History and Scope
Clinical microbiology is the study of microorganisms that cause disease in humans. It involves the diagnosis, treatment and prevention of infectious diseases through the identification of various pathogens. Clinical microbiology has its roots in early experiments in the late 19th century when scientists like Louis Pasteur and Robert Koch discovered specific microbes that caused particular diseases. This established the germ theory of disease which proposed that specific diseases are caused by specific microorganisms.
In the early 20th century, extensive research and laboratory techniques helped isolate and characterize the microbes that cause common infections. Antibiotics were discovered in the 1920s which led to significant progress in treating bacterial infections. Over the subsequent decades, our understanding of viruses, parasites, fungi and other pathogenic microbes expanded greatly. Today, Clinical Microbiology utilizes advanced tools like molecular diagnostics, genomics and proteomics to better understand infectious agents and develop more effective therapies and prevention strategies.
Identification and Characterization of Pathogens
A major focus area for clinical microbiologists is the identification and characterization of microbial pathogens from patient samples. Samples from sites of infection like blood, urine, sputum etc. are examined under the microscope for the presence of microbes. Selective media are used to culture specific microbes from complex clinical specimens. Biochemical tests on cultured isolates help narrow down the possibilities to genus or species level.
Molecular diagnostic techniques have revolutionized microbial identification. Polymerase chain reaction (PCR) can rapidly detect microbial genetic material from patient samples. Real-time PCR assays provide identification within hours compared to days for culture-based methods. DNA sequencing has become accessible for identifying unique bacterial and viral strains. Microarray chips screen for hundreds of pathogens simultaneously through nucleic acid probes. All these methods provide accurate pathogen identification critical for optimal treatment decisions.
Clinical microbiologists also characterize important features of pathogenic isolates like antibiotic susceptibility patterns. This involves testing the cultured organism's sensitivity to various antibiotics using standardized methods like Kirby-Bauer disk diffusion test. The results guide clinicians in selecting effective antibiotics and help track the emergence of antibiotic resistance over time and regions. Molecular characterization of antibiotic resistance genes enhances resistance surveillance.
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