Rapid Methods for Antimicrobial Resistance Diagnostics

Abstract

Antimicrobial resistance (AMR) is one of the most challenging threats in public health; thus, there is a growing demand for methods and technologies that enable rapid antimicrobial susceptibility testing (AST). The conventional methods and technologies addressing AMR diagnostics and AST employed in clinical microbiology are tedious, with high turnaround times (TAT), and are usually expensive. As a result, empirical antimicrobial therapies are prescribed leading to AMR spread, which in turn causes higher mortality rates and increased healthcare costs. This review describes the developments in current cutting-edge methods and technologies, organized by key enabling research domains, towards fighting the looming AMR menace by employing recent advances in AMR diagnostic tools. First, we summarize the conventional methods addressing AMR detection, surveillance, and AST. Thereafter, we examine more recent non-conventional methods and the advancements in each field, including whole genome sequencing (WGS), matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) spectrometry, Fourier transform infrared (FTIR) spectroscopy, and microfluidics technology. Following, we provide examples of commercially available diagnostic platforms for AST. Finally, perspectives on the implementation of emerging concepts towards developing paradigm-changing technologies and methodologies for AMR diagnostics are discussed.

Preparation and Antimicrobial Activity of Chitosan and Its Derivatives: A Concise Review

“…Bacterial infections, both community and hospital-acquired, represent a major cause of mortality, morbidity and prolonged hospitalization, closing a vicious circle and leading to an unfavorable outcome for patients and to an economic burden [ 15 , 46 , 47 ]. The treatment of bacterial infections, especially of those hospital-acquired, raise serious concerns related to the rapid development of antibiotic resistance phenomenon and rapid spread of multidrug resistant strains, leading to a drastic limitation of the therapeutic options [ 48 ].…”

Hydrogel Droplet Microarray for Genotyping Antimicrobial Resistance Determinants in Neisseria gonorrhoeae Isolates

“…The low-density arrays, in which individual elements detect specific sequence variations, provide limited and reliable diagnostic information. The key limitations of microarray-based assays are the use of modified glass slides as substrate and incomplete level of automation of all steps of the procedure that made the process costly and time-consuming [36].…”

Recent Developments in Phenotypic and Molecular Diagnostic Methods for Antimicrobial Resistance Detection in Staphylococcus aureus: A Narrative Review

“…Moreover, phenotypic methods can be divided into manual and (semi) automated. Phenotypic methods such as the broth microdilution method (BMD) or the disk diffusion method represent the classical and “gold standard” in AST [ 26 ]. Although phenotypic methods measure the real resistance and are widely used, they suffer from interlaboratory reproducibility issues; for example, factors affecting reproducibility include the operator conducting the test and manually interpreting/reading the results (a problem that can be solved using automated phenotypic methods), or the environmental/laboratory conditions such as growth media and reagents’ stability [ 27 ].…”

“…Advantages of having POC microfluidic devices (also referred to as lab-on-a-chip) are as follows: easy to use even by non-trained personnel, rapidity, high throughput analysis, low cost, automation, multiplexing, and portability [ 18 ]. Challenges of implementing microfluidic POC systems in routine diagnostics are as follows: the need for specific material with certain features (e.g., electrical conductivity), realistic portability, and the rise of new resistance genes/mechanisms that will impede permanency (and affect the median life) of those devices [ 26 , 114 ]. Khan gave a review focused on the different types of microfluidic systems for AST [ 114 ].…”