Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Diagnosing antimicrobial resistance

Abstract

Antimicrobial resistance constitutes a global burden and is one of the major threats to public health. Although the emergence of resistant microorganisms is a natural phenomenon, the overuse or inappropriate use of antimicrobials has had a great effect on resistance evolution. Rapid diagnostic tests that identify drug-resistant bacteria, determine antimicrobial susceptibility and distinguish viral from bacterial infections can guide effective treatment strategies. Moreover, rapid diagnostic tests could facilitate epidemiological surveillance, as emerging resistant infectious agents and transmission can be monitored. In this Viewpoint article, several experts in the field discuss the drawbacks of current diagnostic methods that are used to identify antimicrobial resistance, novel diagnostic strategies and how such rapid tests can inform drug development and the surveillance of resistance evolution.

Carey-Ann D. Burnham.

Jennifer Leeds.

Patrice Nordmann.

Justin O'Grady.

Jean Patel.

C.-A.D.B.

J.L.

P.N.

J.O'G.

J.P.

C.-A.D.B.

J.L.

P.N.

J.O'G.

J.P.

C.-A.D.B.

J.L.

P.N.

J.O'G.

J.P.

C.-A.D.B.

J.L.

P.N.

J.O'G.

J.P.

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

  1. Kuti, E. L., Patel, A. A. & Coleman, C. I. Impact of inappropriate antibiotic therapy on mortality in patients with ventilator-associated pneumonia and blood stream infection: A meta-analysis. J. Crit. Care 23, 91–100 (2008).

    Article  Google Scholar 

  2. Doern, G. V. & Brecher, S. M. The clinical predictive value (or lack thereof) of the results of in vitro antimicrobial susceptibility tests. J. Clin. Microbiol. 49, S11–S14 (2011).

    Article  Google Scholar 

  3. Clinical and Laboratory Standards Institute. Development of in vitro Susceptibility Testing Criteria and Quality Control Parameters. 4th edn (CLSI, 2008).

  4. Kircher, S. M. et al. The Susceptibility Testing Manufacturers Association presents an opinion for the delay of current susceptibility tests. Clin. Infect. Dis. 63, 1531–1532 (2016).

    Article  Google Scholar 

  5. Kahlmeter, G., Åhman, J. & Matuschek, E. Antimicrobial resistance of Escherichia coli causing uncomplicated urinary tract infections: A European update for 2014 and comparison with 2000 and 2008. Infect. Dis. Ther. 4, 417–423 (2015).

    Article  Google Scholar 

  6. Public Health England. Surveillance of antimicrobial resistance in Neisseria gonorrhoeae: key findings from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP). GOV.UK https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/567602/GRASP_Report_2016.pdf (2016).

  7. Accelerate Diagnostics. Accelerate Pheno system. Accelerate Diagnostics http://acceleratediagnostics.com/products/accelerate-pheno-system/#features (2017).

  8. Nather, D. Inside the Pentagon's biotech strike force. STAT News https://www.statnews.com/2015/11/24/darpa-biotech-infectious-disease/ (2015).

    Google Scholar 

  9. Schmidt, K. et al. Identification of bacterial pathogens and antimicrobial resistance directly from clinical urines by nanopore-based metagenomic sequencing. J. Antimicrob. Chemother. 72, 104–114 (2017).

    CAS  Article  Google Scholar 

  10. US Food and Drug Administration. FDA allows marketing of test to identify organisms that cause bloodstream infections and provide antibiotic sensitivity results. FDA https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm543150.htm (2017).

  11. McHugh, L. et al. A molecular host response assay to discriminate between sepsis and infection-negative systemic inflammation in critically ill patients: discovery and validation in independent cohorts. PLoS Med. 12, e1001916 (2015).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Carey-Ann D. Burnham, Jennifer Leeds, Patrice Nordmann, Justin O'Grady or Jean Patel.

Ethics declarations

Competing interests

J.O'G. received expenses for attending Oxford Nanopore conferences, and Oxford Nanopore co-fund a Ph.D. student in his laboratory. J.L. is an employee and shareholder of Novartis. C.-A.D.B. received Research Grants from bioMerieux, Cepheid, Accelerate Diagnostics, Theravance and Aperture Bio. P.N. is the principal inventor of the rapid polymyxin NP tests and the rapid Carba NP test. J.P does not have any competing interests.

Related links

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Burnham, CA., Leeds, J., Nordmann, P. et al. Diagnosing antimicrobial resistance. Nat Rev Microbiol 15, 697–703 (2017). https://doi.org/10.1038/nrmicro.2017.103

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrmicro.2017.103

Further reading

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing