Diagnostics of Antimicrobial Resistance (AMR): From Phenotypic to Molecular—Volume 2

Dear Colleagues,

Multidrug-resistant bacteria are increasingly isolated and responsible for hospital outbreaks, associated with significant morbidity and mortality. Accordingly, their global dissemination poses a serious threat to public health. The rapid detection of these bacteria is crucial to help physicians to quickly implement the appropriate infection control measures, to quickly adapt antibiotic treatment and to optimize care strategies and outcomes.

Resistance is emerging in many clinically relevant Gram-negative (Enterobacterales, Pseudomonas sp. and Acinetobacter sp. with ESBLs, Carbapenemases or RNA methylases, etc.) and Gram-positive (Staphylococci, Enterococci, etc.) bacteria and mycobacteria. Early detection requires rapid, easy and efficient diagnostic tools that can be adapted to many resource settings.

Screening protocols are mainly based on cultures of nasal and/or rectal swab specimens on selective screening media, followed by confirmation tests such as phenotypic, biochemical, lateral flow immunoassays and mass spectrometry (such as MALDI-TOF) tests. The culture of nasal/rectal swab specimens followed by confirmation testing is time-consuming, and often not compatible with the rapid implementation of reinforced hygiene measures. Molecular-based techniques such as PCR, and whole genome sequencing remain the gold standard for the precise identification of resistance genes. Molecular methods are now available for detecting resistance genes from bacterial cultures and also directly from clinical specimens in less than an hour. However, due to their high costs, they are often used following a risk-based assessment of the patient’s history (recent travel, hospitalization, treatment, etc.).

This Special Issue is dedicated to the recent developments and clinical validation of both traditional and innovative tools for qualitatively/quantitatively detecting resistance traits on cultured bacteria or directly in clinical samples, with a special emphasis on the positioning of these tests in routine settings and on the clinical usefulness of these tests.

Dr. Thierry Naas
Guest Editor

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