Institute of Precision Medicine, Furtwangen University, Jakob-Kienzle-Straße 17, 78054 VS-Schwenningen, Germany.
Department of Pharmaceutical and Medicinal Chemistry, Institute of Pharmaceutical Sciences, Eberhard Karls University Tübingen, Auf der Morgenstelle 8, 72076 Tübingen, Germany.
Int J Mol Sci. 2021 Jan 5;22(1):456. doi: 10.3390/ijms22010456.
Precise and rapid identification and characterization of pathogens and antimicrobial resistance patterns are critical for the adequate treatment of infections, which represent an increasing problem in intensive care medicine. The current situation remains far from satisfactory in terms of turnaround times and overall efficacy. Application of an ineffective antimicrobial agent or the unnecessary use of broad-spectrum antibiotics worsens the patient prognosis and further accelerates the generation of resistant mutants. Here, we provide an overview that includes an evaluation and comparison of existing tools used to diagnose bacterial infections, together with a consideration of the underlying molecular principles and technologies. Special emphasis is placed on emerging developments that may lead to significant improvements in point of care detection and diagnosis of multi-resistant pathogens, and new directions that may be used to guide antibiotic therapy.
准确、快速地鉴定病原体并确定其耐药模式对于感染的充分治疗至关重要，而感染是重症监护医学中日益严重的问题。目前，在检测周转时间和整体效果方面，情况仍远不能令人满意。应用无效的抗菌药物或不必要地使用广谱抗生素会使患者的预后恶化，并进一步加速耐药突变体的产生。在这里，我们提供了一个概述，包括对用于诊断细菌感染的现有工具的评估和比较，以及对潜在的分子原理和技术的考虑。特别强调了可能导致在床边检测和诊断多耐药病原体方面取得重大进展的新兴发展，并探讨了可能用于指导抗生素治疗的新方向。
