Recent Advances in Phenotypic and Alternative Methods for Early Detection of Antimicrobial Resistance

Antimicrobial resistance (AMR) is an emerging global health thread where bacterial infections are becoming increasingly difficult to treat with regular antibiotics. Conventional phenotypic approaches like broth dilution, disk diffusion, disk, and card susceptibility tests involve culturing of bacteria requiring 24–96 h, dedicated manpower, and are resource intensive and yet are often inconclusive. Genotypic methods like whole-genome sequencing, and DNA microarray can identify resistance genes directly, providing rapid and specific results. However, there is a need for specialized equipment, libraries, instrument operation, and result comprehension expertise. Hence, it is a difficult proposition to use these as bedside diagnostics. Alternative diagnostics such as those utilizing sensors and biosensors, as kits and cartridges, potentially overcome the limitations of both these approaches making bedside diagnostics an alternative, pocket-friendly, reliable technology. For the detection of AMR, these technologies would pertain to the development of strategies to screen pathogenic bacteria and/or determine their gram nature and/or genus, thus allowing for timely and targeted antibiotic therapy to curtail AMR. This article reviews conventional phenotypic methods detailing the latest advancements in rapid bacterial pathogen detection and early assessment of AMR in community hospital settings.