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At NGS-Heavy Meeting, Clinical Researchers Still Get Behind PCR for Infectious Disease Dx

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The Association for Molecular Pathology's annual meeting, held in Long Beach, Calif., in October focused strongly on next-generation sequencing and its implementation in the clinic, especially for diagnosing, monitoring, and tailoring treatments for cancer.

However, a number of presentations made it clear that PCR and real-time PCR, while no longer the obvious technology choice for all molecular diagnostic and pathology applications, is still one of the most powerful tools available for infectious disease diagnostics and therapeutic monitoring.

For instance, in his plenary talk, Barry Kreiswirth of the University of Medicine and Dentistry of New Jersey described various strategies used by his institution and others to conduct molecular epidemiological studies and control infectious disease outbreaks.

More specifically, Kreiswirth described a strategy currently being explored to curb Staphylococcus aureus outbreaks in hospital settings by combining information about geographically isolated clones of the bacteria with information on patients' movement and contacts or with data from electronic health records.

To execute such a strategy, clinicians need to employ a method to rapidly genotype these S. aureus strains, Kreiswirth noted. Such methods in the past have included pulsed field gel electrophoresis, multi-locus sequence typing, and staph protein A typing — all of which have drawbacks making them less than ideal for clinical implementation.

Instead, Kreiswirth and colleagues worked to identify customized SNPs for specific MRSA clones using a number of technologies. Then, "we can create customized assays for those SNPs in 96-well plates for rapid strain genotyping and patient tracking."

Kreiswirth noted that molecular beacons — hybridization probes that can be used in real-time PCR assays to provide a high degree of sensitivity and specificity — would be an ideal technology for such assays.

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