In this session we will revisit the strategies that are moving microbiology more and more into the realm of molecular analysis in the clinical laboratory. We will evaluate the use of identifying organisms versus identifying genes and monitoring the systems that organisms use to evolve and transfer mobile genetic elements across species and genera. In addition we will consider the advances as microbiology and the development of personalized medicine to manage the transfer of AMR as well as the molecular physiological responses the bacteria use to mitigate the immune system.