Development and evaluation of a centrifugal disk system for the rapid detection of multiple pathogens and their antibiotic resistance genes in urinary tract infection.
Development and evaluation of a centrifugal disk system for the rapid detection of multiple pathogens and their antibiotic resistance genes in urinary tract infection.
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DOI：
10.3389/fmicb.2023.1157403
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发表时间：
2023
影响因子：
5.2
通讯作者：
中科院分区：
文献类型：
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作者：
尿路感染(UTI)是世界上最常见的细菌感染之一。然而，由于不需要培养尿液就能经验性地治疗不复杂的尿路感染，充分了解尿路病原体的耐药模式是至关重要的。常规的尿液培养和鉴定至少需要2 天。在这里，我们开发了一个基于LAMP和离心盘系统(LCD)的平台，用于同时检测尿路感染中急需关注的主要病原菌和抗生素耐药基因(ARGs)。我们设计了检测上述目的基因的特异性引物，并对其敏感性和特异性进行了评价。我们还评估了我们的预加载LCD平台对645例尿液标本的常规培养方法和桑格测序的结果。对645份临床标本的检测结果表明，该平台对所研究的病原体和ARG具有较高的特异性(0.988-1)和敏感性(0.904-1)。此外，所有病原菌的Kappa值都在0.75以上，这表明LCD法与培养法具有很好的一致性。与表型试验相比，液晶显示平台是一种实用和快速的检测方法，可以检测耐甲氧西林金黄色葡萄球菌、耐万古霉素肠球菌、耐碳青霉烯类肠杆菌、耐碳青霉烯类不动杆菌、耐碳青霉烯类铜绿假单胞菌(卡伯值为ALL>；0.75)和非超广谱β-内酰胺酶产生菌。我们开发了一种准确度高、满足快速诊断需要的检测平台，从标本采集开始，1.5 h内即可完成。它可能是一种强有力的循证尿路感染诊断工具，为合理使用抗生素提供必要的支持。需要更多高质量的临床研究来证明我们平台的有效性。
Urinary tract infections (UTIs) are some of the most common bacterial infections in the world. Nevertheless, as uncomplicated UTIs are treated empirically without culturing the urine, adequate knowledge of the resistance pattern of uropathogens is essential. Conventional urine culture and identification take at least 2 days. Here, we developed a platform based on LAMP and centrifugal disk system (LCD) to simultaneously detect the main pathogens and antibiotic resistant genes (ARGs) of urgent concern multidrug-resistant among UTIs. We designed specific primers to detect the target genes above and evaluated their sensitivity and specificity. We also assessed the result of our preload LCD platform on 645 urine specimens with a conventional culturing method and Sanger sequencing. The results obtained with the 645 clinical samples indicated that the platform has high specificity (0.988–1) and sensitivity (0.904–1) for the studied pathogens and ARGs. Moreover, the kappa value of all pathogens was more than 0.75, revealing an excellent agreement between the LCD and culture method. Compared to phenotypic tests, the LCD platform is a practical and fast detection approach for methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Acinetobacter, carbapenem-resistant Pseudomonas aeruginosa (kappa value of all >0.75), and non-extended-spectrum β-lactamase producers. We developed a detection platform that has high accuracy and that meets the need for rapid diagnosis, which can be completed within 1.5 h from specimen collection. It may be a powerful tool for evidence-based UTIs diagnosis, which has essential support for the rational use of antibiotics. More high-quality clinical studies are required to prove the effectiveness of our platform.
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影响因子：
13.8
作者：
Mach KE;Wong PK;Liao JC
通讯作者：
Liao JC
DOI：
10.1038/nrmicro3432
发表时间：
2015-05
期刊：
Nature reviews. Microbiology
影响因子：
--
作者：
Flores-Mireles AL;Walker JN;Caparon M;Hultgren SJ
通讯作者：
Hultgren SJ
影响因子：
4.4
作者：
Foxman, Betsy
通讯作者：
Foxman, Betsy
影响因子：
3.7
作者：
Aruhomukama, Dickson;Najjuka, Christine F.;Kateete, David P.
通讯作者：
Kateete, David P.
影响因子：
3.7
作者：
Poritz MA;Blaschke AJ;Byington CL;Allen L;Nilsson K;Jones DE;Thatcher SA;Robbins T;Lingenfelter B;Amiott E;Herbener A;Daly J;Dobrowolski SF;Teng DH;Ririe KM
通讯作者：
Ririe KM