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 don’t yet know what exactly these sensitive results mean. If you find 20 organisms, as opposed to the 2 or 3 you might recover on a standard culture, are all 20 pathogenic? Then there is the terminology; PCR, pyrosequencing, 16s rDNA, metagenomics…it can make your head spin.
The reason I bring this up is because our friends at SALSA at the University of Arizona just published an exceptional review of the subject that puts it all in perspective. Here is a link to the full text:
Many thanks to Dr. David Armstrong for alerting me to his paper and allowing me permission to pass it on to my readership.