THE POSSIBILITIES AND LIMITATIONS OF NUCLEIC-ACID AMPLIFICATION TECHNOLOGY IN DIAGNOSTIC MICROBIOLOGY

Nucleic acid amplification technology is examined from the critical vi ewpoint of a clinical microbiologist working in a routine diagnostic b acteriology laboratory Widely recognised limitations of amplification technology include those of false-positive and false-negative results, the difficulty of obtaining quantitative results, the problem of usin g this technology for susceptibility testing, and the difficulty of de tecting routinely the wide range of possible pathogens contained in a clinical sample, On the positive side, amplification technology brings welcome new possibilities for rapid detection of specific pathogens i n a sample, including viruses, slowly growing bacteria, fastidious or uncultivable bacteria, fungi and protozoa, Other possible applications include screening normally sterile clinical samples for non-specific bacterial contamination and the use of amplification-based DNA fingerp rinting methods for identification and typing of micro-organisms, Neve rtheless, it is predicted that-in contrast to research and reference f acilities-routine bacteriology laboratories will continue to rely on c ulture as the preferred 'amplification method' for most diagnostic app lications.