Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing
Journal
Antibiotics
Series/Report No.
Antibiotics
Journal Volume
11
Journal Issue
4
Start Page
511
ISSN
2079-6382
Date Issued
2022-04-12
Author(s)
Tjandra, Kristel C.
Ram-Mohan, Nikhil
Abe, Ryuichiro
Hashemi, Marjan M.
Chin, Siew Mei
Roshardt, Manuel A.
Liao, Joseph C.
Wong, Pak Kin
Yang, Samuel
Abstract
Bloodstream infections (BSI) are a leading cause of death worldwide. The lack of timely and reliable diagnostic practices is an ongoing issue for managing BSI. The current gold standard blood culture practice for pathogen identification and antibiotic susceptibility testing is time-consuming. Delayed diagnosis warrants the use of empirical antibiotics, which could lead to poor patient out-comes, and risks the development of antibiotic resistance. Hence, novel techniques that could offer accurate and timely diagnosis and susceptibility testing are urgently needed. This review focuses on BSI and highlights both the progress and shortcomings of its current diagnosis. We surveyed clinical workflows that employ recently approved technologies and showed that, while offering improved sensitivity and selectivity, these techniques are still unable to deliver a timely result. We then discuss a number of emerging technologies that have the potential to shorten the overall turnaround time of BSI diagnosis through direct testing from whole blood—while maintaining, if not improving—the current assay’s sensitivity and pathogen coverage. We concluded by providing our assessment of potential future directions for accelerating BSI pathogen identification and the antibiotic susceptibility test. While engineering solutions have enabled faster assay turnaround, further progress is still needed to supplant blood culture practice and guide appropriate antibiotic administration for BSI patients.
Subjects
antibiotic susceptibility
emerging tech-nologies
infectious diseases
multidrug-resistant pathogens
pathogen diagnosis
sample preparation
sepsis
Publisher
MDPI AG
Type
journal article