2020-06-012024-05-15https://scholars.lib.ntu.edu.tw/handle/123456789/664535摘要：與細菌和真菌感染高相關性之肺炎和敗血症分別居國人死因第三位與第十二位，約佔總死亡人數的百分之十，且感染引起之臨床表徵眾多，造成醫師判斷不易。每年國內醫院及基層診所之抗生素給藥案件約2,550萬件，抗生素的誤用與濫用會大幅增加超級細菌出現的風險，現行新興致病菌檢測質譜儀的引入，雖已改善檢測繁瑣流程與時間，然其因機台大易受場地空間限制，儀器成本與耗材費用亦高昂，且對致病菌的抗藥性仍有待克服，目前僅有醫學中心使用。因此，臨床致病菌的多樣性及檢測工具之價格與便利性依然是需克服之障礙。 拉曼光譜儀為具備優勢之致病菌檢測新興技術，檢測過程無須進行生物標記，屬非侵入性、非破壞性光學檢測，且水不會干擾其訊號，然目前國內外研究尚無穩定且有效的致病菌檢測拉曼光譜儀。本計畫將透過跨領域團隊之合作，以本身臨床細菌檢驗與生物技術專業知識，導入業界先進尖端拉曼光學儀器、表面增強檢測試劑、與分析軟體的設計能力等多領域研發能量，蒐集臨床常見致病菌之拉曼光譜並進行大數據整合及分析之先期研究，建立更強大的菌種鑑定能力，力求提升醫學檢驗品質。 <br> Abstract: Pneumonia and sepsis, often caused by bacterial and fungal infections, are ranked third and twelfth, respectively, in the cause of death of Taiwan and account for about 10% of the total number of deaths. Due to the various clinical characteristics of the infections, it is difficult for physicians to give a precise diagnose in the first place. Annually, there were about 25.5 million cases of antibiotic administration in domestic hospitals and primary clinics. Antibiotics misuse and abuse will further increase the incidence of multiple-drug resistant bacteria. Though the introduction of the MALDI-TOF MS machine has improved the efficiency in pathogen detection. However, the machine is large, and the price of equipment and cost of each diagnostic is high. Besides, MALDI-TOF MS is still not capable of assessing the antibiotic susceptibility of the pathogenic bacteria. Therefore, an affordable and portable diagnostic platform with the capability to distinguish the diverse clinical pathogens remain highly needed. Raman spectrometer is an emerging technology for the detection of pathogenic bacteria. The detection process does not require the labeling of the sample. It is a non-invasive, non-destructive optical test, and water will not interfere with its signal. However, there is no stable and effective Raman-based pathogen diagnostic platform available so far. Thus, we aimed to build a cross-disciplinary team and to combine our expertise in clinical pathogen identification, design and manufacture of advanced Raman optical instrument, SERS reagent development, intelligent data analysis, and software development to establish the database of Raman spectra of several clinical pathogenic bacteria and to conduct preliminary research on big data integration and analysis. We expect that this project will establish a new Raman-based pathogen identification platform to improve the quality and efficiency of clinical pathogen diagnostic.質譜儀表面增強拉曼散射抗生素抗藥性MALDI-TOF MSSurface-enhanced Raman scatteringAntibiotic resistance