Use of genomic technologies for rapid molecular diagnosis and surveillance of infectious disease has become increasingly important to clinical care and public health practice.56 Specifically, microbial genomic diagnostics have proven useful in a series of high profile disease outbreaks, including the Haitian cholera epidemic, the toxigenic E. coli outbreak in Europe, and a lethal drug resistant Klebsiella outbreak at the NIH Clinical Center.57-60 A recent study retrospectively used microbial genome sequencing to characterize a serious outbreak of MRSA in a neonatal intensive care unit; such techniques may soon become the front line of epidemiologic investigation.61 Numerous commercially available molecular diagnostics tests in clinical care are based on older genetic testing methods for rapid diagnosis of MRSA, gonorrhea, chlamydia, tuberculosis, and a wide variety of viral infections. In many cases, pediatricians ordering these tests are likely unaware that they have ordered “genetic” tests.
