bioMérieux, Microbiology Research, La Balme Les Grottes, France.
bioMérieux, EU Data Science, Marcy L'Etoile, France.
Clin Chem. 2021 Dec 30;68(1):91-98. doi: 10.1093/clinchem/hvab207.
Antimicrobial susceptibility testing (AST) is classically performed using growth-based techniques that essentially require viable bacterial matter to become visible to the naked eye or a sophisticated densitometer.
Technologies based on the measurement of bacterial density in suspension have evolved marginally in accuracy and rapidity over the 20th century, but assays expanded for new combinations of bacteria and antimicrobials have been automated, and made amenable to high-throughput turn-around. Over the past 25 years, elevated AST rapidity has been provided by nucleic acid-mediated amplification technologies, proteomic and other "omic" methodologies, and the use of next-generation sequencing. In rare cases, AST at the level of single-cell visualization was developed. This has not yet led to major changes in routine high-throughput clinical microbiological detection of antimicrobial resistance.
We here present a review of the new generation of methods and describe what is still urgently needed for their implementation in day-to-day management of the treatment of infectious diseases.
抗菌药物敏感性测试(AST)通常使用基于生长的技术进行,这些技术本质上需要有活力的细菌物质才能肉眼可见或通过精密的密度计可见。
基于悬浮细菌密度测量的技术在 20 世纪仅在准确性和快速性方面略有发展,但针对新的细菌和抗菌药物组合进行扩展的检测已实现自动化,并且适合高通量周转。在过去的 25 年中,核酸介导的扩增技术、蛋白质组学和其他“组学”方法以及下一代测序技术为 AST 提供了快速性。在极少数情况下,单细胞可视化的 AST 也得到了发展。但这尚未导致常规高通量临床微生物学检测抗药性方面发生重大变化。
我们在此介绍新一代方法,并描述在日常传染病治疗管理中实施这些方法仍迫切需要什么。