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兽医皮肤病学中的诊断微生物学:现状与未来。

Diagnostic microbiology in veterinary dermatology: present and future.

作者信息

Guardabassi Luca, Damborg Peter, Stamm Ivonne, Kopp Peter A, Broens Els M, Toutain Pierre-Louis

机构信息

Department of Biomedical Sciences, Ross University School of Veterinary Medicine, PO Box 334, Basseterre, St Kitts and Nevis, West Indies.

Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Stigbøjlen 4, 1870, Frederiksberg, Denmark.

出版信息

Vet Dermatol. 2017 Feb;28(1):146-e30. doi: 10.1111/vde.12414.

Abstract

BACKGROUND

The microbiology laboratory can be perceived as a service provider rather than an integral part of the healthcare team.

OBJECTIVES

The aim of this review is to discuss the current challenges of providing a state-of-the-art diagnostic veterinary microbiology service including the identification (ID) and antimicrobial susceptibility testing (AST) of key pathogens in veterinary dermatology.

METHODS

The Study Group for Veterinary Microbiology (ESGVM) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) identified scientific, technological, educational and regulatory issues impacting the predictive value of AST and the quality of the service offered by microbiology laboratories.

RESULTS

The advent of mass spectrometry has significantly reduced the time required for ID of key pathogens such as Staphylococcus pseudintermedius. However, the turnaround time for validated AST methods has remained unchanged for many years. Beyond scientific and technological constraints, AST methods are not harmonized and clinical breakpoints for some antimicrobial drugs are either missing or inadequate. Small laboratories, including in-clinic laboratories, are usually not adequately equipped to run up-to-date clinical microbiologic diagnostic tests.

CONCLUSIONS AND CLINICAL IMPORTANCE

ESGVM recommends the use of laboratories employing mass spectrometry for ID and broth micro-dilution for AST, and offering assistance by expert microbiologists on pre- and post-analytical issues. Setting general standards for veterinary clinical microbiology, promoting antimicrobial stewardship, and the development of new, validated and rapid diagnostic methods, especially for AST, are among the missions of ESGVM.

摘要

背景

微生物学实验室可能被视为服务提供者,而非医疗团队的一个组成部分。

目的

本综述的目的是讨论提供一流诊断兽医微生物学服务当前面临的挑战,包括兽医皮肤病学中关键病原体的鉴定(ID)和抗菌药敏试验(AST)。

方法

欧洲临床微生物学和传染病学会(ESCMID)的兽医微生物学研究组(ESGVM)确定了影响AST预测价值以及微生物学实验室所提供服务质量的科学、技术、教育和监管问题。

结果

质谱技术的出现显著缩短了诸如中间型葡萄球菌等关键病原体的鉴定所需时间。然而,多年来经过验证的AST方法的周转时间一直没有变化。除了科学和技术限制外,AST方法不统一,一些抗菌药物的临床断点缺失或不充分。小型实验室,包括诊所内的实验室,通常没有配备足够的设备来进行最新的临床微生物学诊断测试。

结论及临床意义

ESGVM建议使用采用质谱技术进行ID鉴定、肉汤微量稀释法进行AST检测的实验室,并由专业微生物学家在分析前和分析后问题上提供协助。为兽医临床微生物学设定通用标准、促进抗菌药物管理以及开发新的、经过验证的快速诊断方法,尤其是针对AST的方法,是ESGVM的任务之一。

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