ABSTRACT

Introduction

Until recently antimicrobial susceptibility testing (AST) methods based on the demonstration of phenotypic susceptibility in 16–24 h remained largely unchanged.

Areas covered

Advances in rapid phenotypic and molecular-based AST systems.

Expert opinion

AST has changed over the past decade, with many rapid phenotypic and molecular methods developed to demonstrate phenotypic or genotypic resistance, or biochemical markers of resistance such as β-lactamases associated with carbapenem resistance. Most methods still require isolation of bacteria from specimens before both legacy and newer methods can be used. Bacterial identification by MALDI-TOF mass spectroscopy is now widely used and is often key to the interpretation of rapid AST results. Several PCR arrays are available to detect the most frequent pathogens associated with bloodstream infections and their major antimicrobial resistance genes. Many advances in whole-genome sequencing of bacteria and fungi isolated by culture as well as directly from clinical specimens have been made but are not yet widely available. High cost and limited throughput are the major obstacles to uptake of rapid methods, but targeted use, continued development and decreasing costs are expected to result in more extensive use of these increasingly useful methods.

中文翻译：

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快速抗菌药敏试验系统的最新进展

摘要

介绍

直到最近，基于 16-24 小时表型敏感性证明的抗菌药物敏感性测试 (AST) 方法基本保持不变。

涵盖的领域

快速表型和基于分子的 AST 系统的进展。

专家意见

AST 在过去十年发生了变化，开发了许多快速的表型和分子方法来证明表型或基因型抗性，或抗性的生化标志物，例如与碳青霉烯类抗性相关的 β-内酰胺酶。大多数方法仍然需要从标本中分离细菌，然后才能使用旧方法和新方法。通过 MALDI-TOF 质谱进行细菌鉴定现在被广泛使用，并且通常是解释快速 AST 结果的关键。几种 PCR 阵列可用于检测与血流感染相关的最常见病原体及其主要的抗菌素耐药性基因。通过培养以及直接从临床标本中分离的细菌和真菌的全基因组测序已经取得了许多进展，但尚未广泛应用。