Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing
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. Delaye...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/11/4/511 |
| _version_ | 1797437160328003584 |
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| author | Kristel C. Tjandra Nikhil Ram-Mohan Ryuichiro Abe Marjan M. Hashemi Jyong-Huei Lee Siew Mei Chin Manuel A. Roshardt Joseph C. Liao Pak Kin Wong Samuel Yang |
| author_facet | Kristel C. Tjandra Nikhil Ram-Mohan Ryuichiro Abe Marjan M. Hashemi Jyong-Huei Lee Siew Mei Chin Manuel A. Roshardt Joseph C. Liao Pak Kin Wong Samuel Yang |
| author_sort | Kristel C. Tjandra |
| collection | DOAJ |
| description | 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 outcomes, 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. |
| first_indexed | 2024-03-09T11:14:50Z |
| format | Article |
| id | doaj.art-4d76dad70e554984b39b99e618f77779 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T11:14:50Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-4d76dad70e554984b39b99e618f777792023-12-01T00:33:08ZengMDPI AGAntibiotics2079-63822022-04-0111451110.3390/antibiotics11040511Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility TestingKristel C. Tjandra0Nikhil Ram-Mohan1Ryuichiro Abe2Marjan M. Hashemi3Jyong-Huei Lee4Siew Mei Chin5Manuel A. Roshardt6Joseph C. Liao7Pak Kin Wong8Samuel Yang9Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA 94305, USADepartment of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA 94305, USADepartment of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA 94305, USADepartment of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA 94305, USADepartment of Biomedical Engineering, The Pennsylvania State University, University Park, PA 16802, USADepartment of Biomedical Engineering, The Pennsylvania State University, University Park, PA 16802, USADepartment of Biomedical Engineering, The Pennsylvania State University, University Park, PA 16802, USADepartment of Urology, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Biomedical Engineering, The Pennsylvania State University, University Park, PA 16802, USADepartment of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA 94305, USABloodstream 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 outcomes, 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.https://www.mdpi.com/2079-6382/11/4/511infectious diseasessepsispathogen diagnosisantibiotic susceptibilityemerging technologiessample preparation |
| spellingShingle | Kristel C. Tjandra Nikhil Ram-Mohan Ryuichiro Abe Marjan M. Hashemi Jyong-Huei Lee Siew Mei Chin Manuel A. Roshardt Joseph C. Liao Pak Kin Wong Samuel Yang Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing Antibiotics infectious diseases sepsis pathogen diagnosis antibiotic susceptibility emerging technologies sample preparation |
| title | Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing |
| title_full | Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing |
| title_fullStr | Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing |
| title_full_unstemmed | Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing |
| title_short | Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing |
| title_sort | diagnosis of bloodstream infections an evolution of technologies towards accurate and rapid identification and antibiotic susceptibility testing |
| topic | infectious diseases sepsis pathogen diagnosis antibiotic susceptibility emerging technologies sample preparation |
| url | https://www.mdpi.com/2079-6382/11/4/511 |
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