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Emerging Microtechnologies and Automated Systems for Rapid Bacterial Identification and Antibiotic Susceptibility Testing

机译:新兴的微技术和自动化系统,用于细菌快速鉴定和药敏试验

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Rapid bacterial identification (ID) and antibiotic susceptibility testing (AST) are in great demand due to the rise of drug-resistant bacteria. Conventional culture-based AST methods suffer from a long turnaround time. By necessity, physicians often have to treat patients empirically with antibiotics, which has led to an inappropriate use of antibiotics, an elevated mortality rate and healthcare costs, and antibiotic resistance. Recent advances in miniaturization and automation provide promising solutions for rapid bacterial ID/AST profiling, which will potentially make a significant impact in the clinical management of infectious diseases and antibiotic stewardship in the coming years. In this review, we summarize and analyze representative emerging micro- and nanotechnologies, as well as automated systems for bacterial ID/AST, including both phenotypic (e.g., microfluidic-based bacterial culture, and digital imaging of single cells) and molecular (e.g., multiplex PCR, hybridization probes, nanoparticles, synthetic biology tools, mass spectrometry, and sequencing technologies) methods. We also discuss representative point-of-care (POC) systems that integrate sample processing, fluid handling, and detection for rapid bacterial ID/AST. Finally, we highlight major remaining challenges and discuss potential future endeavors toward improving clinical outcomes with rapid bacterial ID/AST technologies.
机译:由于耐药菌的兴起,对快速细菌鉴定(ID)和抗生素敏感性测试(AST)的需求很大。传统的基于文化的AST方法需要较长的周转时间。必要时,医生经常必须凭经验对患者进行抗生素治疗,这导致了抗生素的不当使用,死亡率和医疗费用的增加以及抗生素的耐药性。小型化和自动化方面的最新进展为细菌ID / AST快速分析提供了有希望的解决方案,这将在未来几年中对传染病的临床管理和抗生素管理产生重大影响。在这篇综述中,我们总结并分析了代表性的新兴微技术和纳米技术以及细菌ID / AST的自动化系统,包括表型(例如,基于微流体的细菌培养和单细胞数字成像)和分子(例如,多重PCR,杂交探针,纳米颗粒,合成生物学工具,质谱和测序技术)方法。我们还将讨论具有代表性的即时服务(POC)系统,该系统集成了样品处理,流体处理和快速细菌ID / AST检测功能。最后,我们重点介绍了主要挑战,并讨论了通过快速细菌ID / AST技术改善临床结果的潜在未来努力。

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