Sullivan Kaede V
Department of Pathology and Laboratory Medicine, Temple University Health System, Temple University Hospital, Lewis Katz School of Medicine at Temple University, 3401 N. Broad St., Room A2 F329, Philadelphia, PA, 19140, USA.
Curr Infect Dis Rep. 2019 May 1;21(6):20. doi: 10.1007/s11908-019-0676-7.
The primary purpose of this review is to provide a summary of new and emerging laboratory technologies and testing platforms that impact infection prevention and antimicrobial stewardship programs. This review also summarizes available data describing the clinical impact of implementing these new technologies.
While there is ample evidence that rapid organism identification technologies for positive blood cultures can ameliorate antimicrobial utilization, an assay that also provides expedited antimicrobial susceptibility testing results is now available and its clinical impact is under investigation. For C. difficile infection diagnosis, data related to performance and impact of "ultrasensitive" toxin assays is emerging in the literature although their role in C. difficile infection diagnosis remains unclear. For hospital-acquired pneumonia, a variety of rapid, automated, multiplexed, "pneumonia" panels have become commercially available and may impact surveillance definitions for ventilator-associated events. Finally, recent FDA clearance of various biochemical and molecular carbapenemase detection tests will facilitate rapid characterization of carbapenem-resistant organisms. Innovations in infectious diseases diagnostics have been making swift strides, broadening diagnostic scope; increasing accuracy and sensitivity; and reducing turnaround time. Many of these innovations directly impact infection prevention and antimicrobial stewardship operations. Close collaboration between infection control, antimicrobial stewardship, and the microbiology laboratory is necessary to ensure that new tests improve patient outcomes.
本综述的主要目的是总结影响感染预防和抗菌药物管理计划的新兴实验室技术和检测平台。本综述还总结了描述实施这些新技术的临床影响的现有数据。
虽然有充分证据表明用于阳性血培养的快速微生物鉴定技术可改善抗菌药物的使用，但现在有一种检测方法还能提供快速的抗菌药物敏感性检测结果，其临床影响正在研究中。对于艰难梭菌感染的诊断，文献中出现了与“超敏”毒素检测的性能和影响相关的数据，但其在艰难梭菌感染诊断中的作用仍不明确。对于医院获得性肺炎，多种快速、自动化、多重的“肺炎”检测板已上市，可能会影响呼吸机相关事件的监测定义。最后，美国食品药品监督管理局（FDA）最近批准了各种生化和分子碳青霉烯酶检测试验，这将有助于快速鉴定耐碳青霉烯类微生物。传染病诊断领域的创新进展迅速，拓宽了诊断范围，提高了准确性和敏感性，缩短了周转时间。其中许多创新直接影响感染预防和抗菌药物管理工作。感染控制、抗菌药物管理和微生物实验室之间的密切合作对于确保新检测方法改善患者预后至关重要。
