Tetz George, Tetz Victor
Human Microbiology Institute, New York, NY 10013, USA.
Microorganisms. 2021 May 4;9(5):990. doi: 10.3390/microorganisms9050990.
Here, we describe the validation of a new phenotypic culture-based AtbFinder method for rapid selection of antibiotics in vitro using specimens with mono- and polybacterial infections. AtbFinder, which can be applied to any type of non-blood tissue, does not require isolation of pure bacterial cultures. The method uses a novel TGV medium that allows more rapid bacterial growth of Gram-positive and Gram-negative monoisolates compared with that achieved with conventional laboratory media, demonstrating overall sensitivity, specificity, PPV, NPV values of 99.6%, 98.1%, 98.5%, and 99.4%, respectively, after 4 h. For polymicrobial infections, AtbFinder utilized a novel paradigm of the population response to antibiotics, enabling bacterial growth in the form of a mixed microbial community and selecting antibiotics targeting not only the principal pathogen, but also those bacteria that support their growth. TGV medium allowed culturing of a more diverse set of bacteria from polymicrobial biospecimens, compared with that achieved with the standard media, and enabled, within 4 h, accurate selection of the antibiotics that completely eliminated all cultivatable bacteria from clinical samples. In conclusion, the AtbFinder system may be a valuable tool in improving antibiotic selection, and enabling targeted empirical therapy and accurate antibiotic replacement, which is especially important in high-risk patients.
在此，我们描述了一种基于表型培养的新型AtbFinder方法的验证，该方法用于使用单菌和多菌感染标本在体外快速选择抗生素。AtbFinder可应用于任何类型的非血液组织，无需分离纯细菌培养物。该方法使用了一种新型的TGV培养基，与传统实验室培养基相比，它能使革兰氏阳性和革兰氏阴性单菌分离株的细菌生长更快，4小时后总体敏感性、特异性、阳性预测值和阴性预测值分别为99.6%、98.1%、98.5%和99.4%。对于多菌感染，AtbFinder采用了一种新型的群体对抗生素反应模式，使细菌以混合微生物群落的形式生长，并选择不仅针对主要病原体，而且针对那些支持其生长的细菌的抗生素。与标准培养基相比，TGV培养基能够从多菌生物标本中培养出更多种类的细菌，并能在4小时内准确选择能从临床样本中完全消除所有可培养细菌的抗生素。总之，AtbFinder系统可能是改善抗生素选择、实现有针对性的经验性治疗和准确更换抗生素的有价值工具，这在高危患者中尤为重要。
