Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy.
Course in Organs and Tissues Transplantation and Cellular Therapies, Department of Precision Medicine Jonic Area, University "Aldo Moro" of Bari, 70124 Bari, Italy.
Int J Mol Sci. 2023 Feb 22;24(5):4361. doi: 10.3390/ijms24054361.
A new paradigm shift for the treatment of () infection would be timely due to a progressive increase in antibiotic resistance. Such a shift in the perspective of the approach should include the preliminary assessment of antibiotic resistance. However, the availability of sensitivity tests is not widespread and the guidelines have always indicated empirical treatments without taking into account the need to make sensitivity tests accessible, i.e., the necessary starting point for improving results in different geographical areas. Currently, the traditional tools for this purpose (culture) are based on performing an invasive investigation (endoscopy) and often involve technical difficulties; thus, they were only confined to the settings where multiple attempts at eradication have failed. In contrast, genotypic resistance testing of fecal samples using molecular biology methods is much less invasive and more acceptable to patients. The purpose of this review is to update the state of the art of molecular fecal susceptibility testing for the management of this infection and to extensively discuss the potential benefits of their large-scale deployment, i.e., novel pharmacological opportunities.
由于抗生素耐药性的不断增加,()感染的治疗方法需要进行范式转变。这种从方法角度出发的转变应该包括对抗生素耐药性的初步评估。然而,敏感性测试的可用性并不广泛,而且指南始终表明进行经验性治疗,而不考虑使敏感性测试能够普及,即改善不同地理区域结果的必要起点。目前,为此目的的传统工具(培养)基于进行侵入性检查(内镜检查),并且经常涉及技术困难;因此,它们仅局限于多次根除尝试失败的环境中。相比之下,使用分子生物学方法对粪便样本进行基因型耐药性测试的侵入性要小得多,并且更能被患者接受。本综述的目的是更新分子粪便药敏检测在这种感染管理方面的最新技术状态,并广泛讨论其大规模应用的潜在益处,即新的药理学机会。