Molecular Diagnostics of Bacterial

Pathogens
Petra F.G. Wolffs, Tanja H. Geelen and Lieke B. van Alphen
Abstract Molecular diagnostics of bacterial pathogens is a rapidly growing field
within clinical microbiology. The first commonly used routine application was the
detection of bacterial sexually transmitted pathogens. Most of these micro-organisms
are difficult to culture and therefore molecular diagnostics are providing a reliable,
easy and high-throughput alternative. Over time, molecular diagnostic methods were
developed and implemented for more easily culturable micro-organisms as well. The
implementation of molecular tests for detection of bacterial gastrointestinal pathogens
is one example that is discussed in this chapter. In this latter area often a
combination of molecular diagnostics with conventional culture is preferred. In the
final part of the chapter, bacterial typing is highlighted. Molecular typing of bacteria
has provided the opportunity, in contrast to conventional typing, to perform same
day, high throughput typing. Furthermore, many of the molecular typing methods
discussed in this chapter have an improved discriminatory power. In conclusion, the
field of molecular diagnostics of bacterial pathogens is constantly moving and new
techniques are being developed and implemented in a continuous search for assays
with an even higher technical and diagnostic sensitivity and/or specificity. The
importance of molecular diagnostics of bacterial pathogens for clinical microbiology
laboratories will likely only further increase in the future.
Keywords Bacterial pathogens _ Sexually transmitted disease _ Gastroenteritis _
Antimicrobial treatment _ Molecular typing
1.1 Introduction
This chapter aims to give a non-comprehensive overview of molecular diagnostics of
clinically relevant bacterial pathogens. Molecular diagnostics of bacterial pathogens
from clinical samples is a relatively new, but rapidly growing field. In contrast to the
difficult-to-culture, slow-growing viruses, for which molecular diagnostics was
rapidly developed to overcome those diagnostic challenges, for bacteria, the ease and
low costs of culture-based diagnostics initially limited the application of molecular
diagnostics. However, in recent years, also for many bacterial pathogens, molecular
tests have been developed. In this chapter we will illustrate developments in this field
using two examples. First we will discuss molecular assays for the detection of
bacterial sexually transmitted infections. Molecular bacterial diagnostics started in
most clinical laboratories in this area. The second example concerns the diagnosis of
bacterial pathogens involved in gastroenteritis. In contrast, this is an area where
developments are more recent, but are widely being implemented. At the end of the
chapter we will focus on the use of molecular techniques for typing of bacteria by
briefly discussing the (choice of) techniques and their added value in a clinical
laboratory that is investigating bacterial pathogens.