Are We Ready for Novel Detection Methods to Treat Respiratory Pathogens in Hospital-Acquired Pneumonia?

被引:61
作者
Endimiani, Andrea [2 ]
Hujer, Kristine M. [2 ]
Hujer, Andrea M. [2 ]
Kurz, Sebastian [2 ]
Jacobs, Michael R. [7 ]
Perlin, David S. [5 ,6 ]
Bonomo, Robert A. [1 ,2 ,3 ,4 ]
机构
[1] Louis Stokes Cleveland Dept Vet Affairs Med Ctr, Infect Dis Sect, VISN GRECC 10, Res Serv, Cleveland, OH 44106 USA
[2] Case Western Reserve Univ, Sch Med, Dept Med, Cleveland, OH 44106 USA
[3] Case Western Reserve Univ, Sch Med, Dept Pharmacol, Cleveland, OH 44106 USA
[4] Case Western Reserve Univ, Sch Med, Dept Mol Biol & Microbiol, Cleveland, OH 44106 USA
[5] Publ Hlth Res Inst, Newark, NJ USA
[6] Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Microbiol & Mol Genet, Newark, NJ 07103 USA
[7] Case Western Reserve Univ, Sch Med, Dept Pathol, Cleveland, OH 44106 USA
基金
美国国家卫生研究院;
关键词
RESISTANT STAPHYLOCOCCUS-AUREUS; SPECTRUM BETA-LACTAMASES; INFECTIOUS-DISEASES SOCIETY; MICROBIAL-ROSETTA-STONE; GENEOHM STAPHSR ASSAY; METHICILLIN-RESISTANT; KLEBSIELLA-PNEUMONIAE; ACINETOBACTER-BAUMANNII; RAPID IDENTIFICATION; TIME PCR;
D O I
10.1093/cid/cir054
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Hospital-acquired pneumonia represents one of the most difficult treatment challenges in infectious diseases. Many studies suggest that the timely administration of appropriate, pathogen-directed therapy can be lifesaving. Because results of culture and antimicrobial susceptibility testing can take 48 h or longer, physicians currently rely on clinical, epidemiological, and demographic factors to assist with the choice of empiric therapy for antibiotic-resistant pathogens. At present, a number of rapid molecular tests are being developed that identify pathogens and the presence of genetic determinants of antimicrobial resistance (eg, GeneXpert [Cepheid], ResPlex [Qiagen], FilmArray [Idaho Technologies], and Microarray [Check-Points]). In this review, the potential impact that molecular diagnostics has to identify and characterize pathogens that cause hospital-acquired bacterial pneumonia at an early stage is examined. In addition, a perspective on a novel technology, polymerase chain reaction followed by electrospray ionization mass spectrometry, is presented, and its prospective use in the diagnosis of pneumonia is also discussed. The complexities of the pulmonary microbiome represent a novel challenge to clinicians, but many questions still remain even as these technologies improve.
引用
收藏
页码:S373 / S383
页数:11
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