Development and Evaluation of Novel Applied Diagnostic Platforms for Clinical Microbiology

临床微生物学新型应用诊断平台的开发和评估

• 批准号: 9154129
• 负责人: Anna Lau
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9154129
• 关键词: Antimicrobial Resistance; Antimicrobial susceptibility; Area; Biological Assay; Clinical; Clinical Microbiology; Complex; Detection; Development; Diagnosis; Diagnostic; Diagnostic Specificity; Enzymes; Evaluation; Genes; Goals; Hematopoietic stem cells; Infection Control; Laboratories; MALDI-TOF Mass Spectrometry; Mainstreaming; Measures; Methods; Microbiology; Molecular; Organism; Patient Care; Patients; Performance; Proteomics; Role; Specimen; Stem cell transplant; Streptococcus; System; Testing; Time; Transplant Recipients; Vancomycin resistant enterococcus; Work; beta-Lactamase; clinically significant; improved; microorganism; new technology; novel; novel diagnostics; novel strategies; research and development; resistance gene; resistance mechanism; therapeutic target

Traditional microbiological work up is slow and sometimes inaccurate, relying on phenotypic culture identification followed by antimicrobial susceptibility testing. Newer technologies, such as matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and real-time molecular detection (antimicrobial resistance genes microarrays) have advanced the diagnostic capabilities of clinical microbiology laboratories and have created an exciting field for research and development. Given the in-depth and highly accurate (sometimes complex) results that are produced by such platforms, careful detailed analyses are required to better understand the clinical significance of the organisms identified and the resistance mechanisms detected. During this fiscal year, we have undertaken a multi-center collaborative study to investigate the role of Streptococcus gallolyticus subsp. pasteurianus in hematopoietic stem cell transplant (HSCT) recipients and to evaluate the performance of two different MALDI-TOF MS systems for the identification of microorganisms to the subspecies level. We are also investigating the performance of a novel real-time PCR assay for the detection of four major carbapenmase genes direct from primary specimens, in parallel with selective culture. Methods to accurately detect extended spectrum beta-lactamases (ESBLs) and vancomycin resistant Enterococci (VREs) from surveillance specimens are also being evaluated in an effort to remove patients from unnecessary and costly infection control precautions, as well as improving the diagnostic specificity for microbiology laboratories. Finally, evaluation of rapid phenotypic methods to detect beta-lactamases from culture and the development of new approaches to detect these enzymes from primary specimens is underway.

传统的微生物检测速度很慢，有时甚至不准确，依赖于表型培养鉴定和药敏试验。较新的技术，如基质辅助激光解吸电离飞行时间质谱仪(MALDI-TOF MS)和实时分子检测(抗菌素耐药基因芯片)，提高了临床微生物学实验室的诊断能力，创造了一个令人兴奋的研发领域。考虑到这种平台产生的深入和高度准确(有时是复杂的)结果，需要仔细详细的分析，以更好地理解所确定的微生物的临床意义和检测到的耐药机制。 在本财政年度内，我们进行了一项多中心合作研究，以调查鸡溶血性链球菌亚种的作用。并评价两种不同的MALDI-TOF MS系统在鉴定微生物亚种水平上的性能。我们还在研究一种新的实时PCR方法的性能，该方法在选择性培养的同时，直接从原始标本中检测四种主要的碳青霉烯酶基因。还在评估从监测样本中准确检测超广谱β-内酰胺酶(ESBL S)和万古霉素耐药肠球菌(VRES)的方法，以努力消除患者不必要和昂贵的感染控制预防措施，并提高微生物实验室的诊断特异性。最后，正在对从培养物中检测β-内酰胺酶的快速表型方法进行评估，并开发从初级标本中检测这些酶的新方法。