This site is intended only for healthcare professionals residing in Singapore
Half of all hospital patients receive at least one antibiotic, and up to 50% of these may be
To successfully manage bacterial infections and further our fight against resistance, prompt and accurate identification of the responsible pathogen is key.3,4 Coordinated efforts, in line with the principles of stewardship, will help in our quest for judicious antibiotic use.5
Read more about actions we can take against antibiotic resistance (ABR).
WHO SAYS HOW
In 2019, the WHO’s (World Health Organization) report on diagnostic defenses against
antibacterial resistance, highlighted unmet needs and priorities for the future.5
Current ways to identify bacterial infections include:5
WHO also outlines new tools that are required to fill diagnostic gaps:5
Diagnostics against antibacterial resistance, summarized by the WHO
Of the available approaches, the Gram stain has remained the most frequently used rapid
diagnostic test for differentiating bacterial infections for over a century. The stain divides
bacteria into two groups – Gram-negative and Gram-positive - based on their cell wall and
membrane permeability to organic solvents.3
Yet, cell culture followed by evaluation to identify particular strains and species, is the gold standard. This method is cost-effective and usually has specificity but is limited by long
turnaround times and can lack sensitivity. Modern mass spectrometry methods can reduce the time needed for identification (from hours to several minutes), but often still require bacterial cultivation as a first step.4
Read about newer approaches for diagnosing different types of bacterial infections below.
The urgent threat of antibacterial resistance means we need appropriate tools and
prescribing. Existing diagnostics are a start, but we must ensure they are used diligently to
identify targeted treatment in our fight against this ever-evolving global health threat.
What techniques can be used to identify Gram-negative bacterial infections?
Milani RV et al. MJ Open Qual 2019;8(1):e000351.
Centers for Disease Control and Prevention. Antibiotic Use in the United States, 2017: Progress and Opportunities.
Available at https://www.cdc.gov/antibiotic-use/stewardship-report/pdf/stewardship-report.pdf. Accessed August 2023.
Steinbach WJ and Shetty AK. Postgrad Med J 2001;77:148–156.
Rentschler S et al. Int J Mol Sci 2021;22(1):456.
World Health Organization. Landscape of diagnostics against antibacterial resistance, gaps and priorities. 2019.
Available at: https://apps.who.int/iris/handle/10665/326480. Accessed August 2023.
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