1 Sue and Bill Gross Stem Cell Research Center, University of California-Irvine, Irvine, CA, USA.
7 Department of Physics and Engineering, Fort Lewis College, Durango, Colorado, USA.
SLAS Technol. 2017 Dec;22(6):585-608. doi: 10.1177/2472630317727519. Epub 2017 Aug 29.
Rapid bacterial identification (ID) and antibiotic susceptibility testing (AST) are in great demand due to the rise of drug-resistant bacteria. Conventional culture-based AST methods suffer from a long turnaround time. By necessity, physicians often have to treat patients empirically with antibiotics, which has led to an inappropriate use of antibiotics, an elevated mortality rate and healthcare costs, and antibiotic resistance. Recent advances in miniaturization and automation provide promising solutions for rapid bacterial ID/AST profiling, which will potentially make a significant impact in the clinical management of infectious diseases and antibiotic stewardship in the coming years. In this review, we summarize and analyze representative emerging micro- and nanotechnologies, as well as automated systems for bacterial ID/AST, including both phenotypic (e.g., microfluidic-based bacterial culture, and digital imaging of single cells) and molecular (e.g., multiplex PCR, hybridization probes, nanoparticles, synthetic biology tools, mass spectrometry, and sequencing technologies) methods. We also discuss representative point-of-care (POC) systems that integrate sample processing, fluid handling, and detection for rapid bacterial ID/AST. Finally, we highlight major remaining challenges and discuss potential future endeavors toward improving clinical outcomes with rapid bacterial ID/AST technologies.
由于耐药菌的出现，快速细菌鉴定（ID）和抗生素药敏试验（AST）的需求很大。传统的基于培养的 AST 方法存在较长的周转时间。由于需要，医生经常不得不凭经验用抗生素治疗患者，这导致了抗生素的不当使用、死亡率和医疗保健成本升高以及抗生素耐药性。微型化和自动化的最新进展为快速细菌 ID/AST 分析提供了有前途的解决方案，这将在未来几年内对传染病的临床管理和抗生素管理产生重大影响。在这篇综述中，我们总结和分析了有代表性的新兴微纳技术，以及用于细菌 ID/AST 的自动化系统，包括表型（例如基于微流控的细菌培养和单细胞的数字成像）和分子（例如多重 PCR、杂交探针、纳米颗粒、合成生物学工具、质谱和测序技术）方法。我们还讨论了集成样本处理、流体处理和快速细菌 ID/AST 检测的有代表性的即时检测（POC）系统。最后，我们强调了主要的剩余挑战，并讨论了通过快速细菌 ID/AST 技术改善临床结果的潜在未来努力。
