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Rapid Susceptibility Testing Methods.

Kenneth P Smith1, James E Kirby2

  • 1Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Center for Life Science, 3 Blackfan Circle-CLS624, Boston, MA 02115, USA.

Clinics in Laboratory Medicine
|August 7, 2019
PubMed
Summary

Rapid antimicrobial susceptibility testing (AST) is crucial for optimizing patient outcomes amid rising antimicrobial resistance. Integrating fast genotypic and sensitive phenotypic methods with real-time decision support is key to effective treatment.

Keywords:
Antimicrobial resistanceGenotypicPhenotypicRapid antimicrobial susceptibility testing

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Area of Science:

  • Microbiology
  • Clinical Diagnostics
  • Pharmacology

Background:

  • Antimicrobial resistance (AMR) necessitates rapid diagnostic methods.
  • Current antimicrobial susceptibility testing (AST) methods face limitations in speed and scope.
  • Optimizing patient outcomes requires timely and accurate therapeutic guidance.

Purpose of the Study:

  • To highlight the need for rapid antimicrobial susceptibility testing (AST).
  • To discuss the advantages and limitations of genotypic and phenotypic AST methods.
  • To emphasize the importance of integrating AST results with decision support systems.

Main Methods:

  • Review of genotypic methods for identifying known resistance elements.
  • Description of phenotypic methods utilizing optical and biophysical techniques to detect pathogen response to antibiotics.
  • Discussion of decision support solutions for real-time therapeutic adjustments.

Main Results:

  • Genotypic methods offer speed but cover a limited range of resistance mechanisms.
  • Phenotypic methods provide clinically relevant minimal inhibitory concentrations with high sensitivity.
  • The full potential of rapid AST requires seamless integration with clinical decision support.

Conclusions:

  • Rapid AST is essential for combating antimicrobial resistance and improving patient care.
  • A combination of genotypic and phenotypic approaches, coupled with real-time decision support, is vital for effective antimicrobial stewardship.