Are We Ready for Novel Detection Methods to Treat Respiratory Pathogens in Hospital-Acquired Pneumonia?

Endimiani, Andrea; Hujer, Kristine M.; Hujer, Andrea M.; Kurz, Sebastian; Jacobs, Michael; Perlin, David S.; Bonomo, Robert A.

doi:10.1093/cid/cir054

Cited by 70 publications

(64 citation statements)

References 115 publications

(136 reference statements)

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“…PRIMERS I evaluated the performance characteristics of 4 molecular diagnostic platforms for identifying β-lactam resistance via identification of genes conferring resistance to β-lactam antibiotics in isolates belonging to Enterobacteriaceae (72 strains of highly drug-resistant Escherichia coli and Klebsiella pneumoniae). The 4 platforms evaluated were polymerase chain reaction combined with electrospray ionization mass spectrometry, PCR/ESI-MS [4]; DNA microarrays that detect β-lactamase (bla) genes, Check-Points [5,6]; a multiplex diagnostic platform that uses allele-specific fluorescently labeled probes to identify genes, molecular beacons (MB) [7]; and a next-generation bench-top sequencing platform, Ion Torrent [8][9][10]. Analyses focused on the detection of β-lactam resistance, as this family of antibiotics represents the "cornerstone of therapy" for many infections caused by Enterobacteriaceae.…”

mentioning

confidence: 99%

Rapid Molecular Diagnostics, Antibiotic Treatment Decisions, and Developing Approaches to Inform Empiric Therapy: PRIMERS I and II

Evans¹,

Hujer²,

Jiang³

et al. 2015

Clin Infect Dis.

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Background. Rapid molecular diagnostic (RMD) platforms may lead to better antibiotic use. Our objective was to develop analytical strategies to enhance the interpretation of RMDs for clinicians.Methods. We compared the performance characteristics of 4 RMD platforms for detecting resistance against β-lactams in 72 highly resistant isolates of Escherichia coli and Klebsiella pneumoniae (PRIMERS I). Subsequently, 2 platforms were used in a blinded study in which a heterogeneous collection of 196 isolates of E. coli and K. pneumoniae (PRIMERS II) were examined. We evaluated the genotypic results as predictors of resistance or susceptibility against β-lactam antibiotics. We designed analytical strategies and graphical representations of platform performance, including discrimination summary plots and susceptibility and resistance predictive values, that are readily interpretable by practitioners to inform decision-making.Results. In PRIMERS I, the 4 RMD platforms detected β-lactamase (bla) genes and identified susceptibility or resistance in >95% of cases. In PRIMERS II, the 2 platforms identified susceptibility against extended-spectrum cephalosporins and carbapenems in >90% of cases; however, against piperacillin/tazobactam, susceptibility was identified in <80% of cases. Applying the analytical strategies to a population with 15% prevalence of ceftazidime-resistance and 5% imipenem-resistance, RMD platforms predicted susceptibility in >95% of cases, while prediction of resistance was 69%-73% for ceftazidime and 41%-50% for imipenem.Conclusions. RMD platforms can help inform empiric β-lactam therapy in cases where bla genes are not detected and the prevalence of resistance is known. Our analysis is a first step in bridging the gap between RMDs and empiric treatment decisions.

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mentioning

confidence: 99%

Rapid Molecular Diagnostics, Antibiotic Treatment Decisions, and Developing Approaches to Inform Empiric Therapy: PRIMERS I and II

Evans¹,

Hujer²,

Jiang³

et al. 2015

Clin Infect Dis.

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“…Rapid molecular methods can be useful to guide therapy for pneumonia based on the type of organism detected and resistance genes present, but clinical trial data have not yet been published (Endimiani et al, 2011).…”

Section: Application Of Microarrays Directly To Patient Samples 413mentioning

confidence: 99%

Solid and Suspension Microarrays for Microbial Diagnostics

Miller

Karaöz

Brodie

et al. 2015

Methods in Microbiology

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“…In the field of medicine there is a constant search for more sensitive and reliable diagnostic methods [21,22]. In some cases only minute amounts of a target substance separate a positive from a negative sample.…”

Section: Fig 1 Dynamic Field Range and Detectivity Of Some Magnetommentioning

confidence: 99%

Modelling and design of planar Hall effect bridge sensors for low-frequency applications

Persson

Bejhed

Østerberg

et al. 2013

Sensors and Actuators A: Physical

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This is an accepted version of a paper published in Sensors and Actuators A-Physical. This paper has been peer-reviewed but does not include the final publisher proofcorrections or journal pagination.Citation for the published paper: Persson, A., Bejhed, R., Oesterberg, F., Gunnarsson, K., Nguyen, H. et al. (2012) "Modelling and design of planar Hall effect bridge sensors for low-frequency applications" Sensors and Actuators Access to the published version may require subscription. AbstractThe applicability of miniaturized magnetic field sensors is being explored in several areas of magnetic field detection due to their integratability, low mass, and potentially low cost. In this respect, different thin-film technologies, especially those employing magnetoresistance, show great potential, being compatible with batch micro-and nanofabrication techniques. For lowfrequency magnetic field detection, sensors based on the planar Hall effect, especially planar Hall effect bridge (PHEB) sensors, show promising performance given their inherent lowfield linearity, limited hysteresis and moderate noise figure. In this work, the applicability of such PHEB sensors to different areas is investigated. An analytical model is constructed to estimate the performance of an arbitrary PHEB sensor geometry in terms of, e.g., sensitivity and detectivity. The model is valid for an ideal case, e.g., disregarding shape anisotropy effects, and also incorporates some approximations. To validate the results, modelled data was compared to measurements on actual PHEBs and was found to predict the measured values within 13% for the investigated geometries. Subsequently, the model was used to establish a design process for optimizing a PHEB to a particular set of requirements on the bandwidth, detectivity, compliance voltage and amplified signal-to-noise ratio. By applying this design process, the size, sensitivity, resistance, bias current and power consumption of the PHEB can be estimated. The model indicates that PHEBs can be applicable to several different areas within science including satellite attitude determination and magnetic bead detection in labon-a-chip applications, where detectivities down towards 1 nTHz -0.5 at 1 Hz are required, and maybe even magnetic field measurements in scientific space missions and archaeological surveying, where the detectivity has to be less than 100 pTHz -0.5 at 1 Hz.

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Are We Ready for Novel Detection Methods to Treat Respiratory Pathogens in Hospital-Acquired Pneumonia?

Cited by 70 publications

References 115 publications

Rapid Molecular Diagnostics, Antibiotic Treatment Decisions, and Developing Approaches to Inform Empiric Therapy: PRIMERS I and II

Rapid Molecular Diagnostics, Antibiotic Treatment Decisions, and Developing Approaches to Inform Empiric Therapy: PRIMERS I and II

Solid and Suspension Microarrays for Microbial Diagnostics

Modelling and design of planar Hall effect bridge sensors for low-frequency applications

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