Development and Evaluation of Novel Applied Diagnostic Platforms for Clinical Microbiology

临床微生物学新型应用诊断平台的开发和评估

• 批准号: 9154129
• 负责人: Anna Lau
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9154129
• 关键词: Antimicrobial Resistance; Antimicrobial susceptibility; Area; Biological Assay; Clinical; Clinical Microbiology; Complex; Detection; Development; Diagnosis; Diagnostic; Diagnostic Specificity; Enzymes; Evaluation; Genes; Goals; Hematopoietic stem cells; Infection Control; Laboratories; MALDI-TOF Mass Spectrometry; Mainstreaming; Measures; Methods; Microbiology; Molecular; Organism; Patient Care; Patients; Performance; Proteomics; Role; Specimen; Stem cell transplant; Streptococcus; System; Testing; Time; Transplant Recipients; Vancomycin resistant enterococcus; Work; beta-Lactamase; clinically significant; improved; microorganism; new technology; novel; novel diagnostics; novel strategies; research and development; resistance gene; resistance mechanism; therapeutic target

Traditional microbiological work up is slow and sometimes inaccurate, relying on phenotypic culture identification followed by antimicrobial susceptibility testing. Newer technologies, such as matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and real-time molecular detection (antimicrobial resistance genes microarrays) have advanced the diagnostic capabilities of clinical microbiology laboratories and have created an exciting field for research and development. Given the in-depth and highly accurate (sometimes complex) results that are produced by such platforms, careful detailed analyses are required to better understand the clinical significance of the organisms identified and the resistance mechanisms detected. During this fiscal year, we have undertaken a multi-center collaborative study to investigate the role of Streptococcus gallolyticus subsp. pasteurianus in hematopoietic stem cell transplant (HSCT) recipients and to evaluate the performance of two different MALDI-TOF MS systems for the identification of microorganisms to the subspecies level. We are also investigating the performance of a novel real-time PCR assay for the detection of four major carbapenmase genes direct from primary specimens, in parallel with selective culture. Methods to accurately detect extended spectrum beta-lactamases (ESBLs) and vancomycin resistant Enterococci (VREs) from surveillance specimens are also being evaluated in an effort to remove patients from unnecessary and costly infection control precautions, as well as improving the diagnostic specificity for microbiology laboratories. Finally, evaluation of rapid phenotypic methods to detect beta-lactamases from culture and the development of new approaches to detect these enzymes from primary specimens is underway.

传统的微生物学工作缓慢，有时不准确，依靠表型培养鉴定，然后进行抗菌敏感性测试。诸如飞行质谱法（MALDI-TOF MS）和实时分子检测（抗微生物耐药基因微阵列）的较新技术，例如辅助飞行质谱仪（MALDI-TOF MS）的电离电离时间，已提高了临床微生物学实验室的诊断能力，并为研究和开发创造了令人兴奋的领域。鉴于此类平台产生的深入且高度准确（有时是复杂）的结果，需要进行仔细的详细分析，以更好地了解所鉴定的生物的临床意义和检测到的抗性机制。 在这个财政年度，我们进行了一项多中心协作研究，以研究Gallolyticus subsp链球菌的作用。造血干细胞移植（HSCT）受体中的巴斯德里亚努斯，并评估两个不同的MALDI-TOF MS系统的性能，以将微生物鉴定为亚种水平。我们还正在研究一种新型的实时PCR分析的性能，以与选择性培养物并行检测直接从主要标本的四个主要碳酸胶酶基因。还在评估了从监视标本中准确检测扩展的谱β-内酰胺酶（ESBL）和耐万古霉素肠球菌（VRE）的方法，以努力将患者从不必要的和昂贵的感染控制预防措施中删除，并改善对微生物学实验室的诊断特异性。最后，正在进行评估从培养物中检测β-内酰胺酶的快速表型方法的评估，并开发了从主要标本中检测这些酶的新方法的开发。