韩国首尔大学Sunghoon Kwon等研究人员合作开发出无需血液培养的超快速抗菌药物敏感性测试。这一研究成果于2024年7月24日在线发表在国际学术期刊《自然》上。

研究人员描述了一种超快速抗菌药物敏感性测试（AST）方法，该方法绕过了传统的血液培养需求，从而使报告药物敏感性分析结果的周转时间比医院AST工作流程减少了40-60小时。通过引入合成的β-2-糖蛋白I肽，该方法从全血中选择性地回收各种微生物病原体，进行物种鉴定或立即增殖，并使用低接种AST芯片对各种药物条件进行表型评估。

通过招募190名怀疑感染的住院患者对该平台进行临床评估，物种鉴定的匹配率达到100%。在八个阳性病例中，六个临床分离株进行了回顾性AST测试，显示总分类一致性为94.90%，从初始血液处理开始，平均理论周转时间为13±2.53小时。

据介绍，败血症的治疗评估和患者预后主要取决于及时使用合适的抗生素。然而，用于分层和选择患者特定最佳治疗的临床协议非常缓慢。特别是，进行快速AST的主要障碍在于漫长的血液培养过程，由于患者血液中病原体数量有限，这一过程长期以来被认为是不可避免的。

附：英文原文

Title: Blood culture-free ultra-rapid antimicrobial susceptibility testing

Author: Kim, Tae Hyun, Kang, Junwon, Jang, Haewook, Joo, Hyelyn, Lee, Gi Yoon, Kim, Hamin, Cho, Untack, Bang, Hyeeun, Jang, Jisung, Han, Sangkwon, Kim, Dong Young, Lee, Chan Mi, Kang, Chang Kyung, Choe, Pyoeng Gyun, Kim, Nam Joong, Oh, Myoung-don, Kim, Taek Soo, Kim, Inho, Park, Wan Beom, Kwon, Sunghoon

Issue&Volume: 2024-07-24

Abstract: Treatment assessment and patient outcome for sepsis depend predominantly on the timely administration of appropriate antibiotics1,2,3. However, the clinical protocols used to stratify and select patient-specific optimal therapy are extremely slow4. In particular, the major hurdle in performing rapid antimicrobial susceptibility testing (AST) remains in the lengthy blood culture procedure, which has long been considered unavoidable due to the limited number of pathogens present in the patient’s blood. Here we describe an ultra-rapid AST method that bypasses the need for traditional blood culture, thereby demonstrating potential to reduce the turnaround time of reporting drug susceptibility profiles by more than 40–60h compared with hospital AST workflows. Introducing a synthetic beta-2-glycoprotein I peptide, a broad range of microbial pathogens are selectively recovered from whole blood, subjected to species identification or instantly proliferated and phenotypically evaluated for various drug conditions using a low-inoculum AST chip. The platform was clinically evaluated by the enrolment of 190hospitalized patients suspected of having infection, achieving 100% match in species identification. Among the eight positive cases, six clinical isolates were retrospectively tested for AST showing an overall categorical agreement of 94.90% with an average theoretical turnaround time of 13±2.53h starting from initial blood processing.

DOI: 10.1038/s41586-024-07725-1

Source: https://www.nature.com/articles/s41586-024-07725-1