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Molecular antimicrobial susceptibility testing in sepsis

    Ignacio Martin-Loeches

    *Author for correspondence:

    E-mail Address: drmartinloeches@gmail.com

    Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James' Hospital, D08 NHY1, Dublin, Ireland

    Hospital Clinic, Institut D'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Ciberes, 08036 Barcelona, Spain

    ,
    João Gonçalves Pereira

    Hospital Vila Franca de Xira, Portugal

    Faculdade de Medicina da Universidade de Lisboa

    ,
    Tee Keat Teoh

    Department of Clinical Microbiology, St James' Hospital, Dublin, Ireland

    ,
    Gavin Barlow

    York Biomedical Research Institute, University of York and Hull York Medical School, UK

    Hull University Teaching Hospitals NHS Trust, Hull, UK

    ,
    Laurent Dortet

    Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France

    INSERM UMR 1184, RESIST Unit, Paris-Saclay University, Le Kremlin-Bicêtre, France

    French National Reference Center for Antimicrobial Resistance, France

    ,
    Enitan D Carrol

    University of Liverpool, Institute of Infection, Veterinary and Ecological Sciences, Liverpool, UK

    Alder Hey Children's Hospital, Department of Infectious Diseases, Liverpool, UK

    ,
    Ulrike Olgemöller

    Department of Cardiology and Pneumology, University of Goettingen, Goettingen, Germany

    ,
    Sara E Boyd

    St George's University Hospital NHS Foundation Trust, London, UK

    Antimicrobial Pharmacodynamics and Therapeutics, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK

    National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, UK

    &
    Julien Textoris

    Medical Affairs, bioMérieux SA, Marcy l'Etoile, France

    Published Online:https://doi.org/10.2217/fmb-2023-0128

    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.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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