Implementation Of Molecular Diagnostics Research Articles

New horizons in genomics for Latin America

Latin America is undergoing a change in technology and healthcare. The implementation of new technologies must go hand in hand with education to better understand the challenges ahead and find solutions. In this editorial, we highlight the importance of sharing knowledge for the advancement of society, especially in the fields of genetics and genomics. There are important achievements and challenges in the implementation of molecular diagnostics in Latin America, such as quality control, ethical dilemmas and cost-benefit analysis. For this reason, we are launching this new journal that aims to create a platform for health professionals to strengthen their knowledge and skills in clinical genetics and genomics. The editor emphasizes the value of collective knowledge and collaboration for the benefit of patients and professional development.

Multicenter feasibility study to assess external quality panels for molecular diagnostics for tuberculosis in China.

The roll-out of molecular diagnostic tools continues to be the most important shift in the tuberculosis diagnostic landscape. The aim of this study was to develop a novel external quality assessment (EQA) panels for molecular TB diagnostics. In addition, we also assessed the performance of the laboratories with the EQA panels in China. Dried Mycobacterium tuberculosis (MTB) DNA in the chelex resin was designed as part of an EQA program. The storage of genomic DNA in the chelex resin layer had no effect on the stability of genomic DNA, even after 12 weeks of storage. Seventy-one laboratories have participated in EQA of molecular diagnostics for TB diagnosis in 2018. GeneXpert (74.6%, 53/71) was the most predominant molecular method, followed by GeneChip (32.3%, 23/71), MeltPro (22.5%, 16/71), and TB-LAMP (7.0%, 5/71). Out of 105 EQA panels, 103 EQA results (98.1%) achieved perfect scores, whereas the other two (1.9%) had satisfactory scores. There were a total of two false-negative results reported from two laboratories with local LAMP, respectively. In conclusion, we firstly develop feasible EQA panels for molecular diagnostics for tuberculosis in China. Our data demonstrate that a majority of participating laboratories are able to produce perfect results with molecular diagnostics in China, giving us important hints for the implementation of molecular diagnostics.

Healing and healing rates of chronic wounds in the age of molecular pathogen diagnostics

To compare healing outcomes at a wound healing centre both before and after the introduction of molecular pathogen diagnostics. An IT consultant was recruited to analyse the medical records of patients at a wound healing centre, comparing patient groups from 2007 and 2009 - before and after the introduction of comprehensive molecular pathogen diagnostic methods. Before the implementation of molecular diagnostics, 244/503 patients (48.5%) healed completely, while after implementation 298/479 patients (62.4%) healed. Furthermore, based on survival analysis and after controlling for potential confounding factors, time to healing was significantly shorter in 2009 than 2007 (p<0.05). Specifically, biofilm-based wound care, along with the implementation of comprehensive molecular diagnostics for venous leg ulcers, pressure ulcers and diabetic foot ulcers and all wounds combined showed, respectively, 21%, 23%, 25% and 22% reductions in the time to healing. In addition, after implementing molecular diagnostics, the use of expensive fi rst-line antibiotics also declined in 2009, while a broader range of targeted antibiotics was used. The results of modern molecular pathogen diagnostic applications allow comprehensive evaluation of the microbial bioburden in chronic wounds. This comprehensive diagnostic in turn has led to a more precise and targeted therapeutic approach to wound care. With the comprehensive nature of molecular diagnostics future advances in topical patient specific therapeutics are now possible.

Nanotechnology and diagnostics in the age of omics

High-throughput technologies driving anonymous discovery in various omic fields are being integrated into medical diagnostics. Nanoscale innovations in chip technology, detection capabilities, and molecular imaging provide both stand-alone applications and promise to improve sensitivity, resolution, and detection limits of current methodologies employing micron or larger scale techniques. However, characterisation of valid biomarkers and development of appropriate information technology infrastructure represent apparent bottlenecks for implementation of molecular diagnostics. This review will highlight various technologies at the micron and nano-scales with potential to change medical diagnostics, as well as discuss these potential implementation barriers and current initiatives to address them.