Nanotools and molecular techniques to rapidly identify and fight bacterial infections

- Multi resistant bacteria are a major health issue, we need new tools to identify (ID) and test susceptibility (AST).
- We review innovative molecular and phenotypic techniques for the study of bacterial infections.
- MALDI-TOF MS, the fundamental technique for ID, is now used with other tools to perform AST.
- Semi automated phenotypic AST systems are widely used, but their reliability requires other techniques.
- Nanomechanical sensors can lead to rapid AST and hold the promise to lead to point-of-care systems.

Reducing the emergence and spread of antibiotic-resistant bacteria is one of the major healthcare issues of our century. In addition to the increased mortality, infections caused by multi-resistant bacteria drastically enhance the healthcare costs, mainly because of the longer duration of illness and treatment. While in the last 20 years, bacterial identification has been revolutionized by the introduction of new molecular techniques, the current phenotypic techniques to determine the susceptibilities of common Gram-positive and Gram-negative bacteria require at least two days from collection of clinical samples. Therefore, there is an urgent need for the development of new technologies to determine rapidly drug susceptibility in bacteria and to achieve faster diagnoses. These techniques would also lead to a better understanding of the mechanisms that lead to the insurgence of the resistance, greatly helping the quest for new antibacterial systems and drugs.In this review, we describe some of the tools most currently used in clinical and microbiological research to study bacteria and to address the challenge of infections. We discuss the most interesting advancements in the molecular susceptibility testing systems, with a particular focus on the many applications of the MALDI-TOF MS system. In the field of the phenotypic characterization protocols, we detail some of the most promising semi-automated commercial systems and we focus on some emerging developments in the field of nanomechanical sensors, which constitute a step towards the development of rapid and affordable point-of-care testing devices and techniques.While there is still no innovative technique that is capable of completely substituting for the conventional protocols and clinical practices, many exciting new experimental setups and tools could constitute the basis of the standard testing package of future microbiological tests.

Reducing the emergence and spread of antibiotic-resistant bacteria is one of the major healthcare issues of our century. There is an urgent need for new technologies to identify infections and assess rapidly drug susceptibility in bacteria. Here we discuss the most promising recent innovations in this field with particular focus on MALDI-TOF MS, semi-automated commercial systems and nanomechanical sensors, which constitute a step towards the development of rapid and affordable point-of-care devices and techniques.300