下一代测序作为抗生素敏感性测试的万能药:是还是不是?
1ShanX Medtech, Eindhoven, Netherlands.
Frontiers in public health
|September 3, 2025
概括
下一代测序 (NGS) 为临床微生物学中的基因组抗菌敏感性测试 (gAST) 提供了潜力. 然而,完整的诊断实施需要降低复杂性,改进数据管理,更快的周转和更低的成本才能取代表型AST.
科学领域:
- 临床微生物学
- 基因组学
- 传染性疾病
背景情况:
- 临床微生物学实验室越来越多地采用下一代测序 (NGS) 技术.
- 全基因组测序 (WGS) 可以识别物种,量化和追踪微生物菌株.
- WGS 便于检测病毒性和抗菌素耐药性 (AMR) 基因,从而实现基因组 AST (gAST).
研究的目的:
- 评估临床微生物学中的NGS和gAST的现状.
- 与传统的抗菌感应性测试 (AST) 方法相比,评估gAST的附加值.
- 讨论gAST临床实施的要求.
主要方法:
- 对目前临床微生物学中的NGS和gAST应用进行审查.
- 对gAST的技术,数据管理,成本和监管挑战进行评估.
- 对gAST与已知的表型AST方法进行比较.
主要成果:
- 目前在常规实验室中无法完全实现gAST的诊断.
- 在技术复杂性,数据管理,及时性和成本效益方面需要显著改进.
- 目前,gAST需要与快速表型AST结合进行常规使用.
结论:
- 但在广泛的临床采用方面面临着巨大的障碍.
- 监管部门的批准 (IVDR,FDA) 和补偿对于市场准入至关重要.
- 需要进一步开发以提高吞吐量,定义临床价值,并简化采用.
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