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近期和新兴技术用于快速诊断感染和抗微生物药物耐药性。

Recent and emerging technologies for the rapid diagnosis of infection and antimicrobial resistance.

机构信息

University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK; Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk, NR4 7UQ, UK.

University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK; Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk, NR4 7UQ, UK.

出版信息

Curr Opin Microbiol. 2019 Oct;51:39-45. doi: 10.1016/j.mib.2019.03.001. Epub 2019 May 9.

Abstract

The rise in antimicrobial resistance (AMR) is predicted to cause 10 million deaths per year by 2050 unless steps are taken to prevent this looming crisis. Microbiological culture is the gold standard for the diagnosis of bacterial/fungal pathogens and antimicrobial resistance and takes 48 hours or longer. Hence, antibiotic prescriptions are rarely based on a definitive diagnosis and patients often receive inappropriate treatment. Rapid diagnostic tools are urgently required to guide appropriate antimicrobial therapy, thereby improving patient outcomes and slowing AMR development. We discuss new technologies for rapid infection diagnosis including: sample-in-answer-out PCR-based tests, BioFire FilmArray and Curetis Unyvero; rapid susceptibility tests, Accelerate Pheno and microfluidic tests; and sequencing-based approaches, focusing on targeted and clinical metagenomic nanopore sequencing.

摘要

抗菌药物耐药性(AMR)的上升预计将导致每年 1000 万人死亡,除非采取措施预防这一迫在眉睫的危机。微生物培养是诊断细菌/真菌病原体和抗菌药物耐药性的金标准,需要 48 小时或更长时间。因此,抗生素的处方很少基于明确的诊断,患者经常接受不适当的治疗。迫切需要快速诊断工具来指导适当的抗菌治疗,从而改善患者的治疗效果并减缓 AMR 的发展。我们讨论了用于快速感染诊断的新技术,包括:基于 PCR 的样本内检测-结果即时测试、BioFire FilmArray 和 Curetis Unyvero;快速药敏测试、Accelerate Pheno 和微流控测试;以及基于测序的方法,重点是靶向和临床宏基因组纳米孔测序。

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