Infectious Disease Management through Point-of-Care Personalized Medicine Molecular Diagnostic Technologies.
Infectious Disease Management through Point-of-Care Personalized Medicine Molecular Diagnostic Technologies.
复制标题
DOI：
10.3390/jpm2020050
复制
发表时间：
2012-05-02
影响因子：
--
通讯作者：
Bergeron MG
中科院分区：
文献类型：
--
作者：
Bissonnette L;Bergeron MG
传染病管理主要包括确定感染的微生物原因，必要时启动针对微生物的抗菌治疗，以及控制宿主对感染的反应。在临床微生物学中，诊断周期的周转时间（大约24小时）往往导致不必要的痛苦和死亡；减轻这一负担的方法包括快速诊断程序和更有效地传播或解释分子微生物学结果。尽管基于核酸的快速诊断测试已经证明它可以影响医院获得性感染的传播，但我们认为，这种挽救生命的程序应该在离患者更近的地方进行，在医疗机构的专用24/7实验室中进行，或者最好在护理点进行。虽然个性化医疗通常旨在询问患者的基因组信息，例如药物代谢多态性，以指导药物选择和剂量，但个性化医疗概念适用于传染病，用于（快速）识别致病微生物并确定其抗菌素耐药性概况，以指导适当的抗菌素治疗，以便对患者进行适当管理。实施传染病即时检测将需要得到医疗当局、新技术和通信平台以及报销做法的接受，从而使尽可能多的病人能够使用节省时间和挽救生命的程序。
Infectious disease management essentially consists in identifying the microbial cause(s) of an infection, initiating if necessary antimicrobial therapy against microbes, and controlling host reactions to infection. In clinical microbiology, the turnaround time of the diagnostic cycle (>24 hours) often leads to unnecessary suffering and deaths; approaches to relieve this burden include rapid diagnostic procedures and more efficient transmission or interpretation of molecular microbiology results. Although rapid nucleic acid-based diagnostic testing has demonstrated that it can impact on the transmission of hospital-acquired infections, we believe that such life-saving procedures should be performed closer to the patient, in dedicated 24/7 laboratories of healthcare institutions, or ideally at point of care. While personalized medicine generally aims at interrogating the genomic information of a patient, drug metabolism polymorphisms, for example, to guide drug choice and dosage, personalized medicine concepts are applicable in infectious diseases for the (rapid) identification of a disease-causing microbe and determination of its antimicrobial resistance profile, to guide an appropriate antimicrobial treatment for the proper management of the patient. The implementation of point-of-care testing for infectious diseases will require acceptance by medical authorities, new technological and communication platforms, as well as reimbursement practices such that time- and life-saving procedures become available to the largest number of patients.