Review Article

Ann Lab Med 2013; 33(1): 14-27

Published online January 1, 2013

Copyright © Korean Society for Laboratory Medicine.

Rapid Clinical Bacteriology and Its Future Impact

Alex van Belkum, Ph.D.1, Géraldine Durand, M.D.1, Michel Peyret, Ph.D.1, Sonia Chatellier, Ph.D.1, Gilles Zambardi, Ph.D.1, Jacques Schrenzel, M.D.2, Dee Shortridge, Ph.D.3, Anette Engelhardt, Ph.D.3, and William Michael Dunne Jr, Ph.D.3

BioMérieux SA1, Unit Microbiology, R&D Microbiology, La Balme Les Grottes, France; Geneva University Hospitals2, Laboratory of Bacteriology and Genomic Research Laboratory, Geneva, Switzerland; BioMérieux Inc.3, Unit Microbiology, Franchise ID/AST, St. Louis, MO, USA

Correspondence to: Alex van Belkum
BioMérieux SA, Unit Microbiology, R&D Microbiology, 3, Route de Porte Michaud, 38390 La Balme Les Grottes, France
Tel: +0033474952656
Fax: +0033474952599

Received: August 6, 2012; Accepted: October 10, 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Clinical microbiology has always been a slowly evolving and conservative science. The sub-field of bacteriology has been and still is dominated for over a century by culturebased technologies. The integration of serological and molecular methodologies during the seventies and eighties of the previous century took place relatively slowly and in a cumbersome fashion. When nucleic acid amplification technologies became available in the early nineties, the predicted “revolution” was again slow but in the end a real paradigm shift did take place. Several of the culture-based technologies were successfully replaced by tests aimed at nucleic acid detection. More recently a second revolution occurred. Mass spectrometry was introduced and broadly accepted as a new diagnostic gold standard for microbial species identification. Apparently, the diagnostic landscape is changing, albeit slowly, and the combination of newly identified infectious etiologies and the availability of innovative technologies has now opened new avenues for modernizing clinical microbiology. However, the improvement of microbial antibiotic susceptibility testing is still lagging behind. In this review we aim to sketch the most recent developments in laboratory-based clinical bacteriology and to provide an overview of emerging novel diagnostic approaches.

Keywords: Antimicrobial susceptibility testing (AST), Antibiotics, Antibiogram, Drug resistance, Laboratory automation, DNA testing, MALDI-TOF MS, Innovation