Emerging Technologies for Rapid Identification of Bloodstream Pathogens
Emerging Technologies for Rapid Identification of Bloodstream Pathogens
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DOI：
10.1093/cid/ciu292
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发表时间：
2014-07-15
影响因子：
11.8
通讯作者：
Haake, David A.
中科院分区：
文献类型：
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作者：
Kothari, Atul;Morgan, Margie;Haake, David A.
微生物快速鉴定技术将为临床微生物学带来革命性的变化，并使危及生命的血液感染患者能够做出明智的决策。使用商业荧光原位杂交测试或质谱仪，可以在几分钟内对阳性血培养中的微生物进行物种鉴定。阳性血培养中的微生物也可以在1-2.5小时内使用基于自动聚合酶链式反应的系统进行鉴定，该系统还可以检测选定的抗生素耐药性标记，如甲氧西林耐药性。当与抗生素管理计划相结合时，这些方法可以改善临床结果并减少医疗支出。在全血样本中进行直接检测是非常可取的，因为它们有可能识别血液病原体，而不需要等待1-2天血液培养呈阳性。然而，全血中病原体检测的结果与传统的血液培养技术并不重叠，我们仍在学习如何最好地使用这些方法。
Technologies for rapid microbial identification are poised to revolutionize clinical microbiology and enable informed decision making for patients with life-threatening bloodstream infections. Species identification of microorganisms in positive blood cultures can be performed in minutes using commercial fluorescence in situ hybridization tests or mass spectroscopy. Microorganisms in positive blood cultures can also be identified within 1-2.5 hours using automated polymerase chain reaction-based systems that can also detect selected antibiotic resistance markers, such as methicillin resistance. When combined with antibiotic stewardship programs, these approaches improve clinical outcomes and reduce healthcare expenditures. Tests for direct detection in whole blood samples are highly desirable because of their potential to identify bloodstream pathogens without waiting 1-2 days for blood cultures to become positive. However, results for pathogen detection in whole blood do not overlap with those of conventional blood culture techniques and we are still learning how best to use these approaches.