Improving the ability of antimicrobial susceptibility tests to predict clinical outcome accurately: Adding metabolic evasion to the equation.

Anti-Bacterial Agents / pharmacology Bacteria / drug effects Bacterial Infections / drug therapy Decision Trees Drug Resistance, Bacterial Humans Microbial Sensitivity Tests Treatment Outcome
Antimicrobial resistance Antimicrobial susceptibility test Bacterial physiology Biofilm Dormancy Intracellular growth Minimal inhibitory concentration (MIC) breakpoints Persisters Slow growing bacteria Tolerance

Journal

Drug discovery today
ISSN: 1878-5832
Titre abrégé: Drug Discov Today
Pays: England
ID NLM: 9604391

Informations de publication

Date de publication:
09 2021
Historique:
received: 30 11 2020
revised: 09 03 2021
accepted: 25 05 2021
pubmed: 14 6 2021
medline: 27 1 2022
entrez: 13 6 2021
Statut: ppublish

Résumé

Antimicrobial susceptibility tests (AST) are based on the minimal inhibitory concentration (MIC), the method used worldwide to guide antimicrobial therapy. Despite its relevance in correctly predicting clinical outcome for most acute infections, this approach is misleading for multiple clinical cases in which pathogens do not grow rapidly, uniformly or with physical protection. This behaviour, named 'metabolic evasion' (ME), enables bacteria to survive antimicrobials. ME can result from different, and sometimes combined, bacterial mechanisms such as biofilms, intracellular growth, persisters or dormancy. We discuss how ME can influence the MIC-based probability of target attainment. We identify clinical cases in which this approach is undermined by ME and propose a new approach that takes ME into account in order to improve patient management and the evaluation of innovative drugs.

Identifiants

DOI: 10.1016/j.drudis.2021.05.018 PMID: 34119667
pubmed: 34119667
pii: S1359-6446(21)00251-8
doi: 10.1016/j.drudis.2021.05.018
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

2182-2189

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Auteurs

Jason Tasse (J)

BTF-E Group, BEAM Alliance, Le Dorian Bât B1 C/O Da Volterra, 172 Rue de Charonne, 75011 Paris, France; Biofilm Pharma, 307 Avenue Jean Jaurès, 69007 Lyon, France.

Guennaëlle Dieppois (G)

BTF-E Group, BEAM Alliance, Le Dorian Bât B1 C/O Da Volterra, 172 Rue de Charonne, 75011 Paris, France; Debiopharm, Chemin Messidor 5-7, Case postale 5911, 1002 Lausanne, Switzerland.

Frédéric Peyrane (F)

BTF-E Group, BEAM Alliance, Le Dorian Bât B1 C/O Da Volterra, 172 Rue de Charonne, 75011 Paris, France.

Nicolas Tesse (N)

BTF-E Group, BEAM Alliance, Le Dorian Bât B1 C/O Da Volterra, 172 Rue de Charonne, 75011 Paris, France; Septeos, 12 Avenue de la Grande Armée, 75017 Paris, France. Electronic address: dr.nicolas.tesse@neteos-groupe.com.

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Improving the ability of antimicrobial...
questionsmedicales.fr › Bactéries › Improving the ability of antimicrobial...
questionsmedicales.fr › Infection › Infections bactériennes et mycoses › Infections bactériennes › Improving the ability of antimicrobial...
questionsmedicales.fr › Concepts mathématiques › Théorie de la décision › Arbres de décision › Improving the ability of antimicrobial...
questionsmedicales.fr › Phénomènes physiologiques › Phénomènes pharmacologiques et toxicologiques › Phénomènes pharmacologiques › Résistance aux substances › Résistance microbienne aux médicaments › Résistance bactérienne aux médicaments › Improving the ability of antimicrobial...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Improving the ability of antimicrobial...
questionsmedicales.fr › Techniques d'investigation › Évaluation préclinique de médicament › Tests de sensibilité microbienne › Improving the ability of antimicrobial...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Improving the ability of antimicrobial...