Modern Microbiology

The tests laboratories use to find out the cause of diarrhoea and vomiting infections can take up to three days to produce results. These tests may not find all the bugs, known as microorganisms, that are in a sample. Also, because there are different types of the same microorganism, when these tests have been completed more specialist investigations are needed to identify the exact type of microorganism found. Therefore it can take several days or even weeks to identify outbreaks of diarrhoea and vomiting.

To speed up initial diagnosis of a patient’s infection and the identification of outbreaks of diarrhoea and vomiting, this study will use two modern microbiological approaches:

1. Rapid Molecular diagnostics

Genetic markers are used to identify the microorganisms, or bugs, that cause disease and to tell them apart from other microorganisms that do not cause illness. Rapid molecular diagnostic tests detect the specific genetic markers of the microorganisms that cause diarrhoea and vomiting.

Faecal (stool) samples from patients in primary care will be tested at one of three NHS laboratories (Liverpool, Manchester, Preston) using a commercially available, approved, rapid molecular testing system. This system detects most of the microorganisms that cause diarrhoea and vomiting, and gives results within 24 hours.  (Note: Results will be reported electronically as soon as available but there may be some delays depending on the time and the day the specimen arrives at the laboratory).   All of the samples will also be tested using the current routine, traditional laboratory tests. The results of the traditional tests will be compared with the results of the rapid molecular tests to evaluate the new approach.

All test results will be reported to General Practitioners and to Public Health England. Public Health England will take any public health action that is needed.

2. State of the art microbial genomics and metagenomics

Microbial genomics and metagenomics are leading edge/ground breaking research methods that determine the genetic code of a microorganism. The Centre for Genomic Research, University of Liverpool uses these research methods and will apply them in this study:

  • To give more detailed information on the microorganisms detected by the rapid molecular diagnostic tests described above and to develop new methods for rapid identification and typing of microorganisms. These new methods will then improve how outbreaks of disease are recognised.
  • Directly to faecal (stool) samples to search for and identify new microorganisms that could cause disease.