Examples of fast ways to identify the right antibiotic

[Ratul]

Hello,

 

I am doing research to see what technologies exist to rapidly identify the correct antibiotic in the case of neonatal sepsis (faster than blood culture and antibiotic sensitivity testing). Would anyone be able to help me understand what technologies exist?

 

To give you some more background, NICUs in India (like much of the rest of developing world) receive a large proportion of neonates with septic infections. The majority of these infections are caused by CONS, Klebsiella, E. Coli, Psuedomnias. Typically a physician will

1) Start a blood culture,

2) Give a first line antibiotics

3) Wait for morphology and then sensitivity results 2-5 days later.

4) Change the antibiotic if the culture results suggest to, or if the baby hasn't responded within a reasonable time (regardless of culture results and their availability).

 

Is there any promising technology that could shortcut the sensitivity testing to identify

1) what is the correct antibiotic to give for this infection

2) or similarly, that the antibiotic being given (i.e. first line or second line antibiotics) will NOT be effective and so they should try something else?

 

I would really appreciate if anyone could point me to some promising technologies (even if in the research phase, and even if only specific to one type of bacteria or one type of antibiotics). For example, perhaps there is research around the mechanism of action of a specific antibiotic, and there is a way to rapidly detect if the cellwall/enzymes/DNA in the whole blood will allow for that mechanism to occur.

 

I apologize in advance as I am new to the microbiology field which is why I reached out to this expert forum. Please email me if you need more clarification or would like to discuss offline.

 

Thanks in advance!

 

Ratul

[CharonY]

Technically we do have quite some tools for rapid identification of bacteria, but the actual implementation is tricky in a clinical setting. For example, a small sample could be taken to amplify ribosomal sequences and compare with database to identify the strain. This is actually been done for high-priority cases, but due to the precision needed during sampling and sample preparation it is prone to errors e.g. due to contamination. And of course on-site sequencing facilities are often limited and one needs trained personnel. While theoretically a higher turnover (in terms of wait times) is possible to a certain degree, the amount of samples, available resources (both instrumental and personnel) limit actual implementation on a large scale.

[Ejihand]

Since you live in India. A medical laboratory text book written by sood called medical laboratory technology volume 2 will be helpful to you. A am medical laboratory scientist based in Nigeria