Rapid pathogen identification and phenotypic antimicrobial susceptibility directly from urine specimens.
Rapid pathogen identification and phenotypic antimicrobial susceptibility directly from urine specimens.
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DOI：
10.1038/s41598-022-22792-y
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发表时间：
2022-11-15
影响因子：
4.6
通讯作者：
Straus, Don
中科院分区：
文献类型：
--
作者：
Burg, Larry;Crewe, Gretel;DiMeo, James;Guo, Xin;Li, Carmen G.;Mayol, Melissa;Tempesta, Andrew;Lauzier, William;Markham, Rachelle;Crissy, Katarzyna;Barry, Colleen;Walsh, Bruce;Kirby, James E.;Straus, Don
在接近感染发生时实施有效的抗菌治疗可降低发病率和死亡率，并减弱抗菌素耐药性的传播。然而，目前的抗菌药物敏感性测试（AST）方法需要几天的时间才能确定最佳治疗方法。我们提供的技术和自动化平台可在 45 分钟内识别 (ID) 尿路感染病原体，并在不到 5 小时内从尿液样本中提供表型 AST 结果，而无需进行菌落分离。 ID 和 AST 测试使用非放大数字成像对用特定 rRNA 探针荧光标记的细胞进行计数。 ID 测试检测到 5 种病原体，浓度为 ≤ 7,000 CFU/mL，线性范围为 ~ 4 个数量级。对于人工标本，与肉汤微量稀释 (BMD) 参考方法相比，AST 测试给出了 93.1% 的绝对一致性，其中非常重大错误 (VME)、重大错误 (ME) 和轻微错误 (mE) 分别为 1.3%、0.3% 和 6.3%。对于临床标本，与 BMD 相比，ID 测试的一致性为 98.6%，AST 测试的分类一致性为 92.3%，分别为 4.2% mE、3.4% ME 和 4.0% VME。提供的数据表明，直接样本 AST 测试可以准确确定含有两种病原体的样本中每种病原体的抗菌敏感性/耐药性。该方法对尿液基质效应以及脱靶共生菌和污染细菌具有鲁棒性。
Implementing effective antimicrobial therapy close to the onset of infection lowers morbidity and mortality and attenuates the spread of antimicrobial resistance. Current antimicrobial susceptibility testing (AST) methods, however, require several days to determine optimal therapies. We present technology and an automated platform that identify (ID) Urinary Tract Infection pathogens in 45 min and provide phenotypic AST results in less than 5 h from urine specimens without colony isolation. The ID and AST tests count cells fluorescently labeled with specific rRNA probes using non-magnified digital imaging. The ID test detected five pathogens at ≤ 7,000 CFU/mL and had a linear range of ~ 4 orders of magnitude. For contrived specimens, AST tests gave 93.1% categorical agreement with 1.3% Very Major Errors (VME), 0.3% Major Errors (ME), and 6.3% minor Errors (mE) compared to the broth microdilution (BMD) reference method. For clinical specimens, the ID test had 98.6% agreement and the AST test had 92.3% categorical agreement with 4.2% mE, 3.4% ME and 4.0% VME compared to BMD. Data presented demonstrates that direct-from-specimen AST tests can accurately determine antimicrobial susceptibility/resistance for each pathogen in a specimen containing two pathogens. The method is robust to urine matrix effects and off-target commensal and contaminating bacteria.
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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
DOI：
10.3390/antibiotics10020209
发表时间：
2021-02-20
期刊：
Antibiotics (Basel, Switzerland)
影响因子：
--
作者：
Kaprou GD;Bergšpica I;Alexa EA;Alvarez-Ordóñez A;Prieto M
通讯作者：
Prieto M
影响因子：
1.7
作者：
Smith, Kenneth P.;Kirby, James E.
通讯作者：
Kirby, James E.
影响因子：
5.4
作者：
Bonkat, Gernot;Cai, Tomasso;Wagenlehner, Florian M. E.
通讯作者：
Wagenlehner, Florian M. E.
DOI：
10.1016/s0140-6736(21)02724-0
发表时间：
2022-02-12
期刊：
Lancet (London, England)
影响因子：
--
作者：
Antimicrobial Resistance Collaborators
通讯作者：
Antimicrobial Resistance Collaborators