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Inside the Lab Microbiology and immunology, Biochemistry and molecular biology, Point of care testing, Training and education

Spreading the Word: Molecular Diagnostics for Infectious Disease

Molecular tests support infectious disease diagnosis by detecting specific organisms – but they aren’t “magic bullets” for pathogen detection. Although tempting, broad-range assays aren’t always the best option for detecting multiple bacteria in a single sample, so pathologists must work with clinical colleagues to select and interpret the most appropriate tests.

Molecular diagnostics have an increasingly important role to play across all areas of pathology, but their importance in infectious disease cannot be underestimated. Thanks to a simple, widely available technique – the polymerase chain reaction (PCR) – molecular techniques now serve a variety of applications in routine clinical laboratories, with real-time PCR allowing the rapid detection of various infectious microorganisms.

But are these cutting-edge assays too easy? Often, pathologists perform them even when there is no prior evidence of infection. It’s true that there are many circumstances where molecular diagnostics can be valuable, but we need to educate our surgical pathologists on what the tests can do – and when they might not be the best option.

As our clinical colleagues become more familiar with the molecular diagnostic tests that are now widely available, surgical pathologists can expect to receive more frequent requests for them. But we cannot blindly follow these requests; we are also diagnosticians and need to be prepared to turn down tests that aren’t suitable or suggest more appropriate alternatives. Pathologists are physicians who are ultimately responsible for the tissue we work on, so we must play an active role in making these decisions. And to do so, we need to fully understand the applications and limitations of molecular diagnostic assays so that we can use them properly.

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About the Author

Bobbi Pritt

Director of the Clinical Parasitology Laboratory in Mayo Clinic’s Department of Laboratory Medicine and Pathology, Rochester, Minnesota, USA.

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