The role and impact of molecular diagnostics in modern clinical microbiology

Molecular diagnostics is defined as methods using detection of genomic  material or variants to detect, diagnose, classify, prognosticate, and guide  treatment for illness. It has playing an increasing role in diagnostic testing  within the specialty of clinical microbiology since the 1990s. There has been  growing use of different molecular diagnostics ranging in the specialty, from  whole genome sequencing in reference laboratories to point-of-care testing of  infectious diseases in the last 10 years. Each molecular method provides its  own unique strengths and weaknesses in diagnosing infectious diseases.  Nonetheless, diagnostic technologies can often outpace evidence for their  clinical utility in guiding patient management. It is important that research is  undertaken to ascertain the benefit of molecular diagnostics with regard to the diagnosis of illnesses, management of patients, antimicrobial prescribing and  infection prevention and control practices. This thesis aims to look at this  important research question by exploring the clinical utility of three different  molecular diagnostic methods applied to a large tertiary referral hospital in  the Mid-West of Ireland in the last 8 years. Unique challenges pertinent to  Mid-West of Ireland include bed shortages and severe crowding of the  emergency department, especially during peak seasonal influenza periods. In  this setting, molecular diagnostics have the potential role to expedite patient  care and allowing the optimisation of healthcare resources by reducing the  impact of costly healthcare associated outbreaks of infection. The results of  this thesis will help with understanding of the role of molecular diagnostics for infectious diseases in the Irish healthcare system and hopefully lead to  further research in the area.