Is There A Better Way To Diagnose Infections?

I have written in the past about my excitement over new molecular techniques to diagnose lower extremity infections. I really believe that this is the future for both bacterial and fungal disease. These tests are incredibly sensitive, specific and rapid with results possible in hours rather than days.

My greatest concern has been that, to borrow an old Saturday Night Live comment, they are “not ready for primetime.” I say this because we do not yet know what exactly these sensitive results mean. If you find 20 organisms as opposed to the two or three you might recover on a standard culture, are all 20 pathogenic? Then there is the terminology with terms such as polymerase chain reaction (PCR), pyrosequencing, 16S rRNA and metagenomics. It can make your head spin.

The reason I bring this up is because our friends at the Southern Arizona Limb Salvage Alliance (SALSA) at the University of Arizona just published an exceptional review of the subject that puts it all in perspective.1 Here is a link to the full text: https://www.biomedcentral.com/1741-7015/13/2 .

Many thanks to David G. Armstrong, DPM, MD, PhD, for alerting me to his paper and allowing me permission to pass it on to my readership.

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.

This blog originally appeared on the Handbook of Lower Extremity Infections Website at  https://www.leinfections.com/antibiotics/a-better-way-to-diagnose-infections/ and has been adapted with permission from Warren Joseph, DPM, FIDSA, and Data Trace Publishing Company. For more information about the Handbook of Lower Extremity Infections, visit www.leinfections.com/ .