Maurer F P, Hentschke M, Rohde H
Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
Antibiotic Stewardship Team, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
Med Klin Intensivmed Notfmed. 2017 Apr;112(3):199-205. doi: 10.1007/s00063-017-0275-z. Epub 2017 Mar 24.
In the light of ever increasing problems related to the emergence of multidrug-resistant bacteria, rapid microbiological diagnostics are of growing importance. Timely pathogen detection and availability of susceptibility data are essential for optimal treatment, but are even more crucial for de-escalation of broad spectrum empiric therapies. Medical microbiology is, thus, an integral part of antimicrobial stewardship programs. Traditional microbiological techniques for species identification and susceptibility testing rely on bacterial growth and are, thus, characterized by inherent slowness. Time-to-report is usually 48 h or longer, and typically delays optimization of therapeutic regimens. Constant improvement of available techniques (e. g., molecular methods) and introduction of novel methods (e. g., matrix-assisted laser desorption ionization time-of-flight [MALDI-ToF] mass spectrometry) have fundamentally changed diagnostic procedures. As a consequence, sensitivity and specificity as well as time-to-report have been dramatically improved. In this manuscript, key methodological advances in medical microbiology are discussed, emphasizing consequences for daily management of infectious disease patients.
鉴于与多重耐药菌出现相关的问题日益增多，快速微生物诊断变得越来越重要。及时的病原体检测和药敏数据的可用性对于优化治疗至关重要，但对于广谱经验性治疗的降阶梯更为关键。因此，医学微生物学是抗菌药物管理计划的一个组成部分。用于菌种鉴定和药敏试验的传统微生物技术依赖于细菌生长，因此具有固有的缓慢特点。报告时间通常为48小时或更长，通常会延迟治疗方案的优化。现有技术（如分子方法）的不断改进和新方法（如基质辅助激光解吸电离飞行时间[MALDI-ToF]质谱）的引入从根本上改变了诊断程序。结果，灵敏度、特异性以及报告时间都得到了显著改善。在本手稿中，讨论了医学微生物学的关键方法进展，强调了对传染病患者日常管理的影响。
