Lathakumari Rahul Harikumar, Vajravelu Leela Kakithakara, Thulukanam Jayaprakash, Narasimhan Ashwin Kumar
Department of Microbiology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu India.
Advanced Nano-Theranostics (ANTs) Research Group, Biomaterials Lab, Department of Biomedical Engineering, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu 603203 India.
Indian J Microbiol. 2025 Mar;65(1):277-296. doi: 10.1007/s12088-024-01337-z. Epub 2024 Jun 20.
Carbapenem resistance represents a pressing public health concern, posing significant challenges due to limited treatment options and escalating mortality rates. In India, the prevalence of carbapenem resistance among Enterobacteriaceae ranges between 18 to 31%, causing severe infections such as bloodstream infections, pneumonia, urinary tract infections, and intra-abdominal infections. Accurate and timely diagnosis, particularly for Enterobacteriaceae producing carbapenemase, is crucial for effective clinical prophylaxis of critical care patients as they are considered as a last resort of therapy. Various genotypic and non-genotypic detection methods have been developed over the past decade, their limitations in terms of sensitivity and specificity have led the exploration of innovative technologies. Advanced opportunities for carbapenem resistance detection using microfluidic-based biosensors have miniaturized various biomedical devices. This enables the use of less sample and reagents, cheap pricing, automation, screening, and improved detection. Despite ongoing research and development, the adoption of these biosensors in healthcare settings is limited due to the lack of awareness and understanding of their efficiency. Therefore, this review primarily focuses on the advantages and limitations of all biosensor-based devices over existing methods for the detection of carbapenem resistance in gram negative bacilli. These biosensors represent substantial advancements in combating carbapenem resistance, providing promise for more reliable and accurate diagnostic techniques that may eventually improve patient care and infection control.
碳青霉烯类耐药性是一个紧迫的公共卫生问题,由于治疗选择有限和死亡率不断上升,带来了重大挑战。在印度,肠杆菌科细菌中碳青霉烯类耐药性的流行率在18%至31%之间,可导致严重感染,如血流感染、肺炎、尿路感染和腹腔内感染。准确及时的诊断,尤其是对产碳青霉烯酶的肠杆菌科细菌的诊断,对于重症监护患者的有效临床预防至关重要,因为它们被视为治疗的最后手段。在过去十年中已经开发了各种基因型和非基因型检测方法,但其在灵敏度和特异性方面的局限性促使人们探索创新技术。利用基于微流控的生物传感器检测碳青霉烯类耐药性的先进技术已经使各种生物医学设备小型化。这使得能够使用更少的样品和试剂,价格低廉,实现自动化、筛选和改进检测。尽管正在进行研发,但由于对其效率缺乏认识和了解,这些生物传感器在医疗环境中的应用仍然有限。因此,本综述主要关注所有基于生物传感器的设备相对于现有革兰氏阴性杆菌碳青霉烯类耐药性检测方法的优缺点。这些生物传感器在对抗碳青霉烯类耐药性方面取得了重大进展,为更可靠、准确的诊断技术带来了希望,最终可能改善患者护理和感染控制。