Vila Jordi, Gómez María Dolores, Salavert Miguel, Bosch Jordi
ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, España; Servicio de Microbiología, Centro de Diagnóstico Biomédico, Hospital Clínic, Barcelona, España.
Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, España.
Enferm Infecc Microbiol Clin. 2017 Jan;35(1):41-46. doi: 10.1016/j.eimc.2016.11.004. Epub 2016 Dec 16.
The diagnostic methods of infectious diseases should be fast, accurate, simple and affordable. The speed of diagnosis can play a crucial role in healing the patient, allowing the administration of appropriate antibiotic treatment. One aspect that increasingly determines the need for rapid diagnostic techniques is the increased rates of serious infections caused by multidrug resistant bacteria, which cause a high probability of error in the empirical treatment. Some of the conventional methods such as Gram staining or antigen detection can generate results in less than 1 hour but lack sensitivity. Today we are witnessing a major change in clinical microbiology laboratories with the technological advances such as molecular diagnostics, digital microbiology and mass spectrometry. There are several studies showing that these changes in the microbiological diagnosis reduce the generation time of the test results, which has an obvious clinical impact. However, if we look into the future, other new technologies which will cover the needs required for a rapid microbiological diagnosis are on the horizon. This review provides an in depth analysis of the clinical impact that the implementation of rapid diagnostic techniques will have on unmet clinical needs.
传染病的诊断方法应快速、准确、简便且经济实惠。诊断速度对于治愈患者至关重要,能够使患者及时接受适当的抗生素治疗。越来越多地决定了对快速诊断技术需求的一个因素是多重耐药菌引起的严重感染发生率上升,这导致经验性治疗出现高错误率。一些传统方法,如革兰氏染色或抗原检测,可在不到1小时内得出结果,但缺乏敏感性。如今,随着分子诊断、数字微生物学和质谱等技术进步,临床微生物学实验室正在经历重大变革。有多项研究表明,微生物诊断方面的这些变化缩短了检测结果的生成时间,具有明显的临床影响。然而,展望未来,其他能够满足快速微生物诊断所需的新技术即将出现。本综述深入分析了快速诊断技术的实施对未满足的临床需求将产生的临床影响。