Innovative and rapid antimicrobial susceptibility testing systems

Abstract

| Antimicrobial resistance (AMR) is a major threat to human health worldwide, and the rapid detection and quantification of resistance, combined with antimicrobial stewardship, are key interventions to combat the spread and emergence of AMR . Antimicrobial susceptibility testing (AST) systems are the collective set of diagnostic processes that facilitate the phenotypic and genotypic assessment of AMR and antibiotic susceptibility. Over the past 30 years, only a few high-throughput AST methods have been developed and widely implemented. By contrast, several studies have established proof of principle for various innovative AST methods, including both molecular-based and genome-based methods, which await clinical trials and regulatory review. In this Review , we discuss the current state of AST systems in the broadest technical, translational and implementation-related scope.

A fast impedance-based antimicrobial susceptibility test

“…An example of a new FDA approved imaging-based AST technology is the Accelerate Pheno system (Accelerate Diagnostics, Tuscon, AZ) that provides a sample ID using FISH and uses morpho-kinetic time-lapse imaging to provide an AST from a positive blood culture in around 6 h 5 . For a recent review on the current state of the art in AST systems see 6 .…”

Application of Targeted Next-Generation Sequencing Assay on a Portable Sequencing Platform for Culture-Free Detection of Drug-Resistant Tuberculosis from Clinical Samples

“…They are portable, robust and low capital cost sequencers that could conceivably be utilized in near-patient settings to conduct tNGS in a manner that could transform TB DST and the treatment decision making process (17,18). Indeed, the Minion platform has the potential to penetrate clinical laboratories far more broadly than other sequencing solutions in terms of cost, space, maintenance and clinical utility, with the added value of potentially being useful for identifying resistance-conferring mutations in near real-time (19,20). In addition, large scale implementation of these portable sequencers could provide early information on transmission through strain identification, resulting in more efficient contact tracing and epidemiological investigations.…”

Synergies with and Resistance to Membrane-Active Peptides

“…Other methods of qualifying MAP efficacy exist beyond MIC assays. A recent comprehensive review of novel methods to determine antimicrobial susceptibility notes using techniques, such as microscopy, microfluidics, cytometry, genomic database searches, and others, to study drug efficacy [ 34 ]. A key advantage of many of these techniques is their ability to circumvent problems discussed above with MIC assays through better tracking of growth changes and morphology changes in the microorganism.…”