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一种用于快速评估尿路感染病原体抗菌药物敏感性的即时检测方法。

A new point-of-care test for the rapid antimicrobial susceptibility assessment of uropathogens.

机构信息

Interuniversity Consortium "Biostructures and Biosystems National Institute" (INBB), Rome, Italy.

Department of Science, Roma Tre University, Rome, Italy.

出版信息

PLoS One. 2023 Jul 5;18(7):e0284746. doi: 10.1371/journal.pone.0284746. eCollection 2023.

Abstract

Bacterial resistance to antimicrobials is considered a major issue worldwide. This condition may account for treatment failure of urinary tract infections, which are among the most common infections both in community and healthcare settings. Therapy against uropathogens is generally administered empirically, possibly leading to unsuccessful therapy, recurrence and development of antibiotic resistance. The reduction in analytical time to obtain antimicrobial susceptibility test (AST) results could play a key role in reducing the cost of healthcare, providing information about antibiotic efficacy and thus preventing from either exploiting new and expensive antibiotics unnecessarily or using obsolete and ineffective ones. A more rational choice among treatment options would hence lead to more effective treatment and faster resolution. In this paper we evaluated the performance of a new Point Of Care Test (POCT) for the rapid prediction of antimicrobial susceptibility in urine samples performed without the need of a laboratory or specialized technicians. 349 patients were enrolled in two open-label, monocentric, non-interventional clinical trials in partnership with an Emergency Medicine ward and the Day Hospital of two large healthcare facilities in Rome. Antibiogram was carried out on 97 patients. Results from analysis of urine samples with the POCT were compared with those from routine AST performed on culture-positive samples, displaying high accuracy (>90%) for all tested antimicrobial drugs and yielding reliable results in less than 12 hours from urine collection thus reducing analytical and management costs.

摘要

细菌对抗生素的耐药性被认为是一个全球性的主要问题。这种情况可能导致尿路感染的治疗失败,尿路感染在社区和医疗机构中都是最常见的感染之一。针对尿路病原体的治疗通常是经验性的,这可能导致治疗无效、复发和抗生素耐药性的发展。减少获得抗生素药敏试验(AST)结果的分析时间可以在降低医疗保健成本方面发挥关键作用,提供有关抗生素疗效的信息,从而防止不必要地使用新的昂贵抗生素或使用过时且无效的抗生素。因此,在治疗方案中做出更合理的选择将导致更有效的治疗和更快的解决。在本文中,我们评估了一种新的即时检测(POCT)在无需实验室或专业技术人员的情况下快速预测尿液样本中抗生素敏感性的性能。在与罗马的两家大型医疗保健机构的急诊病房和日间医院合作的两项开放性、单中心、非干预性临床试验中,共纳入了 349 名患者。对 97 名患者进行了抗生素图谱分析。POCT 分析尿液样本的结果与对培养阳性样本进行常规 AST 的结果进行了比较,显示出对所有测试的抗生素药物的高准确性(>90%),并且在尿液采集后不到 12 小时内即可获得可靠的结果,从而降低了分析和管理成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e926/10321614/7ce12ec4da78/pone.0284746.g001.jpg

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