Next-Generation Antimicrobial Susceptibility Testing

Abstract

bAntimicrobial resistance has emerged as one of the most-significant health care problems of the new millennium, and the clinical microbiology laboratory plays a central role in optimizing the therapeutic management of patients with infection. This minireview explores the potential value of innovative methods for antimicrobial susceptibility testing of microorganisms that could provide valuable alternatives to existing methodologies in the very near future.

Drug repurposing screens and synergistic drug‐combinations for infectious diseases

“…They are also not suitable for testing of optimal drug combinations from hundreds of drug combinations in two‐drug and three‐drug combination formats. Several new methods have been under investigation for antimicrobial susceptibility testing (Smith and Kirby, 2016b; Sun et al , 2016b; van Belkum and Dunne, 2013) (Table 3). Improvement of the current antimicrobial susceptibility testing methods or invention of new methods is needed to meet the challenge of drug‐resistant bacteria.…”

“…Modernization of the methods of testing for antimicrobial susceptibility is needed to meet the challenges of treating of infectious diseases. The bacterial growth assay in a miniaturized format (384‐ or 1536‐well plates) (van Belkum and Dunne, 2013; Smith and Kirby, 2016a; Sun et al , 2016b) or a chip‐based method can be developed and optimized for this purpose. Only a short time (8 ‐ 10 h) is needed for determination of effective antimicrobial agents and effective drug combinations in the bacterial growth assay with an absorbance assay format (Sun et al , 2016b).…”

“…Only a short time (8 ‐ 10 h) is needed for determination of effective antimicrobial agents and effective drug combinations in the bacterial growth assay with an absorbance assay format (Sun et al , 2016b). New methods for rapid diagnosis of pathogens (10 h or less) such as genome sequencing of pathogens are also needed (van Belkum and Dunne, 2013; Dekker and Frank, 2016). The data should be quickly analysed to reveal the nature of pathogens and the information of drug susceptibility for a particular pathogen.…”

Rapid Antimicrobial Susceptibility Testing Using Forward Laser Light Scatter Technology

“…Several methods for rapid AST have been described in the literature (22)(23)(24)(25). Those in clinical use are primarily genotypic and sensitive and offer a rapid TAT.…”

“…The goal of ASPs is to optimize appropriate antimicrobial treatment, thereby reducing adverse outcomes (19)(20)(21) and preventing further antimicrobial resistance. Technologies have evolved to address these needs, and they include not only molecular methods but also methods based on the use of microfluidics, cell lysis detection, mass spectrometry, rapid cytometry, isothermal microcalorimetry, and magnetic bead rotation, among others (22)(23)(24)(25). Forward laser light scatter (FLLS) is another promising emerging technology that depends on electro-optical technology to measure bacterial growth prior to visual assessment.…”