Tan Thean Yen
Department of Microbiology, Cardiff Public Health Laboratory Service, University Hospital Wales, Cardiff, CF14 4XW.
Expert Rev Mol Diagn. 2003 Jan;3(1):93-103. doi: 10.1586/14737159.3.1.93.
The introduction of antibiotics in the 1930s revolutionized the treatment of previously fatal infections. Unfortunately, bacteria adapted quickly to this threat and antibiotic resistance soon developed. Both penicillin and methicillin resistance in Staphylococcus aureus were noted almost immediately following the introduction of penicillin and the penicillinase-resistant penicillins respectively. Antibiotic susceptibility testing rapidly became an integral part of the management of patients with infectious disease and remains the basis for clinical decision-making and antibiotic selection. However, the fundamental principles underlying antibiotic susceptibility testing methods have remained largely unchanged over the last few decades. Due to the inherent time delay imposed by bacterial growth rates, culture-based systems have traditionally provided results several hours to days after initial isolation. Better understanding of the genetic basis of resistance has resulted in the development of molecular methods to detect the genetic changes or mutations present in resistant bacterial phenotypes. Microbiologists and clinicians are faced with increasing options for the use of genotypic or phenotypic methods. This review provides an insight into the current molecular methods available for the detection of antibiotic resistance and to provide a basis for evaluating the choice of testing method to be used.
20世纪30年代抗生素的引入彻底改变了对以前致命感染的治疗方法。不幸的是，细菌很快适应了这种威胁，抗生素耐药性随即出现。分别在青霉素和耐青霉素酶青霉素引入后不久，就发现了金黄色葡萄球菌对青霉素和甲氧西林的耐药性。抗生素敏感性测试迅速成为传染病患者管理中不可或缺的一部分，并且仍然是临床决策和抗生素选择的基础。然而，在过去几十年中，抗生素敏感性测试方法的基本原理在很大程度上保持不变。由于细菌生长速度固有的时间延迟，基于培养的系统传统上在初次分离后数小时至数天才能提供结果。对抗生素耐药性遗传基础的深入了解导致了分子方法的发展，以检测耐药细菌表型中存在的基因变化或突变。微生物学家和临床医生在使用基因型或表型方法方面面临着越来越多的选择。本综述深入探讨了目前可用于检测抗生素耐药性的分子方法，并为评估所使用测试方法的选择提供依据。
