Modern microbiology - a quiet revolution with many benefits

In the clinical microbiology laboratory, classical culture and identification methods are rapidly giving way to molecular techniques with many benefits for clinicians and patients. Building on the discovery of the structure of DNA and the genetic code, four main scientific advances have been made which underpin these techniques (hybridisation probes, polymerase chain reaction, the observation that the microbial species signature can be read in the ribosomal genes and also in the proteins). Early discoveries have paved the way for new diagnostic methods, which are rapid, highly sensitive and specific. Automation has provided high throughput for large numbers of clinical specimens combined with reasonable cost. The benefits for the clinician and patient include confirmation of clinical diagnoses and information about antimicrobial susceptibility within hours compared to days for conventional methods. In resource-poor settings, molecular techniques and automated systems may seem unaffordable but new public-private partnerships, initiatives by the World Health Organization and new, innovative laboratory methods offer the promise of benefit for all.