There are many reasons NGS is a far superior tool in identifying microbes, NOT having to grow anything is just one reason why. Reasons the MicroLab did not find or grow microbes that we detect with DNA sequencing:

1. Science has proven that less than 1% of all microbes can be detected by traditional culture.
2. Pradeep Singh, MD has recently shown (Singh P Copenhagen biofilm meeting 2011-site this) “that cells of Pseudomonas aeruginosa undergo a structural change in the lipopolysaccharide (LPS) of their outer membranes that makes them unable to grow on the surface of agar plates, even if the medium is otherwise ideal.
3. There are National Guidelines for Microbiology (cultures). These guidelines are established by the IDSA and ASM. They require your sample for culture to be at the microlab in 2 hours and kept at room temperature. Why does the IDSA and ASM have strict sample management criteria ? They know that in order for the sample to “grow” it has to be at the lab in a condition that allows the lab to have a chance to successfully grow the specimen on the plate. Look at the lab boxes sitting outside medical offices and ask yourself, “Is that swab or urine specimen going to be at the lab in 2 hours?”
4. PCR and NGS do not have the same limitations of time and temperature as culture!
5. The microbes were part of a biofilm and have changed their genotype and phenotype and “refuse” to grow.
   
   1. The microbes created a team to successfully fool traditional and archaic testing methods.
6. Wrong media was used: If the microbes are anaerobes, they are extremely difficult to grow in desired conditions and will not grow in “normal” agar environments.
7. Fungi takes weeks to grow, if at all.
8. MicroGenDX laboratory uses Molecular Diagnostics of PCR and NGS to identify the microbes by extracting the microbial DNA within each sample. In the PCR Test Level I we detect a precise number of microbes typically known to cause the specific infection. We also identify Antibiotic resistance gene markers and deliver the overall bacteria load within 24 hours. We then take the extracted DNA and use this on our NGS Test or Level II and match the DNA sequence codes to a national data base of 50,000 known microbes to accurately deliver the microbial data of what is really inside the sample collected from the infection site.

Yes, there may be contaminants listed on your report. How could contaminants appear on my lab report?

Contamination could happen during the sampling process. For example, if proper skin prep is not done correctly, normal flora on the skin may attach itself to the needle while penetrating the skin for an aspiration sample of say a knee or shoulder. For example, this should be considered if Staph Epi or P Acne are listed on your lab report. Also we know that lactobacillus is a normal flora in the vaginal area. Normal flora may be on the list but not part of the problem.

Remember, these microbes are there for a reason and if balanced, live in harmony with the host. The area of the sample collection needs to be considered when reviewing your report to determine which microbes are to be treated.