Laboratory Medicine and Nosocomial infections: Solutions in the Pipeline

On the horizon is technology from the molecular diagnostic company Great Basin Scientific (Salt Lake City, UT, USA). The company's technology is designed to improve the traditional methods of diagnostic testing of hospital-acquired infections, such as methicillin-resistant Staphylococcus aureus (MRSA), allowing test results to come back in less than an hour versus the traditional one- to two-day waiting period.

Great Basin Scientific's silicon chip-based technology is simple, cost-effective, and better than the highly complex, traditional polymerase chain reaction (PCR) method that requires the skills of highly trained technicians and sometimes even multiple rooms to avoid cross contamination of tests. The company's sensitive, easy-to-use integrated cartridge system, which can be performed in a clinical laboratory improved amendments (CLIA)-rated moderately complex or waived laboratory, will give health care providers and their patients the benefit of point-of-care test results within a 20- to 60-minute time frame at costs much lower than current molecular solutions.

In the past two decades, one of the most important discoveries to come out of the microbiology world is the fact that bacteria can communicate. They are able converse on a level where they can induce each other to switch on dormant genes that then have the capacity to do harm.

The superbug methicillin-resistant Staphylococcus aureus (MRSA) is part of this phenomenon, called "quorum sensing.” Quorum sensing is the ability of bacteria to communicate and coordinate behavior using signaling molecules called autoinducers. Autoinducers are continuously produced by bacteria but when their concentration reaches a certain threshold--that is, when the bacteria producing it have a quorum--they switch on transcription genes within the bacteria's DNA telling it to do two things: to produce more autoinducer and, crucially, to change behavior.

Once a biofilm is established it is very difficult to get rid of as can be witnessed by the ubiquity of dental plaque and dogged resistance of MRSA to treatment. There have been attempts to solve this problem with some promising results. For example, Jong-Chul Park at the Cellbiocontrol Laboratory, Department of Medical Engineering, Yonsei University College of Medicine (Seoul, Korea) and colleagues reported that they were able to rapidly remove biofilms and planktonic bacteria on glass by using microwave-induced argon plasma at atmospheric pressure. Their work was published on November 28, 2009 in the New Journal of Physics.

Related Links:
Great Basin Scientific
Yonsei University College of Medicine