title: The Changing Role of the Clinical Microbiology Laboratory in Defining Resistance in Gram-negatives.
abstract: The evolution of resistance in Gram-negatives has challenged the clinical microbiology laboratory to implement new methods for their detection. Multidrug-resistant strains present major challenges to conventional and new detection methods. More rapid pathogen identification and antimicrobial susceptibility testing have been developed for use directly on specimens, including fluorescence in situ hybridization tests, automated polymerase chain reaction systems, microarrays, mass spectroscopy, next-generation sequencing, and microfluidics. Review of these methods shows the advances that have been made in rapid detection of resistance in cultures, but limited progress in direct detection from specimens.
authors.affiliation: Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Friedbühlstrasse 51, Bern CH-3010, Switzerland. Electronic address: andrea.endimiani@ifik.unibe.ch.
authors.forename: Andrea
authors.initials: A
authors.lastname: Endimiani
authors.affiliation: Department of Pathology, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jacobs
mesh_terms: D024881:Drug Resistance, Bacterial / Q000235:genetics*; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects / Q000235:genetics; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000382:microbiology; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D058889:Molecular Typing; D016133:Polymerase Chain Reaction; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
keywords: AST; LAMP; MALDI-TOF; Microarray; PCR; Rapid; Real time; Sequencing