One of your recent papers looked at the ability of “matrix-assisted laser desorption ionization-time of flight mass spectrometry” to identify bacteria. In a nutshell, what is this method and why doesn’t it have a handy acronym?
This technology has many applications, one of which is the identification of bacteria (or fungi) growing in culture. To identify bacteria, highly abundant proteins generate unique mass spectrometric signatures that are run against a database of mass spectrometric signatures representing a wide range of bacteria (and fungi). This analysis determines what type of organism is present.
Matrix-assisted laser desorption ionization-time of flight mass spectrometry was invented in the 1980s and subsequently applied to the field of microbiology. It turned out to provide a highly accurate, fast, and relatively inexpensive tool for bacterial (and fungal) identification. Just as important as mass spectrometry is the involved bioinformatics—to me, it is a new “app.”
Terminology needs to be specific or it can be confusing. The “easier” term that’s used in the field is “MALDI-TOF MS,” a term that may not be handy either, since I’ve heard it mistakenly referred to as “Mazel-tov” and “Molotov!”
Your research group has also investigated how to treat biofilm infections with electrical current. Practically speaking, how is this done? Are the infections on implanted devices? On bone?
In my laboratory, we are interested in biofilm pathophysiology, and biofilm-directed diagnostics and therapeutics. One of the challenges of biofilms is that they are relatively resistant to antibiotics. We’re looking at new ways to treat biofilm-associated infections. We showed that a low amount of electric current could treat bacterial biofilms.
We did this with in vitro studies and also an animal model experiment using rabbits. We implanted a foreign body in leg bones infected with Staphylococcus epidermidis. We then treated the animals with a low level of electric current, which was effective in treating the infection. We are not ready to move this into humans yet, but this approach might be useful for management of infected implanted devices in the future.
You’ve done quite a bit of work on biofilm infections on implanted devices. I imagine that as baby boomers age, we’ll be learning more about the hazards of infections associated with joint replacements and other implants. Do you think implants are safe? Would you get one, for instance?
If I needed an implant I would not hesitate to get one. Nothing that we do in life is 100% safe. With implants, there is a very small risk of infection, but there are things that can be done to minimize risk, such as controlling diabetes, losing weight, and, of course, enlisting a competent and experienced surgeon. If there were to be any question of implant failure (for infection or otherwise), I would make sure that I had a medical team experienced with arthroplasty failure.
Overall joint replacements are safe, and people do very well with them, which is why they are so popular.
Where do you see your field in 10 years?
Clinical microbiology is in the midst of a revolution. We now have relatively mature molecular diagnostics, many of which are evolving to panel molecular testing. I predict that there will be widespread adoption of MALDI-TOF MS and increased automation, but that we will still need experienced microbiologists because of the nature of the organisms that we deal with and their ability to rapidly evolve. I also predict that there will be a focus on clinical usefulness and cost effectiveness of diagnostics.
As far as biofilms, I anticipate that we will have more refined and developed biofilm-directed diagnostics and therapeutics.
If you had to change careers today and you could do anything, what would you do?
I can’t think of a better career than this one—I would try to stay in my current career.
What’s your favorite science book?
On the 50th anniversary of ICAAC, ASM published a book called 50 Years of ICAAC: 1960-2010 Contributions to Science. This book provides the history not just of ICAAC, but of antimicrobial therapy and clinical microbiology diagnostics. It highlights science, microbes, epidemics, therapeutics, and diagnostics all while containing some wonderful photos. I would encourage everyone to read and look this book.
What is something about you that most people don’t know?
I play the piano, mostly to accompany my son, who plays the violin. Typically we play violin concertos.