Smith Kenneth P, Kirby James E
Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Center for Life Science, 3 Blackfan Circle-CLS624, Boston, MA 02115, USA.
Clinical Microbiology, Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue-YA309, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Clin Lab Med. 2019 Sep;39(3):333-344. doi: 10.1016/j.cll.2019.04.001. Epub 2019 Jun 12.
With emerging antimicrobial resistance, rapid antimicrobial susceptibility testing (AST) is needed to provide early definitive therapeutic guidance to optimize patient outcome. Genotypic methods are fast, but can identify only a subset of known resistance elements. Phenotypic methods determine clinically predictive minimal inhibitory concentrations and include very sensitive optical and biophysical methods to detect changes in replication or physiology of pathogens in response to antibiotics. For the potential of rapid AST to be fully realized, results must be linked with robust decision support solutions that will implement therapeutic changes in real time.
随着抗菌药物耐药性的不断出现，需要快速进行抗菌药物敏感性测试（AST），以便提供早期明确的治疗指导，从而优化患者的治疗结果。基因分型方法速度快，但只能识别已知耐药元件的一个子集。表型方法可确定具有临床预测性的最低抑菌浓度，并且包括非常灵敏的光学和生物物理方法，以检测病原体在接触抗生素后复制或生理状态的变化。为了充分发挥快速AST的潜力，必须将结果与强大的决策支持解决方案相联系，以便实时实施治疗调整。
