Clinical microbiology in detection and identification of emerging microbial pathogens: past, present and future

Abstract

Clinical microbiology has possessed a marvellous past, an important present and a bright future. Western medicine modernization started with the discovery of bacterial pathogens, and from then, clinical bacteriology became a cornerstone of diagnostics. Today, clinical microbiology uses standard techniques including Gram stain morphology, in vitro culture, antigen and antibody assays, and molecular biology both to establish a diagnosis and monitor the progression of microbial infections. Clinical microbiology has played a critical role in pathogen detection and characterization for emerging infectious diseases as evidenced by the ongoing COVID-19 pandemic. Revolutionary changes are on the way in clinical microbiology with the application of "-omic" techniques, including transcriptomics and metabolomics, and optimization of clinical practice configurations to improve outcomes of patients with infectious diseases.

Keywords: COVID-19; Clinical microbiology; genomics; metabolomics; nucleic acid amplification; point of care; proteomics; transcriptomics.

Figure 1.

Infection is the result of the interaction between the pathogen, the host and the environment. CPD, cell population data; MDW, monocyte distribution width.

Figure 2.

Polarized clinical microbiology practice in the near future with rapid, random-access tests done at point of care (left) and with batched, large volumes of tests done at central laboratory (right).