Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing.
Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing.
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DOI：
10.3390/antibiotics11040511
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发表时间：
2022-04-12
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影响因子：
--
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中科院分区：
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血液感染（BSI）是全球范围内的主要死亡原因。缺乏及时和可靠的诊断实践是管理BSI的一个持续问题。目前用于病原体鉴定和抗生素敏感性测试的金标准血培养实践是耗时的。延迟诊断需要使用经验性抗生素，这可能导致患者预后不良，并有产生抗生素耐药性的风险。因此，迫切需要能够提供准确和及时的诊断和药敏测试的新技术。本文综述了BSI，并强调了其目前诊断的进展和不足。我们调查了采用最近批准的技术的临床工作流程，结果表明，尽管这些技术提高了灵敏度和选择性，但仍然无法提供及时的结果。然后，我们讨论了一些新兴的技术，有可能缩短BSI诊断的整体周转时间，通过直接测试从全血，同时保持，如果不是提高，目前的检测的灵敏度和病原体的覆盖范围。最后，我们对加速BSI病原体鉴定和抗生素敏感性试验的潜在未来方向进行了评估。虽然工程解决方案已经实现了更快的检测周转，但仍需要进一步的进展来取代血液培养实践并指导BSI患者的适当抗生素给药。
Bloodstream infections (BSI) are a leading cause of death worldwide. The lack of timely and reliable diagnostic practices is an ongoing issue for managing BSI. The current gold standard blood culture practice for pathogen identification and antibiotic susceptibility testing is time-consuming. Delayed diagnosis warrants the use of empirical antibiotics, which could lead to poor patient outcomes, and risks the development of antibiotic resistance. Hence, novel techniques that could offer accurate and timely diagnosis and susceptibility testing are urgently needed. This review focuses on BSI and highlights both the progress and shortcomings of its current diagnosis. We surveyed clinical workflows that employ recently approved technologies and showed that, while offering improved sensitivity and selectivity, these techniques are still unable to deliver a timely result. We then discuss a number of emerging technologies that have the potential to shorten the overall turnaround time of BSI diagnosis through direct testing from whole blood—while maintaining, if not improving—the current assay’s sensitivity and pathogen coverage. We concluded by providing our assessment of potential future directions for accelerating BSI pathogen identification and the antibiotic susceptibility test. While engineering solutions have enabled faster assay turnaround, further progress is still needed to supplant blood culture practice and guide appropriate antibiotic administration for BSI patients.
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影响因子：
4.9
作者：
ALBORN, WE;ALLEN, NE;PRESTON, DA
通讯作者：
PRESTON, DA
影响因子：
4.6
作者：
I-Fang Cheng;Chang, Hsien-Chang;Chen, Tzu-Ying;Hu, Chenming;Yang, Fu-Liang
通讯作者：
Yang, Fu-Liang
影响因子：
8.4
作者：
Bisceglia, Emile;Cubizolles, Myriam;Le Pioufle, Bruno
通讯作者：
Le Pioufle, Bruno
DOI：
10.1073/pnas.0704958104
发表时间：
2007-11-27
影响因子：
11.1
作者：
Di Carlo, Dino;Irimia, Daniel;Toner, Mehmet
通讯作者：
Toner, Mehmet
影响因子：
3.7
作者：
Athamanolap P;Parekh V;Fraley SI;Agarwal V;Shin DJ;Jacobs MA;Wang TH;Yang S
通讯作者：
Yang S