Recent and emerging technologies for the rapid diagnosis of infection and antimicrobial resistance

• Published in: Current opinion in microbiology 2019-10, Vol.51, p.39-45
• Main Authors: Trotter, Alexander J., Aydin, Alp, Strinden, Michael J., O’Grady, Justin
• Format: Article
• Language: English
• Subjects: Animals; Anti-Bacterial Agents - pharmacology; Bacteria - drug effects; Bacteria - genetics; Bacteria - isolation & purification; Bacterial Infections - diagnosis; Bacterial Infections - drug therapy; Bacterial Infections - microbiology; Drug Resistance, Bacterial; Humans
• ISSN: 1369-5274; 1879-0364
• DOI: 10.1016/j.mib.2019.03.001

•Rapid diagnostics are essential in the fight against antimicrobial resistance.•BioFire® FilmArray® panels can identify pathogen resistance genes in 1 hour.•Accelerate Pheno™ reads antimicrobial susceptibility from blood cultures in 7 hours.•Nanopore sequencing-based metagenomics can characterise infections in 6 hours. The rise in antimicrobial resistance (AMR) is predicted to cause 10 million deaths per year by 2050 unless steps are taken to prevent this looming crisis. Microbiological culture is the gold standard for the diagnosis of bacterial/fungal pathogens and antimicrobial resistance and takes 48 hours or longer. Hence, antibiotic prescriptions are rarely based on a definitive diagnosis and patients often receive inappropriate treatment. Rapid diagnostic tools are urgently required to guide appropriate antimicrobial therapy, thereby improving patient outcomes and slowing AMR development. We discuss new technologies for rapid infection diagnosis including: sample-in-answer-out PCR-based tests, BioFire FilmArray and Curetis Unyvero; rapid susceptibility tests, Accelerate Pheno and microfluidic tests; and sequencing-based approaches, focusing on targeted and clinical metagenomic nanopore sequencing.