Institute for Nutritional Sciences, Global Health, and Technology, Cornell University, Ithaca, New York, USA.
Lab Chip. 2020 Aug 7;20(15):2607-2625. doi: 10.1039/d0lc00034e. Epub 2020 Jul 9.
Antimicrobial resistance (AMR) is a fundamental global concern analogous to climate change threatening both public health and global development progress. Infections caused by antimicrobial-resistant pathogens pose serious threats to healthcare and human capital. If the increasing rate of AMR is left uncontrolled, it is estimated that it will lead to 10 million deaths annually by 2050. This global epidemic of AMR necessitates radical interdisciplinary solutions to better detect antimicrobial susceptibility and manage infections. Rapid diagnostics that can identify antimicrobial-resistant pathogens to assist clinicians and health workers in initiating appropriate treatment are critical for antimicrobial stewardship. In this review, we summarize different technologies applied for the development of rapid diagnostics for AMR and antimicrobial susceptibility testing (AST). We briefly describe the single-cell technologies that were developed to hasten the AST of infectious pathogens. Then, the different types of genotypic and phenotypic techniques and the commercially available rapid diagnostics for AMR are discussed in detail. We conclude by addressing the potential of current rapid diagnostic systems being developed as point-of-care (POC) diagnostic tools and the challenges to adapt them at the POC level. Overall, this review provides an insight into the current status of rapid and POC diagnostic systems for AMR.
抗菌药物耐药性（AMR）是一个全球性的问题，类似于气候变化，威胁着公共卫生和全球发展进程。抗菌药物耐药病原体引起的感染对医疗保健和人力资本构成严重威胁。如果不控制抗菌药物耐药性的增长率，据估计到 2050 年每年将导致 1000 万人死亡。这种全球抗菌药物耐药性流行病需要采取激进的跨学科解决方案，以更好地检测抗菌药物敏感性和管理感染。能够识别抗菌药物耐药病原体的快速诊断技术对于抗菌药物管理至关重要，可帮助临床医生和卫生工作者启动适当的治疗。在这篇综述中，我们总结了用于开发抗菌药物耐药性和抗菌药物敏感性检测（AST）快速诊断的不同技术。我们简要描述了为加速传染病原体 AST 而开发的单细胞技术。然后，详细讨论了不同类型的表型和基因型技术以及市售的抗菌药物耐药性快速诊断。最后，我们讨论了当前开发的即时诊断系统作为即时诊断工具的潜力以及在即时诊断水平上适应它们的挑战。总的来说，这篇综述提供了对抗菌药物耐药性快速和即时诊断系统现状的深入了解。
