Developmental roadmap for antimicrobial susceptibility testing systems

Abstract

Antimicrobial susceptibility testing (AST) technologies help to accelerate the initiation of targeted antimicrobial therapy for patients with infections and could potentially extend the lifespan of current narrow-spectrum antimicrobials. Although conceptually new and rapid AST technologies have been described, including new phenotyping methods, digital imaging and genomic approaches, there is no single major, or broadly accepted, technological breakthrough that leads the field of rapid AST platform development. This might be owing to several barriers that prevent the timely development and implementation of novel and rapid AST platforms in health-care settings. In this Consensus Statement, we explore such barriers, which include the utility of new methods, the complex process of validating new technology against reference methods beyond the proof-of-concept phase, the legal and regulatory landscapes, costs, the uptake of new tools, reagent stability , optimization of target product profiles, difficulties conducting clinical trials and issues relating to quality and quality control, and present possible solutions.

Evaluation of an optimized method to directly identify bacteria from positive blood cultures using MALDI‐TOF mass spectrometry

“…It is well known that an identification method that saves time is critical for BSI, especially for patients in need of quick treatment. Therefore, early identification of the causative pathogen may lead to a better, more efficient, and less expensive antibiotic treatment . If this technology is adapted and combined with drug resistance detection data in hospitals for the diagnosis and treatment of BSI, anti‐infection treatment plans can be more accurately selected, which can enable curing of pathogenic infections and prevent the overuse of broad‐spectrum antibiotics …”

Discordant bioinformatic predictions of antimicrobial resistance from whole-genome sequencing data of bacterial isolates: An inter-laboratory study

“…Molecular testing has facilitated the implementation of PCR assays that target key AMR mutations and genes [4,5]. However there remains an unmet need for truly rapid point-of-care AST [6,7].…”

Dual activity of PNGM-1, a metallo-β-lactamase and tRNase Z, pinpoints the evolutionary origin of subclass B3 metallo-β-lactamases

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Antibiotic resistance is a steadily increasing global problem which could lead to a fundamental upheaval in clinical care with the potential to return us to the pre-antibiotic era [1][2][3][4] . The production of β-lactamases, a group of enzymes that confer antibiotic resistance in Gram-negative bacteria, is now one of the major barriers in treating Gram-negative infections 5 .

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