Hypothesis-Free Molecular Microbiology: The Case for a Universal Sequencing-Based Diagnostic Test
This perspective article envisions a paradigm shift from symptom-guided, pathogen-specific microbiological testing toward a single universal sequencing-based assay capable of detecting any nucleic acid in a clinical sample. The authors discuss the technical requirements for such hypothesis-free testing, including sufficient sensitivity, turnaround time, and interpretive frameworks. While acknowledging significant remaining barriers, the review argues this approach could fundamentally change how infectious diseases are diagnosed.
The original study
Towards a Universal Molecular Microbiological Test.
- Authors
- Allcock RJN, Jennison AV, Warrilow D
- Journal
- Journal of clinical microbiology
- Type
- Journal Article, Review
- PMID
- 28835478
Original abstract
The standard paradigm for microbiological testing is dependent on the presentation of a patient to a clinician. Tests are then requested based on differential diagnoses using the patient's symptoms as a guide. The era of high-throughput genomic methods has the potential to replace this model for the first time with what could be referred to as "hypothesis-free testing." This approach utilizes one of a variety of methodologies to obtain a sequence from potentially any nucleic acid in a clinical sample, without prior knowledge of its content. We discuss the advantages of such an approach and the challenges in making this a reality.