385predictive model based on a set of signifi cant SNPs and indels showed a high degree
of accuracy in predicting an isolate’s toxicity solely from the genetic signature at these
sites. The results thus highlight the potential of using sequence data to determine clini-
cally relevant parameters and for understanding the microbial virulence of MRSA.
Role of Rapid Molecular Diagnosis at Point of Care
In medicine, quantitative measurement of specifi c strains of infectious organisms is
very important in emergency situations because the physician must start therapy
immediately if the patient is in critical condition. An effective test must be precise,
rapid, and also measure the infectious burden. At the same time, better testing will
quickly identify the organism’s strain and drug susceptibility, reducing the delay in
fi nding the right antibiotic.
Traditional diagnostic testing often requires several days to isolate and grow the
infectious organism, and to test its sensitivity to specifi c antibiotics. Until then, the
physician must use powerful broad-spectrum antibiotics. Widespread use of these
antibiotics leads to the emergence of drug resistance, which then narrows the num-
ber of drugs available to treat serious infections. PCR-based tests for the <1 h detec-
tion and identifi cation of infectious agents are being developed that will revolutionize
the decision-making process of health care professionals.
Detection, identifi cation, and characterization of pathogens is being revolution-
ized by the combination of the seemingly disparate fi elds of nucleic acid analysis,
bioinformatics, data storage and retrieval, nanotechnology, physics, microelectron-
ics, and polymer, solid state, and combinatorial chemistry. The fi rst application of
DNA chips in POC testing will probably be for identifying pathogens and their
antimicrobial resistance potential. These developments, particularly with regard to
POC testing, have important implications for the delivery of health care. It will be
possible to miniaturize test kits, which can be swallowed or added to body fl uids
and coupled with data transmitters so that results can be sent to remote site for
analysis. Rapid molecular diagnosis will improve the initial management of the
patient, determine the need for isolation and help the selection of optimal antimicro-
bials if they are needed. Nanotechnology-based tests for detection of microorgan-
isms are also in development. These refi nements in diagnostic technologies will not
only enable personalized management of infections but will also be an important
factor in the control of emergence of microbial resistance and epidemics.
Personalized Vaccines Against Bacterial Infections
There are inter-individual variations in immune response to commonly used pro-
phylactic vaccines against infectious diseases, which are is infl uenced by sex, MHC,
age and hormones status of individuals. Natural microbiota in the gastrointestinal
tract appear to contribute to nearly every aspect of physiology of the host. It may be
responsible for diverse vaccine effi cacy observed in humans from developing
Personalized Management of Bacterial Infections