In vitro antimicrobial susceptibility testing methods: agar dilution to 3D tissue-engineered models

A. Schumacher, T. Vranken, A. Malhotra, J. J.C. Arts, P. Habibovic

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

In the field of orthopaedic surgery, bacterial invasion of implants and the resulting periprosthetic infections are a common and unresolved problem. Antimicrobial susceptibility testing methods help to define the optimal treatment and identify antimicrobial resistance. This review discusses proven gold-standard techniques and recently developed models for antimicrobial susceptibility testing, while also providing a future outlook. Conventional, gold-standard methods, such as broth microdilution, are still widely applied in clinical settings. Although recently developed methods based on microfluidics and microdroplets have shown advantages over conventional methods in terms of testing speed, safety and the potential to provide a deeper insight into resistance mechanisms, extensive validation is required to translate this research to clinical practice. Recent optical and mechanical methods are complex and expensive and, therefore, not immediately clinically applicable. Novel osteoblast infection and tissue models best resemble infections in vivo. However, the integration of biomaterials into these models remains challenging and they require a long tissue culture, making their rapid clinical implementation unlikely. A method applicable for both clinical and research environments is difficult to realise. With a continuous increase in antimicrobial resistance, there is an urgent need for methods that analyse recurrent infections to identify the optimal treatment approaches.

Original languageEnglish
Pages (from-to)187-208
Number of pages22
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume37
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018

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Keywords

  • Anti-Bacterial Agents/pharmacology
  • Bacteria/drug effects
  • Drug Resistance, Bacterial
  • Humans
  • Microbial Sensitivity Tests/methods
  • Orthopedic Procedures/adverse effects
  • Prosthesis-Related Infections/diagnosis

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