Culture-Independent Bacterial Population Analysis – Clinical Implications for Respiratory and Other Infections

摘要

Despite efforts to quell the rising tide of antimicrobial resistance, national trends show disturbing increases innthe rate of resistance of clinically relevant microorganisms. The primary basis for this trend is inappropriate or insufficientnantimicrobial treatment, which is often due to a lack of rapid diagnostic tools and dependence on time-consuming culturebasednapproaches for pathogen detection and resistance profiling. Microbial ecologists have long made use of cultureindependentnmethods to detect unculturable or difficult to culture organisms. More recently, these tools have becomenmore sophisticated and have been applied to a variety of clinical disease and infection states, revealing considerablyngreater microbial community diversity than previously assumed. Initial reports have revealed that complex microbialncommunities exist in disparate sites of the body and that shifts in community composition correlate with states of healthnand disease. Administration of broad-spectrum antibiotics has a pronounced impact on microbial community compositionnand plays a significant role in the development of antibiotic-resistant organisms. Use of these novel culture-independentnapproaches has proven invaluable to improving our understanding of microbial community dynamics and presents annenormous potential for rapid diagnosis and temporal monitoring of antimicrobial efficacy. Application of such a technologynin a clinical setting could lead to quicker, more accurate diagnosis resulting in a more appropriate therapeutic administration,nthus reducing or possibly even reversing the current precipitous rise in antimicrobial resistance.