Interpreting the results of rapid molecular diagnostic tests for carbapenem-resistant Enterobacterales infection: current clinical perspective while waiting for further evidence.
Expert Rev Mol Diagn
; 24(7): 583-590, 2024 Jul.
Article
in En
| MEDLINE
| ID: mdl-39054637
ABSTRACT
INTRODUCTION:
Carbapenem-resistant Enterobacterales (CRE) causing severe infections in humans have represented an important challenge for clinicians worldwide during the past two decades. AREAS COVERED Novel ß-lactams and ß-lactam/ß-lactamase inhibitor combinations have led to a shift in the first-line approach to the treatment of severe CRE infections from polymyxin-based regimens to treatment with less toxic agents. This new scenario offers the opportunity to apply rapid molecular diagnostic tests for CRE infection to identify different types of carbapenemases. Herein, the authors provide an overview of this subject and follow it with their expert perspectives. EXPERT OPINION When considering studies actually measuring the clinical impact of rapid molecular tests in real-life scenarios, high certainty evidence from randomized controlled trials is still limited and not focused on CRE infections. Nonetheless, it is indisputable that rapid molecular tests have been shown to impact early therapeutic choices (in terms of both escalation and de-escalation) when used in real-life settings, thus issues in the clinical interpretation of their results are already relevant. Overall, increased expertise is required for the appropriate interpretation of rapid molecular tests for personalized antibiotic selection by understanding their strengths and limitations.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Molecular Diagnostic Techniques
/
Enterobacteriaceae Infections
/
Carbapenem-Resistant Enterobacteriaceae
/
Anti-Bacterial Agents
Limits:
Humans
Language:
En
Journal:
Expert Rev Mol Diagn
/
Expert rev. mol. diagn
/
Expert review of molecular diagnostics
Journal subject:
BIOLOGIA MOLECULAR
Year:
2024
Document type:
Article
Affiliation country:
Italia
Country of publication:
Reino Unido