Topical issues of antibiotic resistance: modern methods of identification of bacterial pathogens and determination of their qualities

Abstract

One of the most urgent problems in medicine today is the problem of antibiotic resistance. Why this problem? After all, scientists around the world proclaimed victory over microorganisms in the 50-60s of the last century? And since the 70s already began to appear information about resistant strains. Everything turned out to be not so simple. Due to uncontrolled and irrational use of antibiotics, mankind is rapidly approaching the so-called "post-antibiotic era". How to stop this "approach"? It is necessary to clearly follow the principles of rational antibiotic therapy.
 Rational antibiotic therapy requires identifying the bacterial nature of the disease, determining the sensitivity of the microorganisms to the antibiotic and starting treatment as soon as possible. To comply with these principles, rapid and accurate methods of identification of microorganisms are necessary, because it is on the basis of these methods that the most effective antimicrobial agent is selected.
 There are standard methods of identification, which include the disk-diffusion method and the serial dilution method. The main disadvantage of these methods is the length of time it takes to obtain results.
 So what are the alternative methods available? There are many methods of microbial identification, but not all of them are suitable for widespread use due to the high cost, the need for expensive equipment.
 Of all the current methods, three methods are emphasized in this review: 16S rRNA gene sequencing, MALDI-TOF MS and EUCAST RAST. Sequencing of the 16S rRNA gene is based on decoding the region of the gene, which in bacteria carries information on resistance mechanisms and structure features. MALDI-TOF MS is a desorption method of "soft" ionization caused by exposure of the matrix with the analyzed substance to pulses of laser radiation. The EUCAST RAST method is an accelerated disk-diffusion method.
 This review describes the problem of antibiotic resistance, mechanisms of bacterial resistance, as well as modern and standard methods of bacterial identification and antibiotic sensitivity.
 The aim of this review was to compare routine methods of identification of species and qualitative properties of microorganisms, causative agents of nosocomial infections, with modern technologies of microbiological testing as an important step in solving the problem of priority selection of effective antimicrobial agents.
 So, the main question of this review is: can modern methods displace standard methods of microorganism identification?