Bonkat G, Seifert H-H, Halla A, Bachmann A
Urologische Klinik Universitätsspital Basel.
Aktuelle Urol. 2016 May;47(3):210-3. doi: 10.1055/s-0042-103197. Epub 2016 Apr 20.
Urine culture (UC) confirms the diagnosis of urinary tract infection (UTI) and is still considered the diagnostic 'gold standard' for pathogen identification, quantification and resistance testing. However, up to 80% of samples will not yield bacterial growth. Different techniques are currently approved for resistance testing. However, all of them are culture based and have the disadvantage of being very slow. In the field of urology, the development of drug resistance of uropathogens complicates the optimal administration of antimicrobial agents not only in the treatment, but also in the prevention of UTI before endourological and open surgical procedures. In this context, rapid identification of microbiological agents, including timely antimicrobial resistance testing (ART) is desirable. This overview presents alternative techniques (flow cytometry, PCR-based techniques, MALDI-TOF MS and microcalorimetry) to urine culture and discusses their advantages and disadvantages.
尿培养(UC)可确诊尿路感染(UTI),目前仍被视为病原体鉴定、定量及耐药性检测的诊断“金标准”。然而,高达80%的样本无法培养出细菌生长。目前有不同技术获批用于耐药性检测。然而,所有这些技术均基于培养,且存在速度非常慢的缺点。在泌尿外科领域,尿路病原体耐药性的发展不仅使抗菌药物在治疗UTI时的最佳给药变得复杂,而且在内镜及开放手术前预防UTI时也如此。在此背景下,快速鉴定微生物病原体,包括及时进行抗菌药物耐药性检测(ART)是很有必要的。本综述介绍了尿培养的替代技术(流式细胞术、基于PCR的技术、基质辅助激光解吸电离飞行时间质谱及微量量热法),并讨论了它们的优缺点。