Muldrew Kenneth L
Section of Infectious Diseases, Department of Internal Medicine, Yale University, School of Medicine, New Haven, Connecticut, USA.
Curr Opin Pediatr. 2009 Feb;21(1):102-11. doi: 10.1097/MOP.0b013e328320d87e.
PURPOSE OF REVIEW: The purpose of this article is to review the molecular methods commonly used in medical microbiology as well as to update the clinician as to newer molecular technologies that show promise in the identification of microorganisms as well as evaluation of the presence of virulence factors and antibiotic resistance determinants. RECENT FINDINGS: Numerous molecular assays have been developed recently using a variety of technologies. Direct hybridization techniques have allowed analysis of blood culture bottles for organisms such as methicillin-resistant Staphylococcus aureus. Target amplification methods allow postamplification analysis using a variety of technologies depending on the clinical needs for the assay. Postamplification analysis includes methods such as Sanger sequencing, pyrosequencing, reverse hybridization, and Luminex analysis, which are becoming more widely utilized. In the future, whole genome sequencing, mass spectrometry, and microarray analysis may provide a wealth of information that can be used to specifically tailor the treatment of infectious diseases. SUMMARY: The implications of current trends in molecular infectious diseases are moving towards high-throughput, simple, array-type technologies that will provide a wealth of data regarding types of organisms present in a sample and the virulence factors/resistance determinants that influence the severity of disease. As a result of these developments, infectious diseases will be more accurately and effectively treated.
综述目的:本文旨在回顾医学微生物学中常用的分子方法,并向临床医生介绍一些新的分子技术,这些技术在微生物鉴定、毒力因子检测及抗生素耐药性检测方面展现出了应用前景。 最新发现:近年来,利用多种技术开发了众多分子检测方法。直接杂交技术可用于分析血培养瓶中的耐甲氧西林金黄色葡萄球菌等微生物。目标扩增方法可根据检测的临床需求,利用多种技术进行扩增后分析。扩增后分析包括桑格测序、焦磷酸测序、反向杂交和Luminex分析等方法,这些方法的应用越来越广泛。未来,全基因组测序、质谱分析和微阵列分析可能会提供大量信息,用于指导传染病的精准治疗。 总结:分子传染病学当前的发展趋势正朝着高通量、简单的阵列式技术发展,这些技术将提供有关样本中存在的微生物类型以及影响疾病严重程度的毒力因子/耐药决定因素的大量数据。基于这些进展,传染病将得到更准确、有效的治疗。
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