Rapid Microbial ID Direct From Specimen

摘要 该提案针对BACLIB，这是一种具有成本效益的，直接从临床标本或阳性血液中进行一小时微生物ID检测的方法 文化 微生物ID测试是适当抗菌治疗的重要步骤。今天，阳性微生物培养 指示微生物感染，随后对培养样品进行微生物ID检测以识别菌种。微生物 培养通常需要一天时间才能转为阳性。在此期间，临床医生必须根据经验治疗患者， 适当的治疗，并增加败血症和其他不良事件的风险。 我们开发了BACLIB，一个一小时的测试，直接从阳性血培养（PBC）中识别微生物感染 或尿液样本。BACLIB测量物种特异性微生物膜脂质：革兰氏阴性菌中的脂质A， 革兰氏阳性细菌和真菌中的类似脂质。这些脂质含量丰富，容易提取，而且更敏感 检测和识别的分析物。 在临床PBC样本的初步结果中，BACLIB正确识别了93%的样本。唯一可用的快速ID PBC的测试正确地识别了这些相同样品中的仅61%。因此，BACLIB提供了显著的优势， 血培养阳性的测试BACLIB直接从尿液标本中显示出类似的性能， 目前没有批准的直接来自样本的ID测试。 在这个提议中，我们开发了一个基于BACLIB的原型临床测定。原型将在临床和 制备样品并与标准方法进行比较。 研究方法如下： 具体目标1：直接来自标本的病原体ID。在这个目标中，我们使用免疫荧光法直接从PBC和尿液中鉴定病原体。 沐浴露。 具体目标2。直接来自尿液的病原体的定量。在这个目标中，我们测量 尿液，以确定阳性尿液标本，由微生物浓度定义。 具体目标3。多种微生物标本。在这一目标中，我们评估了BACLIB在临床和制备中识别物种的作用。 多微生物PBC和尿液标本。 适当的抗菌治疗对有效治疗菌尿和菌血症以及预防 和脓毒症的治疗。这些情况仍然是主要的健康问题。此外，在脓毒症进展的情况下， 通常是快速的，因此在诊断时间上节省一个小时就可以显著降低死亡率。因此，更快的测试 需要拯救生命

Abstract This proposal is for BACLIB, a cost-effective, one hour microbial ID test direct from a clinical specimen or positive blood culture. Microbial ID testing is an essential step to appropriate antimicrobial treatment. Today, positive microbial culture indicates a microbial infection, and subsequent microbial ID testing on cultured samples identifies species. Microbial cultures typically take a day to turn positive. During this period, clinicians must treat patients empirically, delaying appropriate therapy, and increasing the risk of sepsis and other adverse events. We have developed BACLIB, a one-hour test that identifies microbial infections directly from positive blood culture (PBC) or urine specimens. BACLIB measures species-specific microbial membrane lipids: lipid A in Gram-negative bacteria, and analogous lipids in Gram-positive bacteria and fungi. These lipids are abundant, easily extracted, and more sensitively detected and identified than analytes used by current tests. In preliminary results with clinical PBC specimens, BACLIB correctly identified 93% of samples. The only available rapid ID test for PBC correctly identified only 61% of these same samples. Thus, BACLIB offers significant advantages over available tests for positive blood culture. BACLIB shows similar performance direct from urine specimens, where there is currently no approved direct-from-specimen ID test. In this proposal, we develop a prototype clinical assay based on BACLIB. The prototype will be evaluated on clinical and prepared specimens and compared with standard methods. The research approach is as follows: Specific Aim 1: Pathogen ID Direct From Specimen. In this aim we identify pathogens direct from PBC and urine using BACLIB. Specific Aim 2. Quantitation of Pathogens Direct From Urine. In this aim we measure the quantity of pathogens in urine, to determine positive urine specimens, defined by microbial concentration. Specific Aim 3. Polymicrobial Specimens. In this aim we evaluate BACLIB in identifying species in clinical and prepared polymicrobial PBC and urine specimens. Appropriate antimicrobial therapy is essential to effective treatment of bacteriuria and bacteremia, and to prevention and treatment of sepsis. These conditions remain major health problems. Furthermore, in the case of sepsis progression is often rapid, so that a single hour saved in diagnosis time can significantly reduce mortality. Faster tests are therefore needed to save lives.