How The Identification Of Bacterial Pathogens Is Moving Into A New Era

Are Louis Pasteur’s techniques for identifying bacterial pathogens fading before the introduction of techniques more akin to crime scene investigation (CSI)? My colleagues and I investigate this in a recent issue of BMC Medicine.¹

Newer molecular tests include 16S rRNA gene sequencing and our study questions whether these tests can identify which pathogens are causative and which are merely colonizers.¹ I believe that this technology will soon be upon us as it is happening right below our feet in hospitals worldwide.

However, what we are able to do with these data is another matter entirely. Are molecular techniques are still too experimental, non-specific or expensive for current clinical use? Can molecular techniques provide clinically relevant, rapid information on the virulence of wound isolates and their antibiotic sensitivities? Those are among the questions we investigate in the study.

It is likely that many, if not most, of the infections that we see will yield a similar "bad actor" that will grow ex vivo in a Louis Pasteur dish just as it would be identified using CSI metagenomic and community profiling techniques. However, I believe there will be a population of patients that may have bacteria that were not readily apparent using traditional methods that proved to be, whether in isolation or in their nefarious community, pathogenic. We are seeing this right now at Southern Arizona Limb Salvage Alliance (SALSA).

Reference

1. Spicher A, Hurwitz BL, Armstrong DG, Lipsky BA. Microbiology of diabetic foot infections: from Louis Pasteur to ‘crime scene investigation.’ BMC Medicine. 2015; 13(1):2.