Antimicrobial resistance: Modern approaches for its detection
Author(s): CD Chavda, JB Kathiria, BJ Trangadiya, DB Barad, BB Javia and SN Ghodasara
Abstract: Antimicrobial resistance (AMR) poses a profound global public health crisis, fueled by overuse and misuse of antibiotics in human medicine and agriculture, resulting in the rapid dissemination of resistant pathogens and resistance determinants with devastating consequences for mortality, healthcare delivery, and economic stability. Resistance has shadowed antibiotic deployment since the earliest clinical applications, emerging swiftly after the introduction of landmark drugs during the Golden Age of discovery and continuing to challenge even last-resort agents like carbapenems and vancomycin. Bacteria employ diverse strategies to evade antimicrobials, including impaired drug permeation, target alteration, enzymatic inactivation, and active efflux, with Gram-negative species particularly adept at combining multiple mechanisms. This comprehensive review evaluates established and emerging technologies for detecting AMR and performing antimicrobial susceptibility testing, encompassing traditional phenotypic approaches (disk diffusion, broth microdilution, and automated systems), molecular techniques (PCR variants, isothermal amplification, and microarrays), advanced spectroscopic methods (MALDI-TOF MS and FTIR), sequencing-based strategies (whole-genome and metagenomic sequencing), and innovative microfluidic lab-on-a-chip platforms that enable rapid genotypic and phenotypic analysis. While these advancements promise faster, more precise diagnostics to support targeted therapy and stewardship efforts, persistent barriers such as cost, standardization, accessibility in resource-limited settings, and integration of sample preparation steps must be addressed through multidisciplinary collaboration to curb the escalating AMR threat effectively.
