Leibniz Institute of Photonic Technology, Albert-Einstein-Str. 9, 07745, Jena, Germany.
Jena Biophotonics and Imaging Laboratory, 07745, Jena, Germany.
Appl Microbiol Biotechnol. 2019 Jan;103(2):549-566. doi: 10.1007/s00253-018-9505-4. Epub 2018 Nov 15.
The development of antibiotic resistances in common pathogens is an increasing challenge for therapy of infections and especially severe complications like sepsis. To prevent administration of broad-spectrum and potentially non-effective antibiotics, the susceptibility spectrum of the pathogens underlying the infection has to be determined. Current phenotypic standard methods for antibiotic susceptibility testing (AST) require the isolation of pathogens from the patient and the subsequent culturing in the presence of antibiotics leading to results only after 24-72 h. Since the early initialization of an effective antibiotic therapy is crucial for positive treatment result in severe infections, faster methods of AST are urgently needed. A large number of different assay systems are currently tested for their practicability for fast detection of antibiotic resistance profiles. They can be divided into genotypic ones which detect the presence of certain genes or gene products associated with resistances and phenotypic assays which determine the effect of antibiotics on the pathogens. In this mini-review, we summarize current developments in fast phenotypic tests that use photonic approaches and critically discuss their status. We further outline steps that are required to bring these assays into clinical practice.
抗生素耐药性在常见病原体中的发展是治疗感染的一个日益严峻的挑战，尤其是对于脓毒症等严重并发症。为了防止使用广谱且可能无效的抗生素，必须确定感染病原体的药敏谱。目前用于抗生素药敏试验（AST）的表型标准方法需要从患者中分离病原体，并在存在抗生素的情况下进行培养，这导致结果只能在 24-72 小时后得出。由于在严重感染中尽早开始有效的抗生素治疗对于治疗结果至关重要，因此迫切需要更快的 AST 方法。目前正在对大量不同的检测系统进行测试，以评估其用于快速检测抗生素耐药谱的实用性。它们可以分为检测与耐药性相关的特定基因或基因产物存在的基因型检测系统和确定抗生素对病原体影响的表型检测系统。在这篇小型综述中，我们总结了目前使用光子方法的快速表型检测方法的发展，并批判性地讨论了它们的现状。我们进一步概述了将这些检测方法应用于临床实践所需的步骤。
