抗菌药物敏感性试验的传统方法与未来趋势
Conventional methods and future trends in antimicrobial susceptibility testing.
作者信息
Salam Md Abdus, Al-Amin Md Yusuf, Pawar Jogendra Singh, Akhter Naseem, Lucy Irine Banu
机构信息
Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University, Malaysia.
Purdue University Interdisciplinary Life Sciences Graduate Program, Purdue University, West Lafayette, IN, USA.
出版信息
Saudi J Biol Sci. 2023 Mar;30(3):103582. doi: 10.1016/j.sjbs.2023.103582. Epub 2023 Feb 10.
Antimicrobial susceptibility testing is an essential task for selecting appropriate antimicrobial agents to treat infectious diseases. Constant evolution has been observed in methods used in the diagnostic microbiology laboratories. Disc diffusion or broth microdilution are classical and conventional phenotypic methods with long turnaround time and labour-intensive but still widely practiced as gold-standard. Scientists are striving to develop innovative, novel and faster methods of antimicrobial susceptibility testing to be applicable for routine microbiological laboratory practice and research. To meet the requirements, there is an increasing trend towards automation, genotypic and micro/nano technology-based innovations. Automation in detection systems and integration of computers for online data analysis and data sharing are giant leaps towards versatile nature of automated methods currently in use. Genotypic methods detect a specific genetic marker associated with resistant phenotypes using molecular amplification techniques and genome sequencing. Microfluidics and microdroplets are recent addition in the continuous advancement of methods that show great promises with regards to safety and speed and have the prospect to identify and monitor resistance mechanisms. Although genotypic and microfluidics methods have many exciting features, however, their applications into routine clinical laboratory practice warrant extensive validation. The main impetus behind the evolution of methods in antimicrobial susceptibility testing is to shorten the overall turnaround time in obtaining the results and to enhance the ease of sample processing. This comprehensive narrative review summarises major conventional phenotypic methods and automated systems currently in use, and highlights principles of some of the emerging genotypic and micro/nanotechnology-based methods in antimicrobial susceptibility testing.
抗菌药物敏感性测试是选择合适抗菌药物治疗感染性疾病的一项重要任务。诊断微生物实验室所使用的方法一直在不断演变。纸片扩散法或肉汤微量稀释法是经典的传统表型方法,周转时间长且 labor-intensive 但仍被广泛用作金标准。科学家们正在努力开发创新、新颖且更快的抗菌药物敏感性测试方法,以适用于常规微生物实验室实践和研究。为满足这些要求,自动化、基于基因型和微/纳米技术的创新呈上升趋势。检测系统的自动化以及计算机用于在线数据分析和数据共享的整合是朝着当前使用的自动化方法的通用性迈出的巨大飞跃。基因型方法使用分子扩增技术和基因组测序来检测与耐药表型相关的特定遗传标记。微流控和微滴是方法不断发展中的最新成果,在安全性和速度方面显示出巨大潜力,并有识别和监测耐药机制的前景。尽管基因型和微流控方法有许多令人兴奋的特性,然而,它们在常规临床实验室实践中的应用需要广泛验证。抗菌药物敏感性测试方法演变背后的主要推动力是缩短获得结果的总体周转时间并提高样品处理的便捷性。这篇全面的叙述性综述总结了目前使用的主要传统表型方法和自动化系统,并重点介绍了抗菌药物敏感性测试中一些新兴的基于基因型和微/纳米技术的方法的原理。