MOLECULAR METHODS - APPLICATIONS FOR CLINICAL INFECTIOUS-DISEASES

The application of molecular biology to microbiology has led to a. sur ge of new information about most infectious microorganisms, the pathog enesis of the infections they cause, and the specific microbial antige ns involved in the immune response to these infections. The simultaneo us application of the same techniques to diagnosis and epidemiology ha s also shown great promise, but these developments have not yet had a major effect on the routine practice of medicine. For some purposes, d irect probe tests perform as well as other available methods. However, for most infections, these methods have not been proven sufficiently sensitive. The latest generation of highly sensitive diagnostics based on the polymerase chain reaction will overcome this technical obstacl e and may revolutionize the management of many infections. Difficultie s inherent in performing these tests will require special procedures a nd training in clinical laboratories to ensure that they are performed reliably. Nucleic acid-based methods for epidemiologic typing of micr oorganisms and for identification of noncultivatable pathogens are par ticularly useful for analysis of poorly cultivatable, dangerous, or ot herwise untypeable microorganisms.