Abstract

Diagnosis of infectious agents has evolved significantly over the past decades. Introduction of immunological testing technologies in the eighties of the previous century was rapidly followed by the acceptation of various forms of molecular testing, mostly facilitated by simplification and automation of the PCR process. This already transformed the routine diagnostic microbiology laboratory to a significant extend. Even more recently, newer technologies for the sensitive and specific detection of pathogens and for definition of their phenotypic characteristics have become available. Mass spectrometry and next generation sequencing (NGS) methods were developed and allow for detection, quantification, antimicrobial or antiviral susceptibility testing and assessment of outbreak potential and virulence. Most recently, data science has found its way into the routine laboratory. Development of dedicated databases for facilitating mass spectrometry and NGS are commonplace, but also the use of extensive demographic and patient-oriented data for completing and detailing clinical diagnostics is becoming accepted at a rapid pace. These technologies will be described in detail and requirements for their routine, high-throughput application will be discussed. The impact of such technologies on both the management of individual patients but also on more global phenomena such as the international rise in antimicrobial resistance will be presented as examples.