Abstract
Antibiotic susceptibility testing (AST) specifies effective antibiotic dosage and formulates a profile of empirical therapy for the proper management of an individual patient’s health against deadly infections. Therefore, rapid diagnostic plays a pivotal role in the treatment of bacterial infection. In this article, the authors review the socio-economic burden and emergence of antibiotic resistance. An overview of the phenotypic, genotypic, and emerging techniques for AST has been provided and discussed, highlighting the advantages and limitations of each. The historical perspective on conventional methods that have paved the way for modern AST like disk diffusion, Epsilometer test (Etest), and microdilution, is presented. Several emerging methods, such as microfluidic-based optical and electrochemical AST have been critically evaluated. Finally, the challenges related with AST and its outlook in the future are presented.
Highlights
Antibiotic resistance is defined as the genetic ability of bacteria to encode the resistance genes that counterfeit the inhibitory effect of potential antibiotics for survival [1]
The understanding of the genetic makeover and the morpho-anatomical changes in bacteria are of prime importance to counteracting the resistance mechanism
Multiple cultures of Campylobacter spp. against seven antibiotics were evaluated by. Epsilometer test (Etest) to determine their resistance [54]. All these results demonstrated the reliability and importance of the Etest in evaluating Minimum inhibitory concentrations (MICs) of a wide range of antibiotics over the present standardized methods, especially for slow-growing bacteria (Campylobacter jejuni, H. pylori) and rare fastidious bacteria (S. pneumoniae and Neisseria spp.)
Summary
Antibiotic resistance is defined as the genetic ability of bacteria to encode the resistance genes that counterfeit the inhibitory effect of potential antibiotics for survival [1]. It can be developed either intrinsically by natural recombination and integration into the bacterial genome, or it can be acquired through horizontal gene mutation events such as conjugation, transformation, and transduction [2]. Minimum inhibitory concentrations (MICs) of various antimicrobial susceptibility testing (AST) are categorized by various international agencies These MIC guidelines determine whether an antibiotic is susceptible or not. Resistance against beta-lactam antibiotics like penicillin is widespread, while resistance against other drugs, such as vancomycin and fluoroquinolone, are less frequently observed (Supplementary Table S1).
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