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Recent Technology of Clinical Microbiology; Whole Genome Sequencing (WGS) and Matrix-Assisted, Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS)

Jeongsook Y

The hottest issue in the field of clinical microbiology in latest years is the application of whole genome sequencing (WGS) to the clinical diagnostics and therapeutics through the methodology of Next generation sequencing. The application of WGS includes species identification, epidemiological study and study of antimicrobial resistance and so on. The single nucleotide polymorphism (SNP) based analysis increases the accuracy and sensitivity of species identification by marked discriminatory power, and the ability of tracking of transmission process enables infection control including outbreaks. We can clarify the antimicrobial resistance mechanism of extended spectrum betalactamases or carbapenemases and elucidate the mechanism of horizontal transfer of mobile genomic islands. In case of setting up a new PCR method, the target and the primer could be chosen by using WGS databases. The MALDI-TOF method is used in nearly all laboratories, identifying bacterial, fungal and mycobacterial species. Direct identification in blood culture bottle is possible in bacteremia patients, and Beta-lactamases or Carbapenemases can be detected. In addition, it can be applied in Shiga toxin E. coli, Salmonella serotypes or C. difficile ribotypes.