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Recent advances in the development and use of molecular tests to predict antimicrobial resistance in Neisseria gonorrhoeae
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- Donà, Valentina (author)
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
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- Low, Nicola (author)
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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- Golparian, Daniel, 1984- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,WHO Collaborating Centre for Gonorrhoea, Örebro University Hospital, Örebro, Sweden
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- 2017-08-03
- 2017
- English.
- In: Expert Review of Molecular Diagnostics. - : Taylor & Francis Group. - 1473-7159 .- 1744-8352. ; 17:9, s. 845-859
- Journal article (peer-reviewed)
Abstract
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- Introduction: The number of genetic tests, mostly real-time PCRs, to detect antimicrobial resistance (AMR) determinants and predict AMR in Neisseria gonorrhoeae is increasing. Several of these assays are promising, but there are important shortcomings and few assays have been adequately validated and quality assured.Areas covered: Recent advances, focusing on publications since 2012, in the development and use of molecular tests to predict gonococcal AMR for surveillance and for clinical use, advantages and disadvantages of these tests and of molecular AMR prediction compared with phenotypic AMR testing, and future perspectives for effective use of molecular AMR tests for different purposes.Expert commentary: Several challenges for direct testing of clinical, especially extra-genital, specimens remain. The choice of molecular assay needs to consider the assay target, quality controls, sample types, limitations intrinsic to molecular technologies, and specific to the chosen methodology, and the intended use of the test. Improved molecular- and particularly genome-sequencing-based methods will supplement AMR testing for surveillance purposes, and translate into point-of-care tests that will lead to personalized treatments, while sparing the last available empiric treatment option (ceftriaxone). However, genetic AMR prediction will never completely replace phenotypic AMR testing, which detects also AMR due to unknown AMR determinants.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinsk bioteknologi -- Biomedicinsk laboratorievetenskap/teknologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Medical Biotechnology -- Biomedical Laboratory Science/Technology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Keyword
- Neisseria gonorrhoeae; antimicrobial resistance; molecular testing; NAAT; ceftriaxone; ciprofloxacin; azithromycin; penA; gyrA; 23S rRNA
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- ref (subject category)
- art (subject category)
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