前，成本和复杂性限制了这些技术的应用；然而，它们很可能在未来十年内发展为常规实验室使用技术，其影响将是巨大的。
