[Advances in diagnostic microbiology : Opportunities and limitations].
In the light of ever increasing problems related to the emergence of multidrug-resistant bacteria, rapid microbiological diagnostics are of growing importance. Timely pathogen detection and availability of susceptibility data are essential for optimal treatment, but are even more crucial for de-escalation of broad spectrum empiric therapies. Medical microbiology is, thus, an integral part of antimicrobial stewardship programs. Traditional microbiological techniques for species identification and susceptibility testing rely on bacterial growth and are, thus, characterized by inherent slowness. Time-to-report is usually 48 h or longer, and typically delays optimization of therapeutic regimens. Constant improvement of available techniques (e. g., molecular methods) and introduction of novel methods (e. g., matrix-assisted laser desorption ionization time-of-flight [MALDI-ToF] mass spectrometry) have fundamentally changed diagnostic procedures. As a consequence, sensitivity and specificity as well as time-to-report have been dramatically improved. In this manuscript, key methodological advances in medical microbiology are discussed, emphasizing consequences for daily management of infectious disease patients.
Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.|Antibiotic Stewardship Team, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
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Maurer
MVZ Labor Dr. Fenner und Kollegen, Bergstraße 14, 20095, Hamburg, Deutschland.
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Hentschke
Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland. rohde@uke.de.
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Rohde
D000073602:Antimicrobial Stewardship; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy*; D001431:Bacteriological Techniques; D003937:Diagnosis, Differential; D018432:Drug Resistance, Multiple; D061345:Early Medical Intervention; D008826:Microbial Sensitivity Tests; D008828:Microbiological Techniques; D060885:Multiplex Polymerase Chain Reaction; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy*; D012680:Sensitivity and Specificity; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D014777:Virus Diseases / Q000175:diagnosis*
Infectious disease diagnostics; MALDI-TOF; Rapid molecular assays; Susceptibility testing