Molecular Antimicrobial Susceptibility Testing in Sepsis

Abstract

Rapidly detecting and identifying pathogens is crucial for appropriate antimicrobial therapy in patients with sepsis. Conventional diagnostic methods have been a great asset to medicine, though they are time consuming and labor intensive. This work will enable healthcare professionals to understand the bacterial community better and enhance their diagnostic capacity by using novel molecular methods that make obtaining quicker, more precise results possible. The authors discuss and critically assess the merits and drawbacks of molecular testing and the added value of these tests, including the shift turnaround time, the implication for clinicians’ decisions, gaps in knowledge, future research directions and novel insights or innovations. The field of antimicrobial molecular testing has seen several novel insights and innovations to improve the diagnosis and management of infectious diseases.

Plain language summary

Sepsis is a life-threatening reaction to an infection. This infection is normally caused by a bacteria. Identifying the bacteria that has caused the infection is very important to choosing the best treatment. This is usually done using molecular testing. This article discusses the advantages and disadvantages of molecular testing, which tests are available and the value of these tests in clinical practice, the implication of molecular tests for clinicians’ decisions and the gaps in our knowledge. It also discusses future innovations in molecular testing.

Keywords::

• antibiotics
• AST
• bacteremia
• ICU
• MDR
• microbiology
• molecular testing
• pneumonia
• sepsis
• septic shock

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors of this paper have received grants, consulting fees or honoraria from or served on the scientific advisory boards of Grifols, Pfizer, Mundipharma, Gilead, Biomerieux, MSD, AOP pharmaceuticals, Abionic, Advanz Pharma, UCB Pharma, Menarini, Shionogi, Biofire, Danaher Diagnostics, Vital Aire, Orion Pharma, Berlin Chemie, Novartis, Sanofi-Aventis, CSL Behring, Sumitovant, Shionogi and the UK Clinical Pharmacy Association. G Barlow is co-Chief Investigator on two UK NIHR-funded clinical trials (BioDriveAFS and MANTRA). J Textoris has also served as a speaker in congress for MSD, Menarini, Advanz, Shionogi and Thermo Fisher. SE Boyd was funded by an RCUK Innovation Fellowship through the NorthWest MRC Scheme in Clinical Pharmacology and has received research support from Roche Pharma. J Textoris is an employee of Biomerieux. The authors have no other competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.