Lainhart William, Yarbrough Melanie L, Jean Sophonie, Burnham Carey-Ann D
Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO.
J Appl Lab Med. 2018 May 1;2(6):925-940. doi: 10.1373/jalm.2017.023101.
The landscape of clinical microbiology laboratories is changing. As new technologies are introduced, we are better able to detect and identify pathogens and to recognize and characterize emerging antimicrobial resistance mechanisms.
In this review, a selected cross-section of current hot topics in clinical microbiology is discussed. These topics include (a) diagnostics for urinary tract and sexually transmitted infections; (b) phenotypic and genotypic methods of detecting carbapenem resistance and discussion of newly approved anti-infective agents for these multi-drug resistant organisms; and (c) the significance, epidemiology, and identification of the emerging pathogens Mycobacterium chimaera and Candida auris.
Communication between clinical microbiologists and their clinical colleagues is imperative to convey the significance of emerging pathogens and resistance determinants, as well as the performance characteristics of new diagnostic methods. Additionally, as antimicrobial resistance is surging, it is important to comprehensively evaluate the resistance profiles of clinical isolates to facilitate antimicrobial stewardship and inform infection prevention measures. Although antimicrobial resistance is a global public health crisis, it is encouraging that new anti-infective agents are in the pipeline and being approved for use in patients.
临床微生物学实验室的格局正在发生变化。随着新技术的引入，我们能够更好地检测和鉴定病原体，并识别和表征新出现的抗菌耐药机制。
在本综述中，讨论了临床微生物学当前一些热门话题的选定横截面。这些话题包括：（a）尿路感染和性传播感染的诊断；（b）检测碳青霉烯类耐药性的表型和基因型方法，以及针对这些多重耐药菌的新批准抗感染药物的讨论；（c）新出现的病原体马尔默分枝杆菌和耳念珠菌的重要性、流行病学及鉴定。
临床微生物学家与其临床同事之间的沟通对于传达新出现病原体和耐药决定因素的重要性以及新诊断方法的性能特征至关重要。此外，由于抗菌耐药性正在激增，全面评估临床分离株的耐药谱以促进抗菌药物管理并为感染预防措施提供依据非常重要。尽管抗菌耐药性是全球公共卫生危机，但令人鼓舞的是，新的抗感染药物正在研发中并已获批用于患者。
