PT  - JOURNAL ARTICLE
AU  - Travis Altheide, S.
AU  - Butina, Michelle
AU  - Chatterjee, Usha
AU  - Evans, Jason
TI  - Evolution of the Clinical Microbiology Laboratory
AID  - 10.29074/ascls.2019001867
DP  - 2019 Oct 01
TA  - American Society for Clinical Laboratory Science
PG  - 146--148
VI  - 32
IP  - 4
4099  - http://hwmaint.clsjournal.ascls.org/content/32/4/146.short
4100  - http://hwmaint.clsjournal.ascls.org/content/32/4/146.full
SO  - Clin Lab Sci2019 Oct 01; 32
AB  - Over the course of nearly 150 years, the clinical laboratory has diagnosed infectious diseases and identified their causative agents using a variety of approaches. These approaches can be broadly placed into 3 categories: biochemical or growth-based methods, molecular and genomic diagnostics, and biomarker and serologic detection of blood components. The principle of the biochemical approach is based on isolating an unknown microorganism before conducting a series of growth-based and preformed-enzyme detection tests to determine an identification and subsequent antimicrobial susceptibilities. The molecular approach is the newest diagnostic approach used by the laboratory and is based on detection of the genetic components of an unknown organism, either isolated or directly in a clinical specimen. There are a variety of molecular techniques with the polymerase chain reaction serving as the basis of most currently available methods. The detection of infection and inflammatory indicators, as well as serologic molecules, has been used for diagnostic purposes nearly as long as growth-based identification methods. The biomarker approach to infectious-disease diagnosis has primarily occurred outside of the traditional microbiology department, usually within chemistry and hematology where large scale automated instruments provide rapid results. In this focus series, a concise review and a brief history of these different approaches are presented. The underlying methods are described with advantages and disadvantages, while specific examples of each are highlighted with the internal and external factors that influence their development.