Emerging Options for the Diagnosis of Bacterial Infections and the Characterization of Antimicrobial Resistance.

Simone Rentschler,Hans-Peter Deigner,Lars Kaiser

doi:10.3390/ijms22010456

Abstract

Precise and rapid identification and characterization of pathogens and antimicrobial resistance patterns are critical for the adequate treatment of infections, which represent an increasing problem in intensive care medicine. The current situation remains far from satisfactory in terms of turnaround times and overall efficacy. Application of an ineffective antimicrobial agent or the unnecessary use of broad-spectrum antibiotics worsens the patient prognosis and further accelerates the generation of resistant mutants. Here, we provide an overview that includes an evaluation and comparison of existing tools used to diagnose bacterial infections, together with a consideration of the underlying molecular principles and technologies. Special emphasis is placed on emerging developments that may lead to significant improvements in point of care detection and diagnosis of multi-resistant pathogens, and new directions that may be used to guide antibiotic therapy.

Highlights

Infectious disease epidemics, emerging new diseases, as well as new and increasing problems with current methods used to treat infectious diseases, represent major challenges to our health care system
Special emphasis is placed on emerging developments that may lead to significant improvements in point of care detection and diagnosis of multi-resistant pathogens, and new directions that may be used to guide antibiotic therapy
The use of modern mass spectrometry methods, including matrix-assisted laser desorption ionization time of flight (MALDI-TOF), reduces the time needed for identification of a given bacterial species from hours to several minutes [15]

Summary

Introduction

Infectious disease epidemics, emerging new diseases, as well as new and increasing problems with current methods used to treat infectious diseases, represent major challenges to our health care system. As infectious micro-organisms emerge over time and have the capacity to evolve, it is important to develop diagnostics at a rate that will evolve rapidly to meet this challenge [2]. New clinical diagnostic methods will be needed to identify both familiar and new pathogens as part of standard clinical care; we need methods that will determine appropriate therapy and that can evaluate the responses to therapy as well as patient prognosis [3]. The application of the appropriate diagnostic tests will be crucial to avoid misdiagnosis and to avoid the application of therapy that is ineffective against a given pathogen. The inappropriate use of antibiotics contributes to the development of antimicrobial-resistant organisms [4,5,6,7]

Methods

Results

Conclusion