Rapid methods for detection of bacterial resistance to antibiotics | Enfermedades Infecciosas y Microbiología Clínica (English Edition)

array:24 ["pii" => "S2529993X17300606" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2017.02.007" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1645" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Enferm Infecc Microbiol Clin. 2017;35:182-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2344 "formatos" => array:3 [ "EPUB" => 9 "HTML" => 1727 "PDF" => 608 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0213005X16303986" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2016.12.005" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1645" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Enferm Infecc Microbiol Clin. 2017;35:182-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 17300 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 14209 "PDF" => 3080 ] ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "Formación médica continuada: Métodos de diagnóstico rápido en Microbiología Clínica" "titulo" => "Métodos rápidos para la detección de la resistencia bacteriana a antibióticos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "182" "paginaFinal" => "188" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Rapid methods for detection of bacterial resistance to antibiotics" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Gabriel Alberto March-Rosselló" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Gabriel Alberto" "apellidos" => "March-Rosselló" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2529993X17300606" "doi" => "10.1016/j.eimce.2017.02.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X17300606?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X16303986?idApp=UINPBA00004N" "url" => "/0213005X/0000003500000003/v2_201706011649/S0213005X16303986/v2_201706011649/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2529993X17300667" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2017.02.013" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1600" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Mirobiologia Clinica" "documento" => "article" "crossmark" => 1 "subdocumento" => "pgl" "cita" => "Enferm Infecc Microbiol Clin. 2017;35:189-95" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 331 "formatos" => array:3 [ "EPUB" => 4 "HTML" => 181 "PDF" => 146 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Consensus statement" "titulo" => "Executive summary of management of prosthetic joint infections. Clinical practice guidelines by the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC)" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "189" "paginaFinal" => "195" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Resumen ejecutivo de tratamiento de las infecciones de prótesis articulares. Guia clínica práctica de la Sociedad Española de Enfermedades Infecciosas y Microbiologia Clínica" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1300 "Ancho" => 2278 "Tamanyo" => 203972 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Javier Ariza, Javier Cobo, Josu Baraia-Etxaburu, Natividad de Benito, Guillermo Bori, Javier Cabo, Pablo Corona, Jaime Esteban, Juan Pablo Horcajada, Jaime Lora-Tamayo, Oscar Murillo, Julián Palomino, Jorge Parra, Carlos Pigrau, Josèc) Luis del Pozo, Melchor Riera, Dolores Rodríguez, Mar Sánchez-Somolinos, Alex Soriano, M. Dolores del Toro, Basilio de la Torre" "autores" => array:23 [ 0 => array:2 [ "nombre" => "Javier" "apellidos" => "Ariza" ] 1 => array:2 [ "nombre" => "Javier" "apellidos" => "Cobo" ] 2 => array:2 [ "nombre" => "Josu" "apellidos" => "Baraia-Etxaburu" ] 3 => array:2 [ "nombre" => "Natividad" "apellidos" => "de Benito" ] 4 => array:2 [ "nombre" => "Guillermo" "apellidos" => "Bori" ] 5 => array:2 [ "nombre" => "Javier" "apellidos" => "Cabo" ] 6 => array:2 [ "nombre" => "Pablo" "apellidos" => "Corona" ] 7 => array:2 [ "nombre" => "Jaime" "apellidos" => "Esteban" ] 8 => array:2 [ "nombre" => "Juan Pablo" "apellidos" => "Horcajada" ] 9 => array:2 [ "nombre" => "Jaime" "apellidos" => "Lora-Tamayo" ] 10 => array:2 [ "nombre" => "Oscar" "apellidos" => "Murillo" ] 11 => array:2 [ "nombre" => "Julián" "apellidos" => "Palomino" ] 12 => array:2 [ "nombre" => "Jorge" "apellidos" => "Parra" ] 13 => array:2 [ "nombre" => "Carlos" "apellidos" => "Pigrau" ] 14 => array:2 [ "nombre" => "Josèc) Luis" "apellidos" => "del Pozo" ] 15 => array:2 [ "nombre" => "Melchor" "apellidos" => "Riera" ] 16 => array:2 [ "nombre" => "Dolores" "apellidos" => "Rodríguez" ] 17 => array:2 [ "nombre" => "Mar" "apellidos" => "Sánchez-Somolinos" ] 18 => array:2 [ "nombre" => "Alex" "apellidos" => "Soriano" ] 19 => array:2 [ "nombre" => "M. Dolores" "apellidos" => "del Toro" ] 20 => array:2 [ "nombre" => "Basilio" "apellidos" => "de la Torre" ] 21 => array:1 [ "colaborador" => "on behalf of the Spanish Network for the Study of Infectious Diseases and the Sociedad Española de Enfermedades Infecciosas" ] 22 => array:1 [ "colaborador" => "Microbiología Clínica (SEIMC) along with expert orthopedic surgeons from the Spanish Group of Septic Pathology of the Locomotive System (GEPSAL)" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X17300667?idApp=UINPBA00004N" "url" => "/2529993X/0000003500000003/v1_201703250110/S2529993X17300667/v1_201703250110/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2529993X17300655" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2017.02.012" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1558" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Mirobiologia Clinica" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Enferm Infecc Microbiol Clin. 2017;35:179-81" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 377 "formatos" => array:3 [ "EPUB" => 10 "HTML" => 237 "PDF" => 130 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Brief report" "titulo" => "Epidemiological investigation of the first human brucellosis case in Spain due to Brucella suis biovar 1 strain 1330" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "179" "paginaFinal" => "181" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Investigación epidemiológica del primer caso de brucelosis humana en España por Brucella suis biovariedad 1 cepa 1330" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 751 "Ancho" => 1000 "Tamanyo" => 69389 ] ] "descripcion" => array:1 [ "en" => "Multiplex PCR (Suis-ladder<a class="elsevierStyleCrossRef" href="#bib0125">11</a>) differentiating B. suis biovars. Lane1: ladder (100base pairs). Lanes 2–6: B. suis reference (control) strains: B. suis biovar 1 – 1330 – (2), B. suis biovar 2-Thomsem – (3), B. suis biovar 3 – 686 – (4), B. suis biovar 4 – 40 – (5), B. suis biovar 5 – 513 – (6). Lanes 7–8: case strain. Lane 9: B. suis biovar 1 reference 1330 control strain (repeated to facilitate comparisons). Lane 10: negative control." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cecilia Compés Dea, Joaquín Guimbao Bescós, Juan Pablo Alonso Pérez de Ágreda, Pilar María Muñoz Álvaro, José María Blasco Martínez, María Cruz Villuendas Usón" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Cecilia" "apellidos" => "Compés Dea" ] 1 => array:2 [ "nombre" => "Joaquín" "apellidos" => "Guimbao Bescós" ] 2 => array:2 [ "nombre" => "Juan Pablo" "apellidos" => "Alonso Pérez de Ágreda" ] 3 => array:2 [ "nombre" => "Pilar María" "apellidos" => "Muñoz Álvaro" ] 4 => array:2 [ "nombre" => "José María" "apellidos" => "Blasco Martínez" ] 5 => array:2 [ "nombre" => "María Cruz" "apellidos" => "Villuendas Usón" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X17300655?idApp=UINPBA00004N" "url" => "/2529993X/0000003500000003/v1_201703250110/S2529993X17300655/v1_201703250110/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "cabecera" => "Continuing medical education: Methods of rapid diagnosis" "titulo" => "Rapid methods for detection of bacterial resistance to antibiotics" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "182" "paginaFinal" => "188" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Gabriel Alberto March-Rosselló" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Gabriel Alberto" "apellidos" => "March-Rosselló" "email" => array:1 [ 0 => "gmr810@hotmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Métodos rápidos para la detección de la resistencia bacteriana a antibióticos" ] ] "textoCompleto" => "IntroductionTo achieve a favourable clinical course in patients who suffer from infections, the clinical microbiology laboratory should report the agent causing the infection as quickly as possible. If it is a bacterium that does not have uniform sensitivity to antibiotics, the antibiogram should also be reported, since the significant increase in antimicrobial resistance represents an obstacle to empirical treatment in some cases.Routine antibiogram techniques are based on a phenotypic study in which microbial growth is observed in the presence of different antibiotics. These techniques include agar dilution (the gold standard for the antibiogram), broth macrodilution and microdilution, and strips with an antibiotic gradient. They yield results in around 17h. To shorten this time, it would be desirable to have fast and reliable antibiogram results. To evaluate reliability, according to the US Food and Drug Administration (FDA),<a class="elsevierStyleCrossRef" href="#bib0320">1</a> the results of a rapid antibiogram are classified, compared to the antibiogram obtained through the gold standard, as agreements (concordance), minor errors (erroneous intermediate sensitivity result), major errors (false resistance) and very major errors (false sensitivity).There are many instrumental techniques that allow an antibiogram to be made quickly. Notable among these are molecular techniques, microarrays, commercial methods used in routine work, immunochromatographic techniques, colourimetric methods, imaging methods, nephelometry, MALDI-TOF mass spectrometry, flow cytometry, chemiluminescence and bioluminescence, microfluids and bacterial lysis methods. The basis of each of these techniques and the results obtained are presented below.Molecular techniquesMolecular techniques enable the detection of genetic material, both deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). Polymerase chain reaction (PCR) is the molecular technique that has acquired the greatest diagnostic value, since it not only allows the infectious agent to be accurately identified, but is also the leading method to characterise its resistance and virulence genotypes. Conventional PCR requires approximately 12h to perform and consists of 3 steps. The first step consists of extraction of genetic material. The second step, performed in a thermocycler, consists of DNA amplification. The thermocycler reaches the optimal temperatures required for each of the 3 steps comprising an amplification cycle (denaturation of the DNA to be used as a mould, ringing of synthetic primers and extension catalysed by the polymerase DNA of the primers) to take place. Amplification is repeated a certain number of times, generally 25–35. Each time, the number of product molecules (amplicons) is duplicated. Thus a high number of amplicons is synthesised, which allows very small initial amounts of DNA to be detected.<a class="elsevierStyleCrossRef" href="#bib0325">2</a> The third and final step of PCR consists of detection of amplicons through agarose gel electrophoresis. Real-time PCR was designed to shorten the time to diagnosis of conventional PCR. In real-time PCR, amplification and detection of the amplicons synthesised take place at the same time through different methods. Thus, real-time PCR yields results in a few hours.<a class="elsevierStyleCrossRef" href="#bib0325">2</a>Several real-time PCRs which identify several pathogenic agents and genes that directly confer antibiotic resistance based on different samples have been marketed. These PCRs are fully automated: samples are processed in just a few minutes. The Verigene® system (Nanosphere) is based on grown blood culture bottles. Detection of amplicons takes place through hybridisation with synthetic specific oligonucleotides marked with gold nanoparticles. In Gram-positive bacteria, it detects 9 species and 4 genera of bacteria, as well as the resistance genes mecA and vanA/B, in less than 3h with a sensitivity and a specificity very close to 100%.<a class="elsevierStyleCrossRef" href="#bib0330">3</a> In Gram-negative bacteria, it detects 5 species and 4 genera of bacteria, as well as the resistance genes that encode CTX-M extended-spectrum beta-lactamases (ESBLs) and KPC, NDM, VIM, IMP and OXA carbapenemases, with the same response time and with a sensitivity and a specificity in excess of 93%.<a class="elsevierStyleCrossRef" href="#bib0335">4</a> The FilmArray Blood Culture Identification Panel system (BioFire Diagnostics) is also applied to the grown blood culture bottle. In this case a nested PCR is performed. First, a region of DNA that contains the target segment is amplified. Next, this amplification product is used as a mould for a second PCR which takes place in a matrix with wells that contain the primers for the different assays. Finally, the instrument uses the fluorochrome LCGreen® Plus (BioFire Diagnostics) to evaluate the fusion curve of the DNA in each well of the matrix to determine whether a PCR product appears in said well. In an hour, this system detects 11 species and 15 genera of Gram-positive and Gram-negative bacteria and 5 species of yeast. It also detects the resistance genes mecA, vanA/B and KPC. Sensitivity ranges from 83% to 100%, and specificity is more than 99%, depending on the pathogen studied.<a class="elsevierStyleCrossRef" href="#bib0330">3</a> The GeneXpert® system performs real-time PCR in single-use disposable cartridges. There are many cartridges for performing different analyses. To detect Staphylococcus aureus and its methicillin resistance in clinical samples, 2 cartridges are available: the Xpert® MRSA/SA BC cartridge, which uses grown blood culture bottles, and the Xpert® MRSA/SA SSTI cartridge, which uses swabs to diagnose skin and soft-tissue infections. Both tests yield results in an hour and have a sensitivity and a specificity very close to 100%.<a class="elsevierStyleCrossRefs" href="#bib0330">3,5</a> The Xpert MTB/RIF® cartridge detects Mycobacterium tuberculosis and its rifampicin resistance in sputum and biological fluids in 2h. In this case a semiquantitative nested PCR takes place. It has been observed that in sputum and bronchoalveolar lavage, the test has a sensitivity and a specificity of 86.8% and 93.1%, respectively, thereby improving sputum smear microscopy results.<a class="elsevierStyleCrossRef" href="#bib0345">6</a>Many PCRs – “in-house”, commercial and automated – and PCR kits that accurately detect, with a sensitivity and a specificity of practically 100%, a large number of genes that confer antibiotic resistance have been described in the literature.<a class="elsevierStyleCrossRef" href="#bib0350">7</a> It should be noted that these methodologies do not provide microbial identification and that they are applied, in the majority of cases, to colonies grown on isolation plates.The main commercial automated real-time PCRs are detailed below. The NucliSENS EasyQ® KPC platform (bioMérieux) detects genes that encode KPC carbapenemases in 2h.<a class="elsevierStyleCrossRef" href="#bib0355">8</a> The Xpert® Carba-R cartridge from GeneXpert® detects genes that encode KPC, NDM, VIM, IMP and OXA-48 carbapenemases in an hour.<a class="elsevierStyleCrossRef" href="#bib0360">9</a> The eazyplex® system (Amplex Biosystems GmbH) consists of a platform that performs nucleic acid amplification through the loop-mediated isothermal amplification (LAMP) technique. This technique is based on DNA amplification through chain displacement at a constant temperature; thus, the system does not require a thermocycler. To carry out amplification, the DNA extracted is inserted in a tube containing a lyophilisate with the reagents required to perform nucleic acid amplification; next, this tube is inserted in the Genie® II apparatus (OptiGene), which keeps the tube at a constant temperature and detects the amplicons formed in real time. For this platform, several kits have been marketed that detect genes that confer antibiotic resistance in less than 30min. Notable among them is the eazyplex® SuperBug CRE which detects genes that encode CTX-M ESBL and VIM, NDM, KPC and OXA-48 carbapenemases, both in colonies grown on isolation plates and directly from urine samples and grown blood culture bottles.<a class="elsevierStyleCrossRef" href="#bib0365">10</a> AID Autoimmun Diagnostika GmbH has marketed a PCR based on line probe assays. In this case, once the PCR has been performed, reverse hybridisation of the amplicons takes place with complementary probes anchored to a nitrocellulose strip. Hybridisation is detected using a biotin marker present in the primers used in the PCR. Thus a band pattern is obtained which is interpreted visually or with a scanner. Notable among antibiotic resistance kits is the AID ESBL, which detects genes that encode TEM, SHV and CTX-M ESBLs and KPC carbapenemases in 5h.<a class="elsevierStyleCrossRef" href="#bib0370">11</a>Notable among the kits marketed to detect genes that confer bacterial resistance to antibiotics are the following: LightMix (Roche Diagnostics) and Check-Direct CPE (Check-Points Health B.V.). The LightMix kit, using the LightCycler® 480 Instrument II platform (Roche Diagnostics), detects KPC, NDM, VIM, IMP and OXA-48 carbapenemases in an hour and a half. It should be noted that this kit may also be applied to grown blood culture bottles.<a class="elsevierStyleCrossRef" href="#bib0375">12</a> The Check-Direct CPE kit may be used on several real-time PCR platforms, such as the ABI 7500 (Applied), CFX96™ (Bio-Rad), LightCycler® 480 system I & II (Roche), Rotor-Gene Q (Qiagen) and BD MAX™ (Becton Dickinson) platforms. This kit includes the reagents required to detect genes that encode KPC, NDM, VIM and OXA-48 carbapenemases in 2h.<a class="elsevierStyleCrossRef" href="#bib0360">9</a> In addition, some kits to perform a ligation-mediated PCR have been marketed. Briefly, this PCR uses 2 DNA probes that recognise one of the 2 strands of the gene to be detected. If hybridisation occurs, the probes remain adjacent and a DNA ligase binds them, thereby generating a double-chain DNA. This ligation step is performed in the MyCycler apparatus (Bio-Rad). Finally, real-time PCR takes place on the ABI 7500 (Applied) platform using some universal primers. Notable among the kits that detect genes that encode bacterial resistance to antibiotics through ligation-mediated PCR are one kit for CTX-M, TEM and SHV ESBLs<a class="elsevierStyleCrossRef" href="#bib0380">13</a> and another kit for KPC, NDM, IMP, VIM, and OXA-48 carbapenemases.<a class="elsevierStyleCrossRef" href="#bib0385">14</a> Both kits yield results in 4h and a half.Finally, it should be noted that the commercial molecular methods mentioned above have a limited percentage of false negatives as these methods do not detect all allelic variants of genes that confer antibiotic resistance.<a class="elsevierStyleCrossRef" href="#bib0390">15</a>MicroarraysThis method is based on using an image analysis to detect hybridisation of a target molecule to a specific probe immobilised on a solid base. Microarrays detect a large number of resistance genes in a single assay given that these probes, which are normally oligonucleotides, are attached very close to one another. Several microarrays have been marketed, such as the Check-MDR CT102, the Check-MD CT103 and the Check-MDR CT103 XL (Check points Health BV). These microarrays detect a large number of genes that encode different beta-lactamases (ESBLs, AmpCs and carbapenemases) based on colonies grown on isolation plates. These 3 microarrays require a first step of a PCR with a pair of universal primers marked with biotin. Next, the amplicons are classified through hybridisation with the oligonucleotide probes. Finally, the manufacturer's software program detects hybridisation using the biotin marker, automatically translates the data and expresses the results in the form of the presence or absence of a gene. These microarrays yield results in 8h and have a sensitivity and a specificity of practically 100%.<a class="elsevierStyleCrossRefs" href="#bib0395">16–18</a>Commercial antibiogram methodsDifferent commercial antibiogram methods used in routine clinical microbiology laboratory work have been applied directly based on different clinical samples. Commercial strips with an antibiotic gradient have been used to make a direct antibiogram based on respiratory samples. To do this, the sample is inoculated in Mueller Hinton agar plates and the strips with antibiotic are added. The plates are incubated for 24h and, once the colonies have grown, the MIC is obtained. Boyer et al.<a class="elsevierStyleCrossRef" href="#bib0410">19</a> obtained a rate of agreements of 88.9%, a rate of very major errors of 1.5% and a rate of major errors of 9.6%. Bouza et al.<a class="elsevierStyleCrossRef" href="#bib0415">20</a> obtained a rate of agreements of 96.44%, a rate of major errors of 1.98% and a rate of minor errors of 1.56%.Semiautomated broth microdilution methods (MicroScan, VITEK2 and Phoenix) allow the bacteria to be identified and the antibiogram to be obtained directly based on the grown blood culture bottle. The bacteria are identified in 3h, with poor results in Gram-positive bacteria and acceptable results in Gram-negative bacteria, and the antibiogram is obtained in 14h, with good results in both Gram-positive and Gram-negative bacteria.<a class="elsevierStyleCrossRef" href="#bib0325">2</a>Immunochromatographic techniquesThese techniques yield results in around 20min. They are affordably priced and require neither instrumentation nor expert staff. This means that they may be performed in any laboratory. In antibiotic resistance, they detect bacterial enzymes that hydrolyse the antibiotic. The procedure consists of suspending the bacterium in a diluent. Next, a few drops of this diluent are deposited on one end of the strip (normally made of nitrocellulose), and the bacteria move by means of capillarity towards the other end of the strip. If a coloured band appears on the test position of the strip, where an antibody that recognises the antigen of the bacteria is fixed, this means that the test is positive. Two immunochromatography systems that detect OXA-48 and KPC carbapenemases (Coris BioConcept) with a sensitivity and a specificity of practically 100% have been marketed.<a class="elsevierStyleCrossRef" href="#bib0420">21</a> The BinaxNOW PBP2a test (Alere) has been marketed to detect the methicillin resistance of S. aureus. This test shows a sensitivity and a specificity of practically 100%. It was also applied to grown blood culture bottles and offered a sensitivity of 95.4% and a specificity of practically 100%.<a class="elsevierStyleCrossRef" href="#bib0330">3</a>Colourimetric methodsSeveral kits have been marketed to detect carbapenemases, such as the RAPIDEC® CARBA NP kit (bioMérieux) and the Rapid CARB Screen® kit (Rosco Diagnostica A/S). These kits yield results in around 2h with a sensitivity and a specificity very close to 100%.<a class="elsevierStyleCrossRef" href="#bib0425">22</a> In these tests, the bacterium is incubated in the presence of the antibiotic. If the bacterium possesses a carbapenemase, the antibiotic is hydrolysed and there is a change in the pH of the medium which is detected through a change in the colour of the indicator. These tests do not characterise the type of carbapenemase. However, in a phenotypic study, they can detect any carbapenemase variant that is being expressed.Resazurin, added to a bacterial suspension resistant to the antibiotic with which it is incubated, is reduced by the metabolic activity of the bacterium. If the bacterium is sensitive to the antibiotic, its metabolism stops, and consequently resazurin remains in its oxidised form. Given that the reduced form of resazurin is stable and red in colour, and photometrically distinguishable from the oxidised form, which is blue in colour, cell viability may be monitored through spectrophotometry, colourimetry or fluorimetry. In 6h, Coban et al.<a class="elsevierStyleCrossRefs" href="#bib0430">23,24</a> determined the sensitivity of S. aureus to methicillin and vancomycin. March et al.<a class="elsevierStyleCrossRefs" href="#bib0440">25,26</a> made an antibiogram for staphylococci, enterococci and enterobacteria in 2h. However, the disadvantage of resazurin is that it is not metabolised by non-fermenting Gram-negative bacilli. Another colourimetric method consists of measuring the activity of the bacterial enzyme nitrate reductase. When the bacterium is incubated in the presence of NO3− ions and antibiotic, if the bacterium is resistant to the antibiotic, NO2− ions are going to be generated that, with Griess reagents, yield a compound that is red in colour. In around 6h, this method determines the sensitivity of S. aureus to methicillin and vancomycin.<a class="elsevierStyleCrossRefs" href="#bib0430">23,24</a> These 2 colourimetric methods have also been applied in mycobacteria and the antibiogram has been obtained in 7–14 days.<a class="elsevierStyleCrossRef" href="#bib0450">27</a> In all cases, the rate of correlation with the reference methods that was obtained was close to 100%.Imaging methodsBased on grown blood culture bottles, the ACCELERATE pheno™ SYSTEM apparatus (Accelerate Diagnostics) identifies 10 species and 6 genera of bacteria through the fluorescence in situ hybridisation (FISH) technique in 1h. To make the direct antibiogram, the bacterial growth of a strain incubated in the presence of different concentrations of antibiotic is monitored through imaging. Thus, in 5h this piece of equipment reports the MIC and the phenotypes for high-level resistance to gentamicin and streptomycin in enterococci and for induction of clindamycin resistance by erythromycin in staphylococci. Depending on the pathogen studied, the sensitivity obtained has a rate of agreement of 92–100% with that obtained through broth microdilution.<a class="elsevierStyleCrossRef" href="#bib0455">28</a>NephelometryNephelometry is a technique that measures the intensity of scattered radiation that is generated when a beam of light passes through a suspension of particles. Given that light diffusion is proportional to particle concentration, this instrument-based technique allows microorganisms to be quantified.<a class="elsevierStyleCrossRef" href="#bib0325">2</a> The Alfred 60 apparatus (Alifax) performs a urine sample screening to diagnose urinary tract infections. To do this, an aliquot of urine is spiked in a tube with liquid enrichment medium and bacterial growth is monitored through nephelometry for 3h. With this piece of equipment, by monitoring bacterial growth in marketed tubes that contained a liquid enrichment medium and antibiotic together with an aliquot of the sample, an antibiogram directly based on urine and bottles of blood culture was made in 5h.<a class="elsevierStyleCrossRefs" href="#bib0460">29,30</a>MALDI-TOF mass spectrometryThe MALDI-TOF system uses a protein analysis to identify bacteria (including mycobacteria), yeasts and filamentous moulds in minutes.<a class="elsevierStyleCrossRef" href="#bib0325">2</a> Regarding the rapid antibiogram, the MALDI-TOF system predicts whether the bacteria produce enzymes that hydrolyse the antibiotics, such as carbapenemases and ESBLs, in less than 3h. To do this, the microorganisms are incubated for a while with the antibiotic. Centrifugation is performed and the supernatant obtained is analysed using MALDI-TOF. If the microorganism possesses the enzyme that degrades the antibiotic, the peak corresponding to the antibiotic will be seen to disappear and new peaks corresponding to the metabolites resulting from the rupture of the antibiotic will be seen to appear. If the bacterium does not hydrolyse the antibiotic, only the peak corresponding to the antibiotic will be observed. This methodology has yielded sensitivities of practically 100%, both based on colonies grown on isolation plates<a class="elsevierStyleCrossRef" href="#bib0470">31</a> and based on grown blood culture bottles from patients.<a class="elsevierStyleCrossRef" href="#bib0475">32</a> It is also possible to predict resistance to chloramphenicol and clindamycin by detecting the 16S ribosomal RNA methylation performed by methyltransferases.<a class="elsevierStyleCrossRef" href="#bib0480">33</a> Moreover, both methicillin-sensitive and methicillin-resistant S. aureus strains have been observed to yield specific identification peaks; thus, from a database that is normally prepared in the laboratory itself, it is possible to distinguish between methicillin-sensitive and methicillin-resistant S. aureus strains in a few minutes based on colonies grown on isolation plates.<a class="elsevierStyleCrossRef" href="#bib0485">34</a> Similarly, the MALDI-TOF system also discriminates between strains of vancomycin-resistant and vancomycin-sensitive enterococci.<a class="elsevierStyleCrossRef" href="#bib0490">35</a> Antibiotic sensitivity may also be studied through incubation of microorganisms in the presence of antibiotic in a medium with isotope-marked molecules. If the microorganism is resistant, it will incorporate the marked molecules which may be detected by MALDI-TOF.<a class="elsevierStyleCrossRef" href="#bib0495">36</a> Jung et al.<a class="elsevierStyleCrossRef" href="#bib0500">37</a> developed an antibiogram based on a semiquantitative analysis. They incubated an aliquot from the grown blood culture bottle in a liquid medium, both in the presence and in the absence of antibiotic. The latter was the control group. The mass spectra were obtained from the sediments and the relative intensity of the peaks and the area under the curve (AUC) were calculated. For purposes of interpreting the antibiogram, a strain was considered to be resistant to the antibiotic if it yielded a peak intensity and AUC similar to those of the control group when incubated with the antibiotic. By contrast, a strain was considered to be sensitive to the antibiotic if, when incubated with antibiotic, it provided a peak intensity and AUC lower than those of the control group. An antibiogram was thus obtained based on the grown blood culture bottle in 4h, with a 2% discrepancy rate compared to the sensitivity obtained by the E-test.Flow cytometryFlow cytometry is a technique based on the formation of a flow of particles (generally cells) arranged in a row with an intensity of 500–4000particles/second. Thanks to this alignment, the technique allows multiple characteristics of a single cell to be measured simultaneously such that it is possible to characterise, separate and quantify the different cell subpopulations that are included in a set. In addition, various bacterial parameters (membrane potential, cell size, enzyme activity, cell membrane integrity and microbial concentration) which provide information about the sensitivity of microorganisms to antibiotics may be studied using various fluorochromes.<a class="elsevierStyleCrossRef" href="#bib0325">2</a>Through histograms which represented scattered light at a 90-degree angle (side scatter channel [SSC]) to the fluorescence signal, Shrestha et al.<a class="elsevierStyleCrossRef" href="#bib0505">38</a> managed to distinguish between methicillin-resistant and methicillin-sensitive S. aureus strains following an incubation period of 4h in the presence of the antibiotic. The Sysmex UF-1000i flow cytometry apparatus (Sysmex Corporation) is used in microbiology laboratories to perform a urine screening using the bacterial count. This piece of equipment was used to obtain 2 antibiograms by comparing the counts obtained from strains incubated in a liquid medium with antibiotics to the counts obtained for the same strains incubated without antibiotic (control group). A strain was considered to be resistant to the antibiotic if it yielded a microbial count very similar to that of the control group when incubated with the antibiotic. By contrast, a strain was considered to be sensitive to the antibiotic if it yielded a microbial count lower than that of the control group when incubated with the antibiotic. Broeren et al.<a class="elsevierStyleCrossRef" href="#bib0510">39</a> calculated the MIC of amoxicillin, gentamicin and piperacillin in Escherichia coli, Pseudomonas aeruginosa and S. aureus. In 4h they obtained an antibiogram with a rate of agreement of 100% compared to the antibiogram obtained through the VITEK2, E-test and broth macrodilution systems. March et al.<a class="elsevierStyleCrossRef" href="#bib0515">40</a> made an antibiogram based on 100 grown blood culture bottles and obtained, in just 2h, a rate of agreement of 98% compared to the sensitivity obtained through the E-test, MicroScan and VITEK2 commercial methods. Faria-Ramos et al.<a class="elsevierStyleCrossRef" href="#bib0520">41</a> managed to distinguish between ESBL-producing and non-ESBL-producing strains in less than 3h based on bacteria incubated in the presence of ceftazidime and cefotaxime with and without clavulanic acid, using the fluorochrome DiBAC4(3), which only penetrates non-viable bacteria. Gauthier et al.<a class="elsevierStyleCrossRef" href="#bib0525">42</a> made an antibiogram through flow cytometry based on urine. They used 2 fluorochromes, DiBAC4(3) and propidium iodide, which also only penetrates non-viable bacteria. They analysed 114 urine samples and, by measuring the fluorescence signal after incubating the aliquots of urine for 2h in the presence of different antibiotics, obtained a 2% discrepancy rate compared to the sensitivity obtained through broth microdilution.In yeasts, it is possible to obtain an antifungigram in 6h through the use of propidium iodide.<a class="elsevierStyleCrossRefs" href="#bib0530">43,44</a> In mycobacteria, Pina-Vaz et al.<a class="elsevierStyleCrossRef" href="#bib0540">45</a> determined the sensitivity of M. tuberculosis to streptomycin, isoniazid, rifampicin and ethambutol. After 3 days of incubation in the presence of the antituberculosis drug in the BACTEC MGIT 960 system (Becton Dickinson), the microorganisms were stained with the fluorochrome SYTO 16, which only penetrates microorganisms with a cell membrane abnormality. By comparing the intensity of the fluorescence signal obtained from these microorganisms to that obtained from microorganisms incubated during the same time without the presence of the antituberculosis drug, they distinguished between sensitive, intermediate and resistant strains and obtained results that showed excellent agreement with those obtained from 3 weeks of incubation in the BACTEC MGIT 960 system. Kirk et al.<a class="elsevierStyleCrossRef" href="#bib0545">46</a> determined the sensitivity of M. tuberculosis by studying the capacity of the mycobacteria to hydrolyse, through esterases, the substrate fluorescein diacetate, which turns into fluorescein, a compound which emits fluorescence when it is excited with light from a suitable wavelength. If the mycobacterium is sensitive to the antituberculosis drug, the hydrolytic capacity of the mycobacterium decreases, and therefore the fluorescence signal detected also decreases. By comparing the fluorescence signal and the scattered light at 90 degrees obtained through flow cytometry based on mycobacteria without contact with the antituberculosis drug to the signals obtained from mycobacteria with an incubation period of 24h with isoniazid, ethambutol and rifampicin, they obtained rates of agreement of 95%, 92% and 83%, respectively, compared to the antibiogram obtained through the method of proportions.Chemiluminescence and bioluminescenceChemiluminescence is a process of light emission that occurs in certain chemical reactions when excited molecules return to the ground state. To obtain light, menadione must be added to the microorganism culture. The bacterial membrane is permeable to this molecule. Once menadione penetrates the microorganisms, it is reduced and various compounds are generated that diffuse to the extracellular environment where they self-oxidise and light photons are emitted.<a class="elsevierStyleCrossRef" href="#bib0325">2</a> The viability of the microorganisms is established by comparing the chemiluminescence signal of strains incubated with antibiotics to the chemiluminescence signal of the same strains incubated without antibiotics.<a class="elsevierStyleCrossRefs" href="#bib0550">47–50</a> If the strain is sensitive to the antibiotic, then the culture incubated with antibiotic will yield a much weaker signal than the culture incubated without antibiotic. If the strain is resistant to the antibiotic, the signals obtained from the cultures incubated in the presence and absence of antibiotic will be very similar. With an incubation period of around 4h, chemiluminescence yields an MIC with a rate of agreement of 88–100% compared to the MICs obtained through broth macrodilution or microdilution.<a class="elsevierStyleCrossRefs" href="#bib0550">47,48,50</a> In a period of 8h, it also detects intermediate and vancomycin-heteroresistant strains of S. aureus.<a class="elsevierStyleCrossRef" href="#bib0560">49</a> Finally, it has been found that chemiluminescence can be used to determine mycobacteria sensitivity in 4 days.<a class="elsevierStyleCrossRef" href="#bib0570">51</a>Bioluminescence is a form of chemiluminescence that occurs as a result of a chemical reaction that takes place in some living organisms such as fireflies.<a class="elsevierStyleCrossRef" href="#bib0325">2</a> Studies conducted on an antibiogram are based on measuring the levels of bacterial ATP of intracellular origin, extracellular origin or overall, by comparing the bioluminescence signal obtained from microorganisms incubated without the presence of antibiotic (control group) to the signal obtained from the same microorganisms incubated in the presence of antibiotic.<a class="elsevierStyleCrossRefs" href="#bib0575">52,53</a> Regarding the control group, if the intracellular ATP is measured, the strains that are sensitive to the antibiotic studied will yield a decrease in the bioluminescence signal<a class="elsevierStyleCrossRef" href="#bib0585">54</a>; if the extracellular ATP of the sensitive strains is measured, they will yield an increase in the signal<a class="elsevierStyleCrossRef" href="#bib0590">55</a>; and if the total ATP of the sensitive strains is measured, they will yield a decrease in the ATP signal.<a class="elsevierStyleCrossRefs" href="#bib0575">52,53,56</a> By contrast, if the microorganism is resistant to the antibiotic, the control group measurements will be practically identical to those obtained from the strains incubated with antibiotic. With this methodology, it is possible to obtain a reliable antibiogram in just 2h.<a class="elsevierStyleCrossRef" href="#bib0595">56</a> In addition, several studies referring to antibiograms obtained through bioluminescence based on a direct sample have been published. Ivancic et al.<a class="elsevierStyleCrossRef" href="#bib0600">57</a> made an antibiogram based on urine by comparing the ATP signal obtained from an aliquot of urine incubated without antibiotic to the ATP signal from another aliquot of the same urine incubated with antibiotic. In 2h, they achieved a rate of agreement of 91% compared to the MIC obtained from the colony. Dong and Zhao<a class="elsevierStyleCrossRef" href="#bib0605">58</a> developed a microfluidic simulator with immobilised antibodies through which, based on urine, the identification of 13 species of bacteria and the antibiogram are obtained in 6h. In yeasts and mycobacteria, bioluminescence yields a reliable antibiogram in 6h and 7 days, respectively.<a class="elsevierStyleCrossRefs" href="#bib0610">59,60</a>MicrofluidsAdvances in nanotechnology have made it possible to make antibiograms on platforms or chips using small working volumes to carry out multiple assays that provide information on the sensitivity of bacteria to antibiotics, such as cell rupture, bacterial culture and hybridisation and amplification of nucleic acids. Tang et al.<a class="elsevierStyleCrossRef" href="#bib0620">61</a> developed a platform with which, by measuring pH changes that occur as a result of the accumulation of metabolic products, it is possible to detect bacterial growth in 2h. Mach et al.<a class="elsevierStyleCrossRef" href="#bib0625">62</a> made an antibiogram directly based on urine samples using a microfluidic system with a built-in electrochemical sensor to quantify 16S ribosomal RNA. In 3h and a half, this group obtained a rate of agreement of 94% compared to the sensitivity obtained through broth microdilution.Bacterial lysis methodsAnother methodology for determining sensitivity consists of detecting bacterial lysis. To do this, the bacterium is incubated in the presence of the antibiotic at the desired concentration. Then, the bacterium is immobilised in an agarose microgel and exposed to a lysis solution that causes DNA release. Subsequently, the preparation is incubated with the fluorochrome SYBR Gold and the integrity of the DNA may be studied through observation under a fluorescence microscope. This methodology yields an antibiogram in less than 2h.<a class="elsevierStyleCrossRef" href="#bib0630">63</a>In conclusion, the methodologies described in this review shorten the time needed to determine the sensitivity of bacteria to antibiotics compared to the usual methods. To interpret the antibiogram, it is essential to be familiar with the species of bacteria that is being studied. In this regard, the rapid identification provided by the MALDI-TOF system allows the methodologies by which a rapid antibiogram is made to be implemented. However, to determine whether these techniques yield a sensitivity and a specificity that are acceptable for clinical practice, the number of bacterial strains and antibiotics studied must be increased. Given the significant benefits that derive from obtaining a rapid result for sensitivity of bacteria to antibiotics (increase in survival, reduction in expenses and delay in selection of resistant bacterial strains), it can be affirmed that the antibiogram in clinical microbiology, far from being definitively established, is continuously evolving.Conflicts of interestThe author declares that there are no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:19 [ 0 => array:3 [ "identificador" => "xres820125" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec817060" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres820124" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec817059" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Molecular techniques" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Microarrays" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Commercial antibiogram methods" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Immunochromatographic techniques" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Colourimetric methods" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Imaging methods" ] 11 => array:2 [ "identificador" => "sec0040" "titulo" => "Nephelometry" ] 12 => array:2 [ "identificador" => "sec0045" "titulo" => "MALDI-TOF mass spectrometry" ] 13 => array:2 [ "identificador" => "sec0050" "titulo" => "Flow cytometry" ] 14 => array:2 [ "identificador" => "sec0055" "titulo" => "Chemiluminescence and bioluminescence" ] 15 => array:2 [ "identificador" => "sec0060" "titulo" => "Microfluids" ] 16 => array:2 [ "identificador" => "sec0065" "titulo" => "Bacterial lysis methods" ] 17 => array:2 [ "identificador" => "sec0070" "titulo" => "Conflicts of interest" ] 18 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-11-22" "fechaAceptado" => "2016-12-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec817060" "palabras" => array:3 [ 0 => "Rapid antibiotic susceptibility test" 1 => "Direct antibiotic susceptibility test" 2 => "Susceptibility" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec817059" "palabras" => array:3 [ 0 => "Antibiograma rápido" 1 => "Antibiograma directo" 2 => "Sensibilidad" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "The most widely used antibiotic susceptibility testing methods in Clinical Microbiology are based on the phenotypic detection of antibiotic resistance by measuring bacterial growth in the presence of the antibiotic being tested. These conventional methods take typically 24h to obtain results. Here we review the main techniques for rapid determination of antibiotic susceptibility. Data obtained with different methods such as molecular techniques, microarrays, commercial methods used in work routine, immunochromatographic methods, colorimetric methods, image methods, nephelometry, MALDI-TOF mass spectrometry, flow cytometry, chemiluminescence and bioluminescence, microfluids and methods based on cell disruption are analysed in detail." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "Los métodos más frecuentemente utilizados en Microbiología Clínica para la determinación de la sensibilidad de las bacterias a los antibióticos se basan en un estudio fenotípico, observando el crecimiento bacteriano de una cepa incubada en presencia del antibiótico a estudiar. Estos métodos requieren normalmente un tiempo de unas 24h para la obtención de resultados. En esta revisión se exponen el fundamento y los resultados de las principales técnicas instrumentales que proporcionan un antibiograma rápido. De manera pormenorizada se exponen datos relativos a técnicas moleculares, microarrays, métodos comerciales utilizados en el trabajo de rutina, técnicas inmunocromatográficas, métodos colorimétricos, métodos de imagen, nefelometría, espectrometría de masas MALDI-TOF, citometría de flujo, quimioluminiscencia y bioluminiscencia, microfluidos y métodos de lisis bacteriana." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: March-Rosselló GA. Métodos rápidos para la detección de la resistencia bacteriana a antibióticos. Enferm Infecc Microbiol Clin. 2017;35:182–188." ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:63 [ 0 => array:3 [ "identificador" => "bib0320" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available from: http://www.fda.gov/ohrms/dockets/98fr/000109gd.pdf [accessed 15.11.16]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidance on Review Criteria for Assessment of Antimicrobial Susceptibility Devices" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Food and Drug Administration (FDA)" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "1991" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0325" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antibiograma rápido en Microbiología Clínica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.A. March Rosselló" 1 => "M.A. Bratos Pérez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eimc.2014.11.014" "Revista" => array:6 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2016" "volumen" => "34" "paginaInicial" => "61" "paginaFinal" => "68" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25559705" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0330" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic assays for identification of microorganisms and antimicrobial resistance determinants directly from positive blood culture broth" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.A. Pence" 1 => "E. McElvania TeKippe" 2 => "C.A. Burnham" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.cll.2013.03.010" "Revista" => array:6 [ "tituloSerie" => "Clin Lab Med" "fecha" => "2013" "volumen" => "33" "paginaInicial" => "651" "paginaFinal" => "684" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23931843" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0335" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identification of gram-negative bacteria and genetic resistance determinants from positive blood culture broths by use of the Verigene Gram-Negative Blood Culture Multiplex Microarray-Based molecular assay" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.A. Ledeboer" 1 => "B.K. Lopansri" 2 => "N. Dhiman" 3 => "R. Cavagnolo" 4 => "K.C. Carroll" 5 => "P. Granato" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.00581-15" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2015" "volumen" => "53" "paginaInicial" => "2460" "paginaFinal" => "2472" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25994165" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0340" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Direct detection of Staphylococcus osteoarticular infections by use of Xpert MRSA/SA SSTI real-time PCR" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Dubouix-Bourandy" 1 => "A. de Ladoucette" 2 => "V. Pietri" 3 => "N. Mehdi" 4 => "D. Benzaquen" 5 => "R. Guinand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.00334-11" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2011" "volumen" => "49" "paginaInicial" => "4225" "paginaFinal" => "4230" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21998420" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0345" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparative study of GeneXpert with ZN stain and culture in samples of suspected pulmonary tuberculosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Agrawal" 1 => "A. Bajaj" 2 => "V. Bhatia" 3 => "S. Dutt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7860/JCDR/2016/19958.8339" "Revista" => array:6 [ "tituloSerie" => "J Clin Diagn Res" "fecha" => "2016" "volumen" => "10" "paginaInicial" => "DC09" "paginaFinal" => "DC12" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27656437" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0350" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Detection of carbapenemases in Enterobacteriaceae: a challenge for diagnostic microbiological laboratories" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Hrabak" 1 => "E. Chudackova" 2 => "C.C. Papagiannitsis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1469-0691.12678" "Revista" => array:6 [ "tituloSerie" => "Clin Microbiol Infect" "fecha" => "2014" "volumen" => "20" "paginaInicial" => "839" "paginaFinal" => "853" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24813781" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0355" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of the New NucliSENS EasyQ KPC test for rapid detection of Klebsiella pneumoniae carbapenemase genes (blaKPC)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Spanu" 1 => "B. Fiori" 2 => "T. d’Inzeo" 3 => "G. Canu" 4 => "S. Campoli" 5 => "T. Giani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.00284-12" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2012" "volumen" => "50" "paginaInicial" => "2783" "paginaFinal" => "2785" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22622445" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0360" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of three commercial assays for rapid detection of genes encoding clinically relevant carbapenemases in cultured bacteria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Findlay" 1 => "K.L. Hopkins" 2 => "D. Meunier" 3 => "N. Woodford" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jac/dku571" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2015" "volumen" => "70" "paginaInicial" => "1338" "paginaFinal" => "1342" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25630646" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0365" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extended-spectrum beta-lactamase (ESBL) detection directly from urine samples with the rapid isothermal amplification-based eazyplex(R) SuperBug CRE assay: proof of concept" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "V. Hinic" 1 => "J. Ziegler" 2 => "C. Straub" 3 => "D. Goldenberger" 4 => "R. Frei" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.mimet.2015.10.015" "Revista" => array:6 [ "tituloSerie" => "J Microbiol Methods" "fecha" => "2015" "volumen" => "119" "paginaInicial" => "203" "paginaFinal" => "205" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26506282" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0370" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of the AID ESBL line probe assay for rapid detection of extended-spectrum beta-lactamase (ESBL) and KPC carbapenemase genes in Enterobacteriaceae" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.V. Bloemberg" 1 => "S. Polsfuss" 2 => "V. Meyer" 3 => "E.C. Bottger" 4 => "M. Hombach" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jac/dkt345" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2014" "volumen" => "69" "paginaInicial" => "85" "paginaFinal" => "90" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24004861" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0375" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of a novel procedure for rapid detection of carbapenemase-producing Enterobacteriaceae (CPE) using the LightMix® modular carbapenemase kits" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Oviano" 1 => "I. Torres" 2 => "M. Gonzalez" 3 => "G. Bou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jac/dkw356" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2016" "volumen" => "71" "paginaInicial" => "3420" "paginaFinal" => "3423" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27566313" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0380" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of a commercial real-time PCR for the detection of extended spectrum beta-lactamase genes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I. Willemsen" 1 => "L. Hille" 2 => "A. Vrolijk" 3 => "A. Bergmans" 4 => "J. Kluytmans" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1099/jmm.0.070110-0" "Revista" => array:6 [ "tituloSerie" => "J Med Microbiol" "fecha" => "2014" "volumen" => "63" "paginaInicial" => "540" "paginaFinal" => "543" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24473202" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0385" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Probe ligation and real-time detection of KPC, OXA-48, VIM, IMP, and NDM carbapenemase genes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Cuzon" 1 => "T. Naas" 2 => "P. Bogaerts" 3 => "Y. Glupczynski" 4 => "P. Nordmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.diagmicrobio.2013.05.004" "Revista" => array:6 [ "tituloSerie" => "Diagn Microbiol Infect Dis" "fecha" => "2013" "volumen" => "76" "paginaInicial" => "502" "paginaFinal" => "505" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23791387" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0390" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid screening for carbapenem resistant organisms: current results and future approaches" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Anandan" 1 => "S. Damodaran" 2 => "R. Gopi" 3 => "Y.D. Bakthavatchalam" 4 => "B. Veeraraghavan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7860/JCDR/2015/14708.6623" "Revista" => array:6 [ "tituloSerie" => "J Clin Diagn Res" "fecha" => "2015" "volumen" => "9" "paginaInicial" => "DM01" "paginaFinal" => "DM03" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26557523" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0395" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Detection of carbapenemase-producing Enterobacteriaceae with a commercial DNA microarray" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.C. Stuart" 1 => "G. Voets" 2 => "J. Scharringa" 3 => "A.C. Fluit" 4 => "M.A. Leverstein-van Hall" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1099/jmm.0.041673-0" "Revista" => array:6 [ "tituloSerie" => "J Med Microbiol" "fecha" => "2012" "volumen" => "61" "paginaInicial" => "809" "paginaFinal" => "812" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22383444" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0400" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of a DNA microarray for the rapid detection of extended-spectrum beta-lactamases (TEM, SHV and CTX-M), plasmid-mediated cephalosporinases (CMY-2-like, DHA, FOX, ACC-1, ACT/MIR and CMY-1-like/MOX) and carbapenemases (KPC, OXA-48, VIM, IMP and NDM)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Cuzon" 1 => "T. Naas" 2 => "P. Bogaerts" 3 => "Y. Glupczynski" 4 => "P. Nordmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jac/dks156" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2012" "volumen" => "67" "paginaInicial" => "1865" "paginaFinal" => "1869" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22604450" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0405" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of a DNA microarray for rapid detection of the most prevalent extended-spectrum beta-lactamases, plasmid-mediated cephalosporinases and carbapenemases in Enterobacteriaceae, Pseudomonas and Acinetobacter" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Bogaerts" 1 => "G. Cuzon" 2 => "S. Evrard" 3 => "M. Hoebeke" 4 => "T. Naas" 5 => "Y. Glupczynski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijantimicag.2016.05.006" "Revista" => array:6 [ "tituloSerie" => "Int J Antimicrob Agents" "fecha" => "2016" "volumen" => "48" "paginaInicial" => "189" "paginaFinal" => "193" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27374747" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0410" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Direct testing of bronchoalveolar lavages from ventilator-associated pneumonia patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Boyer" 1 => "J. Medrano" 2 => "F. Mzali" 3 => "C.C. Balick-Weber" 4 => "E. Bessède" 5 => "W. Picard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.diagmicrobio.2012.02.017" "Revista" => array:6 [ "tituloSerie" => "Diagn Microbiol Infect Dis" "fecha" => "2012" "volumen" => "73" "paginaInicial" => "107" "paginaFinal" => "110" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22483191" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0415" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Direct E-test (AB Biodisk) of respiratory samples improves antimicrobial use in ventilator-associated pneumonia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Bouza" 1 => "M.V. Torres" 2 => "C. Radice" 3 => "E. Cercenado" 4 => "R. de Diego" 5 => "C. Sánchez-Carrillo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/510587" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2007" "volumen" => "44" "paginaInicial" => "382" "paginaFinal" => "387" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17205445" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0420" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of two new commercial immunochromatographic assays for the rapid detection of OXA-48 and KPC carbapenemases from cultured bacteria" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Glupczynski" 1 => "S. Evrard" 2 => "I. Ote" 3 => "P. Mertens" 4 => "T.D. Huang" 5 => "T. Leclipteux" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jac/dkv472" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2016" "volumen" => "71" "paginaInicial" => "1217" "paginaFinal" => "1222" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26825120" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0425" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of the RAPIDEC® CARBA NP, the Rapid CARB Screen® and the Carba NP test for biochemical detection of carbapenemase-producing Enterobacteriaceae" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Dortet" 1 => "A. Agathine" 2 => "T. Naas" 3 => "G. Cuzon" 4 => "L. Poirel" 5 => "P. Nordmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jac/dkv213" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2015" "volumen" => "70" "paginaInicial" => "3014" "paginaFinal" => "3022" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26260131" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0430" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid determination of methicillin resistance among Staphylococcus aureus clinical isolates by colorimetric methods" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.Y. Coban" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.00471-12" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2012" "volumen" => "50" "paginaInicial" => "2191" "paginaFinal" => "2193" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22518854" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0435" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Two new colorimetric methods for early detection of vancomycin and oxacillin resistance in Staphylococcus aureus" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.Y. Coban" 1 => "B. Bozdogan" 2 => "C.C. Cihan" 3 => "E. Cetinkaya" 4 => "K. Bilgin" 5 => "O. Darka" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.44.2.580-582.2006" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2006" "volumen" => "44" "paginaInicial" => "580" "paginaFinal" => "582" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16455915" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0440" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A two-hour procedure for determining the susceptibility of enterococci and staphylococci to antibiotics by a colourimetric method" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.A. March-Rossello" 1 => "M.P. Gutierrez-Rodriguez" 2 => "M. Simarro-Grande" 3 => "A. Orduna-Domingo" 4 => "M.A. Bratos-Perez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Quimioter" "fecha" => "2015" "volumen" => "28" "paginaInicial" => "247" "paginaFinal" => "255" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26437755" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0445" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available from http://seimc.org/contenidos/congresosyeventos/seimcanteriores/seimc-EIMC-2015.pdf [accessed 15.11.16]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antibiograma rápido en enterobacterias mediante un método colorimétrico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.A. March" 1 => "M.P. Gutiérrez" 2 => "M. Simarro" 3 => "A. Orduña" 4 => "M.A. Bratos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "titulo" => "Comunicación 605. XIX Congreso de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC)" "serieFecha" => "2015" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0450" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of nitrate reduction assay, resazurin microtiter assay and microscopic observation drug susceptibility assay for first line antitubercular drug susceptibility testing of clinical isolates of M. tuberculosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Dixit" 1 => "U. Singh" 2 => "P. Sharma" 3 => "A. Jain" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.mimet.2011.11.006" "Revista" => array:6 [ "tituloSerie" => "J Microbiol Methods" "fecha" => "2012" "volumen" => "88" "paginaInicial" => "122" "paginaFinal" => "126" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22133919" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0455" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multiplexed automated digital microscopy for rapid identification and antimicrobial susceptibility testing of bacteria and yeast directly from clinical samples" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Chantell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Microbiol Newsl" "fecha" => "2015" "volumen" => "37" "paginaInicial" => "161" "paginaFinal" => "167" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0460" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antibiotic susceptibility tests directly on urine samples using Uro-Quick, a rapid automated system" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Roveta" 1 => "A. Marchese" 2 => "E.A. Debbia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1179/joc.2006.18.1.12" "Revista" => array:6 [ "tituloSerie" => "J Chemother" "fecha" => "2006" "volumen" => "18" "paginaInicial" => "12" "paginaFinal" => "19" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16572888" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0465" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New method for rapid susceptibility testing on blood culture with HB&L system: preliminary data" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. Rondinelli" 1 => "S. Giglio" 2 => "R. Masciari" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Microbiol Med" "fecha" => "2010" "volumen" => "25" "paginaInicial" => "238" "paginaFinal" => "243" ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0470" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficient detection of carbapenemase activity in enterobacteriaceae by matrix-assisted laser desorption ionization-time of flight mass spectrometry in less than 30 minutes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Lasserre" 1 => "L. de Saint Martin" 2 => "G. Cuzon" 3 => "P. Bogaerts" 4 => "E. Lamar" 5 => "Y. Glupczynski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.03467-14" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2015" "volumen" => "53" "paginaInicial" => "2163" "paginaFinal" => "2171" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25926485" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0475" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid detection of Enterobacteriaceae producing extended spectrum beta-lactamases directly from positive blood cultures by matrix-assisted laser desorption ionization-time of flight mass spectrometry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Oviano" 1 => "B. Fernandez" 2 => "A. Fernandez" 3 => "M.J. Barba" 4 => "C. Mourino" 5 => "G. Bou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1469-0691.12729" "Revista" => array:6 [ "tituloSerie" => "Clin Microbiol Infect" "fecha" => "2014" "volumen" => "20" "paginaInicial" => "1146" "paginaFinal" => "1157" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24942177" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0480" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Determination of the target nucleosides for members of two families of 16S rRNA methyltransferases that confer resistance to partially overlapping groups of aminoglycoside antibiotics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Savic" 1 => "J. Lovric" 2 => "T.I. Tomic" 3 => "B. Vasiljevic" 4 => "G.L. Conn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/nar/gkp575" "Revista" => array:6 [ "tituloSerie" => "Nucleic Acids Res" "fecha" => "2009" "volumen" => "37" "paginaInicial" => "5420" "paginaFinal" => "5431" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19589804" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0485" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identification of Staphylococcus aureus and determination of its methicillin resistance by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Z. Du" 1 => "R. Yang" 2 => "Z. Guo" 3 => "Y. Song" 4 => "J. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Anal Chem" "fecha" => "2002" "volumen" => "74" "paginaInicial" => "5487" "paginaFinal" => "5491" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12433077" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0490" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of matrix-assisted laser desorption ionization-time of flight mass spectrometry to identify vancomycin-resistant enterococci and investigate the epidemiology of an outbreak" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.M. Griffin" 1 => "G.R. Price" 2 => "J.M. Schooneveldt" 3 => "S. Schlebusch" 4 => "M.H. Tilse" 5 => "T. Urbanski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.01000-12" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2012" "volumen" => "50" "paginaInicial" => "2918" "paginaFinal" => "2931" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22740710" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0495" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Establishing drug resistance in microorganisms by mass spectrometry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.A. Demirev" 1 => "N.S. Hagan" 2 => "M.D. Antoine" 3 => "J.S. Lin" 4 => "A.B. Feldman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s13361-013-0609-x" "Revista" => array:6 [ "tituloSerie" => "J Am Soc Mass Spectrom" "fecha" => "2013" "volumen" => "24" "paginaInicial" => "1194" "paginaFinal" => "1201" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23568030" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0500" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of a semi-quantitative MALDI-TOF MS method for rapid antimicrobial susceptibility testing of positive blood cultures" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.S. Jung" 1 => "C. Hamacher" 2 => "B. Gross" 3 => "K. Sparbier" 4 => "C. Lange" 5 => "M. Kostrzewa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.01131-16" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2016" "volumen" => "54" "paginaInicial" => "2820" "paginaFinal" => "2824" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27629893" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0505" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid differentiation of methicillin-resistant and methicillin-susceptible Staphylococcus aureus by flow cytometry after brief antibiotic exposure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N.K. Shrestha" 1 => "N.M. Scalera" 2 => "D.A. Wilson" 3 => "G.W. Procop" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.02548-10" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2011" "volumen" => "49" "paginaInicial" => "2116" "paginaFinal" => "2120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21471343" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0510" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antimicrobial susceptibility testing in 90min by bacterial cell count monitoring" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.A. Broeren" 1 => "Y. Maas" 2 => "E. Retera" 3 => "N.L. Arents" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1469-0691.2012.03800.x" "Revista" => array:6 [ "tituloSerie" => "Clin Microbiol Infect" "fecha" => "2013" "volumen" => "19" "paginaInicial" => "286" "paginaFinal" => "291" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22390723" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0515" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new approach to determine the susceptibility of bacteria to antibiotics directly from positive blood culture bottles in two hours" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G.A. March" 1 => "M.C. Garcia-Loygorri" 2 => "M. Simarro" 3 => "M.P. Gutierrez" 4 => "A. Orduna" 5 => "M.A. Bratos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.mimet.2014.12.007" "Revista" => array:6 [ "tituloSerie" => "J Microbiol Methods" "fecha" => "2015" "volumen" => "109" "paginaInicial" => "49" "paginaFinal" => "55" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25529277" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0520" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A novel flow cytometric assay for rapid detection of extended-spectrum beta-lactamases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Faria-Ramos" 1 => "M.J. Espinar" 2 => "R. Rocha" 3 => "J. Santos-Antunes" 4 => "A.G. Rodrigues" 5 => "R. Cantón" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1469-0691.2012.03986.x" "Revista" => array:6 [ "tituloSerie" => "Clin Microbiol Infect" "fecha" => "2013" "volumen" => "19" "paginaInicial" => "E8" "paginaFinal" => "E15" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23145853" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib0525" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid antimicrobial susceptibility testing of urinary tract isolates and samples by flow cytometry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Gauthier" 1 => "Y. St-Pierre" 2 => "R. Villemur" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1099/0022-1317-51-3-192" "Revista" => array:6 [ "tituloSerie" => "J Med Microbiol" "fecha" => "2002" "volumen" => "51" "paginaInicial" => "192" "paginaFinal" => "200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11871613" "web" => "Medline" ] ] ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib0530" "etiqueta" => "43" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Flow cytometry antifungal susceptibility testing of pathogenic yeasts other than Candida albicans and comparison with the NCCLS broth microdilution test" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Ramani" 1 => "V. Chaturvedi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Antimicrob Agents Chemother" "fecha" => "2000" "volumen" => "44" "paginaInicial" => "2752" "paginaFinal" => "2758" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10991856" "web" => "Medline" ] ] ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib0535" "etiqueta" => "44" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A flow cytometry method for testing the susceptibility of Cryptococcus spp. to amphotericin B" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Benaducci" 1 => "M.T. Matsumoto" 2 => "J.C. Sardi" 3 => "A.M. Fusco-Almeida" 4 => "M.J. Mendes-Giannini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.riam.2014.06.004" "Revista" => array:6 [ "tituloSerie" => "Rev Iberoam Micol" "fecha" => "2015" "volumen" => "32" "paginaInicial" => "159" "paginaFinal" => "163" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25639695" "web" => "Medline" ] ] ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib0540" "etiqueta" => "45" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safe susceptibility testing of Mycobacterium tuberculosis by flow cytometry with the fluorescent nucleic acid stain SYTO 16" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Pina-Vaz" 1 => "S. Costa-de-Oliveira" 2 => "A.G. Rodrigues" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1099/jmm.0.45627-0" "Revista" => array:6 [ "tituloSerie" => "J Med Microbiol" "fecha" => "2005" "volumen" => "54" "paginaInicial" => "77" "paginaFinal" => "81" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15591259" "web" => "Medline" ] ] ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib0545" "etiqueta" => "46" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Flow cytometric testing of susceptibilities of Mycobacterium tuberculosis isolates to ethambutol, isoniazid, and rifampin in 24 hours" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.M. Kirk" 1 => "R.F. Schell" 2 => "A.V. Moore" 3 => "S.M. Callister" 4 => "G.H. Mazurek" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "1998" "volumen" => "36" "paginaInicial" => "1568" "paginaFinal" => "1573" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9620378" "web" => "Medline" ] ] ] ] ] ] ] ] 46 => array:3 [ "identificador" => "bib0550" "etiqueta" => "47" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of a novel automated chemiluminescent assay system for antimicrobial susceptibility testing" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I. Manome" 1 => "M. Ikedo" 2 => "Y. Saito" 3 => "K.K. Ishii" 4 => "M. Kaku" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2003" "volumen" => "41" "paginaInicial" => "279" "paginaFinal" => "284" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12517861" "web" => "Medline" ] ] ] ] ] ] ] ] 47 => array:3 [ "identificador" => "bib0555" "etiqueta" => "48" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rapid antimicrobial susceptibility test based on chemiluminescence assay and its application to screening of genotypes in vancomycin-resistant enterococci" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Z. Nagasawa" 1 => "I. Manome" 2 => "A. Nagayama" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10156-004-0329-z" "Revista" => array:6 [ "tituloSerie" => "J Infect Chemother" "fecha" => "2004" "volumen" => "10" "paginaInicial" => "220" "paginaFinal" => "226" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15365863" "web" => "Medline" ] ] ] ] ] ] ] ] 48 => array:3 [ "identificador" => "bib0560" "etiqueta" => "49" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid detection of Staphylococcus aureus strains having reduced susceptibility to vancomycin using a chemiluminescence-based drug-susceptibility test" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Tajima" 1 => "M. Komatsu" 2 => "T. Ito" 3 => "K. Hiramatsu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.mimet.2007.05.020" "Revista" => array:6 [ "tituloSerie" => "J Microbiol Methods" "fecha" => "2007" "volumen" => "70" "paginaInicial" => "434" "paginaFinal" => "441" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17655957" "web" => "Medline" ] ] ] ] ] ] ] ] 49 => array:3 [ "identificador" => "bib0565" "etiqueta" => "50" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Menadione-catalyzed luminol chemiluminescent assay for the viability of Escherichia coli ATCC 25922" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Yamashoji" 1 => "M. Takeda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Microbiol Immunol" "fecha" => "2001" "volumen" => "45" "paginaInicial" => "737" "paginaFinal" => "741" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11791666" "web" => "Medline" ] ] ] ] ] ] ] ] 50 => array:3 [ "identificador" => "bib0570" "etiqueta" => "51" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Menadione-catalyzed luminol chemiluminescent assay for viability of Mycobacterium bovis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Yamashoji" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Microbiol Immunol" "fecha" => "2002" "volumen" => "46" "paginaInicial" => "571" "paginaFinal" => "573" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12363021" "web" => "Medline" ] ] ] ] ] ] ] ] 51 => array:3 [ "identificador" => "bib0575" "etiqueta" => "52" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid antibiotic susceptibility tests on Enterobacteriaceae by ATP bioluminescence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.F. Wheat" 1 => "J.G. Hastings" 2 => "R.C. Spencer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1099/00222615-25-2-95" "Revista" => array:6 [ "tituloSerie" => "J Med Microbiol" "fecha" => "1988" "volumen" => "25" "paginaInicial" => "95" "paginaFinal" => "99" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3276899" "web" => "Medline" ] ] ] ] ] ] ] ] 52 => array:3 [ "identificador" => "bib0580" "etiqueta" => "53" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A novel luminometer for rapid antimicrobial susceptibility tests on gram-positive cocci by ATP bioluminescence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.F. Wheat" 1 => "R.C. Spencer" 2 => "J.G. Hastings" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1099/00222615-29-4-277" "Revista" => array:6 [ "tituloSerie" => "J Med Microbiol" "fecha" => "1989" "volumen" => "29" "paginaInicial" => "277" "paginaFinal" => "282" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2760913" "web" => "Medline" ] ] ] ] ] ] ] ] 53 => array:3 [ "identificador" => "bib0585" "etiqueta" => "54" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of ampicillin on intracellular levels of adenosine triphosphate in bacterial cultures related to antibiotic susceptibility" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Thore" 1 => "L. Nilsson" 2 => "H. Hojer" 3 => "S. Ansehn" 4 => "L. Brote" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Pathol Microbiol Scand B" "fecha" => "1977" "volumen" => "85" "paginaInicial" => "161" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/324235" "web" => "Medline" ] ] ] ] ] ] ] ] 54 => array:3 [ "identificador" => "bib0590" "etiqueta" => "55" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rapid bioluminescent method for the detection of methicillin-resistant Staphylococcus aureus colonies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.P. Barton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "1985" "volumen" => "15" "paginaInicial" => "61" "paginaFinal" => "67" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3844404" "web" => "Medline" ] ] ] ] ] ] ] ] 55 => array:3 [ "identificador" => "bib0595" "etiqueta" => "56" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A two-hour antibiotic susceptibility test by ATP-bioluminescence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G.A. March Rossello" 1 => "M.C. Garcia-Loygorri Jordan de Urries" 2 => "M.P. Gutierrez Rodriguez" 3 => "M. Simarro Grande" 4 => "A. Orduna Domingo" 5 => "M.A. Bratos Perez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eimc.2015.03.013" "Revista" => array:6 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2016" "volumen" => "34" "paginaInicial" => "334" "paginaFinal" => "339" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25979598" "web" => "Medline" ] ] ] ] ] ] ] ] 56 => array:3 [ "identificador" => "bib0600" "etiqueta" => "57" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid antimicrobial susceptibility determination of uropathogens in clinical urine specimens by use of ATP bioluminescence" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Ivancic" 1 => "M. Mastali" 2 => "N. Percy" 3 => "J. Gornbein" 4 => "J.T. Babbitt" 5 => "Y. Li" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.02036-07" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2008" "volumen" => "46" "paginaInicial" => "1213" "paginaFinal" => "1219" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18272708" "web" => "Medline" ] ] ] ] ] ] ] ] 57 => array:3 [ "identificador" => "bib0605" "etiqueta" => "58" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid identification and susceptibility testing of uropathogenic microbes via immunosorbent ATP-bioluminescence assay on a microfluidic simulator for antibiotic therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T. Dong" 1 => "X. Zhao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1021/ac504428t" "Revista" => array:6 [ "tituloSerie" => "Anal Chem" "fecha" => "2015" "volumen" => "87" "paginaInicial" => "2410" "paginaFinal" => "2418" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25584656" "web" => "Medline" ] ] ] ] ] ] ] ] 58 => array:3 [ "identificador" => "bib0610" "etiqueta" => "59" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid detection of susceptibility to fluconazole in Candida species by a bioluminescence assay of intracellular ATP" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Kretschmar" 1 => "T. Nichterlein" 2 => "P. Kuntz" 3 => "H. Hof" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Diagn Microbiol Infect Dis" "fecha" => "1996" "volumen" => "25" "paginaInicial" => "117" "paginaFinal" => "121" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8902406" "web" => "Medline" ] ] ] ] ] ] ] ] 59 => array:3 [ "identificador" => "bib0615" "etiqueta" => "60" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of techniques for antimicrobial susceptibility testing of mycobacteria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D.I. Limb" 1 => "P.F. Wheat" 2 => "R.C. Spencer" 3 => "G.S. Harris" 4 => "A.B. Rayner" 5 => "B. Watt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Pathol" "fecha" => "1993" "volumen" => "46" "paginaInicial" => "403" "paginaFinal" => "407" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8320319" "web" => "Medline" ] ] ] ] ] ] ] ] 60 => array:3 [ "identificador" => "bib0620" "etiqueta" => "61" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid antibiotic susceptibility testing in a microfluidic pH sensor" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Tang" 1 => "L. Zhen" 2 => "J. Liu" 3 => "J. Wu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1021/ac303282j" "Revista" => array:6 [ "tituloSerie" => "Anal Chem" "fecha" => "2013" "volumen" => "85" "paginaInicial" => "2787" "paginaFinal" => "2794" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23360389" "web" => "Medline" ] ] ] ] ] ] ] ] 61 => array:3 [ "identificador" => "bib0625" "etiqueta" => "62" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A biosensor platform for rapid antimicrobial susceptibility testing directly from clinical samples" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.E. Mach" 1 => "R. Mohan" 2 => "E.J. Baron" 3 => "M.C. Shih" 4 => "V. Gau" 5 => "P.K. Wong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.juro.2010.09.022" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2011" "volumen" => "185" "paginaInicial" => "148" "paginaFinal" => "153" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21074208" "web" => "Medline" ] ] ] ] ] ] ] ] 62 => array:3 [ "identificador" => "bib0630" "etiqueta" => "63" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rapid in situ procedure for determination of bacterial susceptibility or resistance to antibiotics that inhibit peptidoglycan biosynthesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Santiso" 1 => "M. Tamayo" 2 => "J. Gosalvez" 3 => "G. Bou" 4 => "M.C. Fernandez" 5 => "J.L. Fernandez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2180-11-191" "Revista" => array:5 [ "tituloSerie" => "BMC Microbiol" "fecha" => "2011" "volumen" => "11" "paginaInicial" => "191" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21867549" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/2529993X/0000003500000003/v1_201703250110/S2529993X17300606/v1_201703250110/en/main.assets" "Apartado" => array:4 [ "identificador" => "64519" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Continuing medical education: Methods of rapid diagnosis" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/2529993X/0000003500000003/v1_201703250110/S2529993X17300606/v1_201703250110/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X17300606?idApp=UINPBA00004N"]

Statistics

Continuing medical education: Methods of rapid diagnosis

Rapid methods for detection of bacterial resistance to antibiotics

Métodos rápidos para la detección de la resistencia bacteriana a antibióticos

Gabriel Alberto March-Rosselló

Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain

Read

26807

Times
was read the article

3546

Total PDF

23261

Total HTML

Share statistics

 array:24 [
  "pii" => "S2529993X17300606"
  "issn" => "2529993X"
  "doi" => "10.1016/j.eimce.2017.02.007"
  "estado" => "S300"
  "fechaPublicacion" => "2017-03-01"
  "aid" => "1645"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Enfermedades Infecciosas y Microbiolog&#237;a Cl&#237;nica"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Enferm Infecc Microbiol Clin. 2017;35:182-8"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2344
    "formatos" => array:3 [
      "EPUB" => 9
      "HTML" => 1727
      "PDF" => 608
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0213005X16303986"
      "issn" => "0213005X"
      "doi" => "10.1016/j.eimc.2016.12.005"
      "estado" => "S300"
      "fechaPublicacion" => "2017-03-01"
      "aid" => "1645"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Enfermedades Infecciosas y Microbiolog&#237;a Cl&#237;nica"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "Enferm Infecc Microbiol Clin. 2017;35:182-8"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 17300
        "formatos" => array:3 [
          "EPUB" => 11
          "HTML" => 14209
          "PDF" => 3080
        ]
      ]
      "es" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Formaci&#243;n m&#233;dica continuada&#58; M&#233;todos de diagn&#243;stico r&#225;pido en Microbiolog&#237;a Cl&#237;nica</span>"
        "titulo" => "M&#233;todos r&#225;pidos para la detecci&#243;n de la resistencia bacteriana a antibi&#243;ticos"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "182"
            "paginaFinal" => "188"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Rapid methods for detection of bacterial resistance to antibiotics"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Gabriel Alberto March-Rossell&#243;"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "Gabriel Alberto"
                "apellidos" => "March-Rossell&#243;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2529993X17300606"
          "doi" => "10.1016/j.eimce.2017.02.007"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X17300606?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X16303986?idApp=UINPBA00004N"
      "url" => "/0213005X/0000003500000003/v2_201706011649/S0213005X16303986/v2_201706011649/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2529993X17300667"
    "issn" => "2529993X"
    "doi" => "10.1016/j.eimce.2017.02.013"
    "estado" => "S300"
    "fechaPublicacion" => "2017-03-01"
    "aid" => "1600"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Enfermedades Infecciosas y Mirobiologia Clinica"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "pgl"
    "cita" => "Enferm Infecc Microbiol Clin. 2017;35:189-95"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 331
      "formatos" => array:3 [
        "EPUB" => 4
        "HTML" => 181
        "PDF" => 146
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Consensus statement</span>"
      "titulo" => "Executive summary of management of prosthetic joint infections&#46; Clinical practice guidelines by the Spanish Society of Infectious Diseases and Clinical Microbiology &#40;SEIMC&#41;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "189"
          "paginaFinal" => "195"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Resumen ejecutivo de tratamiento de las infecciones de pr&#243;tesis articulares&#46; Guia cl&#237;nica pr&#225;ctica de la Sociedad Espa&#241;ola de Enfermedades Infecciosas y Microbiologia Cl&#237;nica"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:6 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1300
              "Ancho" => 2278
              "Tamanyo" => 203972
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Javier Ariza, Javier Cobo, Josu Baraia-Etxaburu, Natividad de Benito, Guillermo Bori, Javier Cabo, Pablo Corona, Jaime Esteban, Juan Pablo Horcajada, Jaime Lora-Tamayo, Oscar Murillo, Juli&#225;n Palomino, Jorge Parra, Carlos Pigrau, Jos&#232;c&#41; Luis del Pozo, Melchor Riera, Dolores Rodr&#237;guez, Mar S&#225;nchez-Somolinos, Alex Soriano, M&#46; Dolores del Toro, Basilio de la Torre"
          "autores" => array:23 [
            0 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Ariza"
            ]
            1 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Cobo"
            ]
            2 => array:2 [
              "nombre" => "Josu"
              "apellidos" => "Baraia-Etxaburu"
            ]
            3 => array:2 [
              "nombre" => "Natividad"
              "apellidos" => "de Benito"
            ]
            4 => array:2 [
              "nombre" => "Guillermo"
              "apellidos" => "Bori"
            ]
            5 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Cabo"
            ]
            6 => array:2 [
              "nombre" => "Pablo"
              "apellidos" => "Corona"
            ]
            7 => array:2 [
              "nombre" => "Jaime"
              "apellidos" => "Esteban"
            ]
            8 => array:2 [
              "nombre" => "Juan Pablo"
              "apellidos" => "Horcajada"
            ]
            9 => array:2 [
              "nombre" => "Jaime"
              "apellidos" => "Lora-Tamayo"
            ]
            10 => array:2 [
              "nombre" => "Oscar"
              "apellidos" => "Murillo"
            ]
            11 => array:2 [
              "nombre" => "Juli&#225;n"
              "apellidos" => "Palomino"
            ]
            12 => array:2 [
              "nombre" => "Jorge"
              "apellidos" => "Parra"
            ]
            13 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Pigrau"
            ]
            14 => array:2 [
              "nombre" => "Jos&#232;c&#41; Luis"
              "apellidos" => "del Pozo"
            ]
            15 => array:2 [
              "nombre" => "Melchor"
              "apellidos" => "Riera"
            ]
            16 => array:2 [
              "nombre" => "Dolores"
              "apellidos" => "Rodr&#237;guez"
            ]
            17 => array:2 [
              "nombre" => "Mar"
              "apellidos" => "S&#225;nchez-Somolinos"
            ]
            18 => array:2 [
              "nombre" => "Alex"
              "apellidos" => "Soriano"
            ]
            19 => array:2 [
              "nombre" => "M&#46; Dolores"
              "apellidos" => "del Toro"
            ]
            20 => array:2 [
              "nombre" => "Basilio"
              "apellidos" => "de la Torre"
            ]
            21 => array:1 [
              "colaborador" => "on behalf of the Spanish Network for the Study of Infectious Diseases and the Sociedad Espa&#241;ola de Enfermedades Infecciosas"
            ]
            22 => array:1 [
              "colaborador" => "Microbiolog&#237;a Cl&#237;nica &#40;SEIMC&#41; along with expert orthopedic surgeons from the Spanish Group of Septic Pathology of the Locomotive System &#40;GEPSAL&#41;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X17300667?idApp=UINPBA00004N"
    "url" => "/2529993X/0000003500000003/v1_201703250110/S2529993X17300667/v1_201703250110/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2529993X17300655"
    "issn" => "2529993X"
    "doi" => "10.1016/j.eimce.2017.02.012"
    "estado" => "S300"
    "fechaPublicacion" => "2017-03-01"
    "aid" => "1558"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Enfermedades Infecciosas y Mirobiologia Clinica"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Enferm Infecc Microbiol Clin. 2017;35:179-81"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 377
      "formatos" => array:3 [
        "EPUB" => 10
        "HTML" => 237
        "PDF" => 130
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Brief report</span>"
      "titulo" => "Epidemiological investigation of the first human brucellosis case in Spain due to <span class="elsevierStyleItalic">Brucella suis</span> biovar 1 strain 1330"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "179"
          "paginaFinal" => "181"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Investigaci&#243;n epidemiol&#243;gica del primer caso de brucelosis humana en Espa&#241;a por <span class="elsevierStyleItalic">Brucella suis</span> biovariedad 1 cepa 1330"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 751
              "Ancho" => 1000
              "Tamanyo" => 69389
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Multiplex PCR &#40;Suis-ladder<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">11</span></a>&#41; differentiating <span class="elsevierStyleItalic">B&#46; suis</span> biovars&#46; Lane1&#58; ladder &#40;100<span class="elsevierStyleHsp" style=""></span>base pairs&#41;&#46; Lanes 2&#8211;6&#58; <span class="elsevierStyleItalic">B&#46; suis</span> reference &#40;control&#41; strains&#58; <span class="elsevierStyleItalic">B&#46; suis</span> biovar 1 &#8211; 1330 &#8211; &#40;2&#41;&#44; <span class="elsevierStyleItalic">B&#46; suis</span> biovar 2-Thomsem &#8211; &#40;3&#41;&#44; <span class="elsevierStyleItalic">B&#46; suis</span> biovar 3 &#8211; 686 &#8211; &#40;4&#41;&#44; <span class="elsevierStyleItalic">B&#46; suis</span> biovar 4 &#8211; 40 &#8211; &#40;5&#41;&#44; <span class="elsevierStyleItalic">B&#46; suis</span> biovar 5 &#8211; 513 &#8211; &#40;6&#41;&#46; Lanes 7&#8211;8&#58; case strain&#46; Lane 9&#58; <span class="elsevierStyleItalic">B&#46; suis</span> biovar 1 reference 1330 control strain &#40;repeated to facilitate comparisons&#41;&#46; Lane 10&#58; negative control&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Cecilia Comp&#233;s Dea, Joaqu&#237;n Guimbao Besc&#243;s, Juan Pablo Alonso P&#233;rez de &#193;greda, Pilar Mar&#237;a Mu&#241;oz &#193;lvaro, Jos&#233; Mar&#237;a Blasco Mart&#237;nez, Mar&#237;a Cruz Villuendas Us&#243;n"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Cecilia"
              "apellidos" => "Comp&#233;s Dea"
            ]
            1 => array:2 [
              "nombre" => "Joaqu&#237;n"
              "apellidos" => "Guimbao Besc&#243;s"
            ]
            2 => array:2 [
              "nombre" => "Juan Pablo"
              "apellidos" => "Alonso P&#233;rez de &#193;greda"
            ]
            3 => array:2 [
              "nombre" => "Pilar Mar&#237;a"
              "apellidos" => "Mu&#241;oz &#193;lvaro"
            ]
            4 => array:2 [
              "nombre" => "Jos&#233; Mar&#237;a"
              "apellidos" => "Blasco Mart&#237;nez"
            ]
            5 => array:2 [
              "nombre" => "Mar&#237;a Cruz"
              "apellidos" => "Villuendas Us&#243;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X17300655?idApp=UINPBA00004N"
    "url" => "/2529993X/0000003500000003/v1_201703250110/S2529993X17300655/v1_201703250110/en/main.assets"
  ]
  "en" => array:18 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Continuing medical education&#58; Methods of rapid diagnosis</span>"
    "titulo" => "Rapid methods for detection of bacterial resistance to antibiotics"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "182"
        "paginaFinal" => "188"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Gabriel Alberto March-Rossell&#243;"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Gabriel Alberto"
            "apellidos" => "March-Rossell&#243;"
            "email" => array:1 [
              0 => "gmr810&#64;hotmail&#46;com"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Microbiolog&#237;a e Inmunolog&#237;a&#44; Hospital Cl&#237;nico Universitario de Valladolid&#44; Valladolid&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "M&#233;todos r&#225;pidos para la detecci&#243;n de la resistencia bacteriana a antibi&#243;ticos"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">To achieve a favourable clinical course in patients who suffer from infections&#44; the clinical microbiology laboratory should report the agent causing the infection as quickly as possible&#46; If it is a bacterium that does not have uniform sensitivity to antibiotics&#44; the antibiogram should also be reported&#44; since the significant increase in antimicrobial resistance represents an obstacle to empirical treatment in some cases&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Routine antibiogram techniques are based on a phenotypic study in which microbial growth is observed in the presence of different antibiotics&#46; These techniques include agar dilution &#40;the gold standard for the antibiogram&#41;&#44; broth macrodilution and microdilution&#44; and strips with an antibiotic gradient&#46; They yield results in around 17<span class="elsevierStyleHsp" style=""></span>h&#46; To shorten this time&#44; it would be desirable to have fast and reliable antibiogram results&#46; To evaluate reliability&#44; according to the US Food and Drug Administration &#40;FDA&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">1</span></a> the results of a rapid antibiogram are classified&#44; compared to the antibiogram obtained through the gold standard&#44; as agreements &#40;concordance&#41;&#44; minor errors &#40;erroneous intermediate sensitivity result&#41;&#44; major errors &#40;false resistance&#41; and very major errors &#40;false sensitivity&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">There are many instrumental techniques that allow an antibiogram to be made quickly&#46; Notable among these are molecular techniques&#44; microarrays&#44; commercial methods used in routine work&#44; immunochromatographic techniques&#44; colourimetric methods&#44; imaging methods&#44; nephelometry&#44; MALDI-TOF mass spectrometry&#44; flow cytometry&#44; chemiluminescence and bioluminescence&#44; microfluids and bacterial lysis methods&#46; The basis of each of these techniques and the results obtained are presented below&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Molecular techniques</span><p id="par0020" class="elsevierStylePara elsevierViewall">Molecular techniques enable the detection of genetic material&#44; both deoxyribonucleic acid &#40;DNA&#41; and ribonucleic acid &#40;RNA&#41;&#46; Polymerase chain reaction &#40;PCR&#41; is the molecular technique that has acquired the greatest diagnostic value&#44; since it not only allows the infectious agent to be accurately identified&#44; but is also the leading method to characterise its resistance and virulence genotypes&#46; Conventional PCR requires approximately 12<span class="elsevierStyleHsp" style=""></span>h to perform and consists of 3 steps&#46; The first step consists of extraction of genetic material&#46; The second step&#44; performed in a thermocycler&#44; consists of DNA amplification&#46; The thermocycler reaches the optimal temperatures required for each of the 3 steps comprising an amplification cycle &#40;denaturation of the DNA to be used as a mould&#44; ringing of synthetic primers and extension catalysed by the polymerase DNA of the primers&#41; to take place&#46; Amplification is repeated a certain number of times&#44; generally 25&#8211;35&#46; Each time&#44; the number of product molecules &#40;amplicons&#41; is duplicated&#46; Thus a high number of amplicons is synthesised&#44; which allows very small initial amounts of DNA to be detected&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">2</span></a> The third and final step of PCR consists of detection of amplicons through agarose gel electrophoresis&#46; Real-time PCR was designed to shorten the time to diagnosis of conventional PCR&#46; In real-time PCR&#44; amplification and detection of the amplicons synthesised take place at the same time through different methods&#46; Thus&#44; real-time PCR yields results in a few hours&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Several real-time PCRs which identify several pathogenic agents and genes that directly confer antibiotic resistance based on different samples have been marketed&#46; These PCRs are fully automated&#58; samples are processed in just a few minutes&#46; The Verigene<span class="elsevierStyleSup">&#174;</span> system &#40;Nanosphere&#41; is based on grown blood culture bottles&#46; Detection of amplicons takes place through hybridisation with synthetic specific oligonucleotides marked with gold nanoparticles&#46; In Gram-positive bacteria&#44; it detects 9 species and 4 genera of bacteria&#44; as well as the resistance genes <span class="elsevierStyleItalic">mecA</span> and <span class="elsevierStyleItalic">vanA&#47;B</span>&#44; in less than 3<span class="elsevierStyleHsp" style=""></span>h with a sensitivity and a specificity very close to 100&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">3</span></a> In Gram-negative bacteria&#44; it detects 5 species and 4 genera of bacteria&#44; as well as the resistance genes that encode CTX-M extended-spectrum beta-lactamases &#40;ESBLs&#41; and KPC&#44; NDM&#44; VIM&#44; IMP and OXA carbapenemases&#44; with the same response time and with a sensitivity and a specificity in excess of 93&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">4</span></a> The FilmArray Blood Culture Identification Panel system &#40;BioFire Diagnostics&#41; is also applied to the grown blood culture bottle&#46; In this case a nested PCR is performed&#46; First&#44; a region of DNA that contains the target segment is amplified&#46; Next&#44; this amplification product is used as a mould for a second PCR which takes place in a matrix with wells that contain the primers for the different assays&#46; Finally&#44; the instrument uses the fluorochrome LCGreen<span class="elsevierStyleSup">&#174;</span> Plus &#40;BioFire Diagnostics&#41; to evaluate the fusion curve of the DNA in each well of the matrix to determine whether a PCR product appears in said well&#46; In an hour&#44; this system detects 11 species and 15 genera of Gram-positive and Gram-negative bacteria and 5 species of yeast&#46; It also detects the resistance genes <span class="elsevierStyleItalic">mecA</span>&#44; <span class="elsevierStyleItalic">vanA&#47;B</span> and <span class="elsevierStyleItalic">KPC</span>&#46; Sensitivity ranges from 83&#37; to 100&#37;&#44; and specificity is more than 99&#37;&#44; depending on the pathogen studied&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">3</span></a> The GeneXpert<span class="elsevierStyleSup">&#174;</span> system performs real-time PCR in single-use disposable cartridges&#46; There are many cartridges for performing different analyses&#46; To detect <span class="elsevierStyleItalic">Staphylococcus aureus</span> and its methicillin resistance in clinical samples&#44; 2 cartridges are available&#58; the Xpert<span class="elsevierStyleSup">&#174;</span> MRSA&#47;SA BC cartridge&#44; which uses grown blood culture bottles&#44; and the Xpert<span class="elsevierStyleSup">&#174;</span> MRSA&#47;SA SSTI cartridge&#44; which uses swabs to diagnose skin and soft-tissue infections&#46; Both tests yield results in an hour and have a sensitivity and a specificity very close to 100&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">3&#44;5</span></a> The Xpert MTB&#47;RIF<span class="elsevierStyleSup">&#174;</span> cartridge detects <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> and its rifampicin resistance in sputum and biological fluids in 2<span class="elsevierStyleHsp" style=""></span>h&#46; In this case a semiquantitative nested PCR takes place&#46; It has been observed that in sputum and bronchoalveolar lavage&#44; the test has a sensitivity and a specificity of 86&#46;8&#37; and 93&#46;1&#37;&#44; respectively&#44; thereby improving sputum smear microscopy results&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">6</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Many PCRs &#8211; &#8220;in-house&#8221;&#44; commercial and automated &#8211; and PCR kits that accurately detect&#44; with a sensitivity and a specificity of practically 100&#37;&#44; a large number of genes that confer antibiotic resistance have been described in the literature&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">7</span></a> It should be noted that these methodologies do not provide microbial identification and that they are applied&#44; in the majority of cases&#44; to colonies grown on isolation plates&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The main commercial automated real-time PCRs are detailed below&#46; The NucliSENS EasyQ<span class="elsevierStyleSup">&#174;</span> KPC platform &#40;bioM&#233;rieux&#41; detects genes that encode KPC carbapenemases in 2<span class="elsevierStyleHsp" style=""></span>h&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">8</span></a> The Xpert<span class="elsevierStyleSup">&#174;</span> Carba-R cartridge from GeneXpert<span class="elsevierStyleSup">&#174;</span> detects genes that encode KPC&#44; NDM&#44; VIM&#44; IMP and OXA-48 carbapenemases in an hour&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">9</span></a> The eazyplex<span class="elsevierStyleSup">&#174;</span> system &#40;Amplex Biosystems GmbH&#41; consists of a platform that performs nucleic acid amplification through the loop-mediated isothermal amplification &#40;LAMP&#41; technique&#46; This technique is based on DNA amplification through chain displacement at a constant temperature&#59; thus&#44; the system does not require a thermocycler&#46; To carry out amplification&#44; the DNA extracted is inserted in a tube containing a lyophilisate with the reagents required to perform nucleic acid amplification&#59; next&#44; this tube is inserted in the Genie<span class="elsevierStyleSup">&#174;</span> II apparatus &#40;OptiGene&#41;&#44; which keeps the tube at a constant temperature and detects the amplicons formed in real time&#46; For this platform&#44; several kits have been marketed that detect genes that confer antibiotic resistance in less than 30<span class="elsevierStyleHsp" style=""></span>min&#46; Notable among them is the eazyplex<span class="elsevierStyleSup">&#174;</span> SuperBug CRE which detects genes that encode CTX-M ESBL and VIM&#44; NDM&#44; KPC and OXA-48 carbapenemases&#44; both in colonies grown on isolation plates and directly from urine samples and grown blood culture bottles&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">10</span></a> AID Autoimmun Diagnostika GmbH has marketed a PCR based on line probe assays&#46; In this case&#44; once the PCR has been performed&#44; reverse hybridisation of the amplicons takes place with complementary probes anchored to a nitrocellulose strip&#46; Hybridisation is detected using a biotin marker present in the primers used in the PCR&#46; Thus a band pattern is obtained which is interpreted visually or with a scanner&#46; Notable among antibiotic resistance kits is the AID ESBL&#44; which detects genes that encode TEM&#44; SHV and CTX-M ESBLs and KPC carbapenemases in 5<span class="elsevierStyleHsp" style=""></span>h&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">11</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Notable among the kits marketed to detect genes that confer bacterial resistance to antibiotics are the following&#58; LightMix &#40;Roche Diagnostics&#41; and Check-Direct CPE &#40;Check-Points Health B&#46;V&#46;&#41;&#46; The LightMix kit&#44; using the LightCycler<span class="elsevierStyleSup">&#174;</span> 480 Instrument II platform &#40;Roche Diagnostics&#41;&#44; detects KPC&#44; NDM&#44; VIM&#44; IMP and OXA-48 carbapenemases in an hour and a half&#46; It should be noted that this kit may also be applied to grown blood culture bottles&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">12</span></a> The Check-Direct CPE kit may be used on several real-time PCR platforms&#44; such as the ABI 7500 &#40;Applied&#41;&#44; CFX96&#8482; &#40;Bio-Rad&#41;&#44; LightCycler<span class="elsevierStyleSup">&#174;</span> 480 system I &#38; II &#40;Roche&#41;&#44; Rotor-Gene Q &#40;Qiagen&#41; and BD MAX&#8482; &#40;Becton Dickinson&#41; platforms&#46; This kit includes the reagents required to detect genes that encode KPC&#44; NDM&#44; VIM and OXA-48 carbapenemases in 2<span class="elsevierStyleHsp" style=""></span>h&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">9</span></a> In addition&#44; some kits to perform a ligation-mediated PCR have been marketed&#46; Briefly&#44; this PCR uses 2 DNA probes that recognise one of the 2 strands of the gene to be detected&#46; If hybridisation occurs&#44; the probes remain adjacent and a DNA ligase binds them&#44; thereby generating a double-chain DNA&#46; This ligation step is performed in the MyCycler apparatus &#40;Bio-Rad&#41;&#46; Finally&#44; real-time PCR takes place on the ABI 7500 &#40;Applied&#41; platform using some universal primers&#46; Notable among the kits that detect genes that encode bacterial resistance to antibiotics through ligation-mediated PCR are one kit for CTX-M&#44; TEM and SHV ESBLs<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">13</span></a> and another kit for KPC&#44; NDM&#44; IMP&#44; VIM&#44; and OXA-48 carbapenemases&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">14</span></a> Both kits yield results in 4<span class="elsevierStyleHsp" style=""></span>h and a half&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Finally&#44; it should be noted that the commercial molecular methods mentioned above have a limited percentage of false negatives as these methods do not detect all allelic variants of genes that confer antibiotic resistance&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">15</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Microarrays</span><p id="par0050" class="elsevierStylePara elsevierViewall">This method is based on using an image analysis to detect hybridisation of a target molecule to a specific probe immobilised on a solid base&#46; Microarrays detect a large number of resistance genes in a single assay given that these probes&#44; which are normally oligonucleotides&#44; are attached very close to one another&#46; Several microarrays have been marketed&#44; such as the Check-MDR CT102&#44; the Check-MD CT103 and the Check-MDR CT103 XL &#40;Check points Health BV&#41;&#46; These microarrays detect a large number of genes that encode different beta-lactamases &#40;ESBLs&#44; AmpCs and carbapenemases&#41; based on colonies grown on isolation plates&#46; These 3 microarrays require a first step of a PCR with a pair of universal primers marked with biotin&#46; Next&#44; the amplicons are classified through hybridisation with the oligonucleotide probes&#46; Finally&#44; the manufacturer&#39;s software program detects hybridisation using the biotin marker&#44; automatically translates the data and expresses the results in the form of the presence or absence of a gene&#46; These microarrays yield results in 8<span class="elsevierStyleHsp" style=""></span>h and have a sensitivity and a specificity of practically 100&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">16&#8211;18</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Commercial antibiogram methods</span><p id="par0055" class="elsevierStylePara elsevierViewall">Different commercial antibiogram methods used in routine clinical microbiology laboratory work have been applied directly based on different clinical samples&#46; Commercial strips with an antibiotic gradient have been used to make a direct antibiogram based on respiratory samples&#46; To do this&#44; the sample is inoculated in Mueller Hinton agar plates and the strips with antibiotic are added&#46; The plates are incubated for 24<span class="elsevierStyleHsp" style=""></span>h and&#44; once the colonies have grown&#44; the MIC is obtained&#46; Boyer et al&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">19</span></a> obtained a rate of agreements of 88&#46;9&#37;&#44; a rate of very major errors of 1&#46;5&#37; and a rate of major errors of 9&#46;6&#37;&#46; Bouza et al&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">20</span></a> obtained a rate of agreements of 96&#46;44&#37;&#44; a rate of major errors of 1&#46;98&#37; and a rate of minor errors of 1&#46;56&#37;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Semiautomated broth microdilution methods &#40;MicroScan&#44; VITEK2 and Phoenix&#41; allow the bacteria to be identified and the antibiogram to be obtained directly based on the grown blood culture bottle&#46; The bacteria are identified in 3<span class="elsevierStyleHsp" style=""></span>h&#44; with poor results in Gram-positive bacteria and acceptable results in Gram-negative bacteria&#44; and the antibiogram is obtained in 14<span class="elsevierStyleHsp" style=""></span>h&#44; with good results in both Gram-positive and Gram-negative bacteria&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Immunochromatographic techniques</span><p id="par0065" class="elsevierStylePara elsevierViewall">These techniques yield results in around 20<span class="elsevierStyleHsp" style=""></span>min&#46; They are affordably priced and require neither instrumentation nor expert staff&#46; This means that they may be performed in any laboratory&#46; In antibiotic resistance&#44; they detect bacterial enzymes that hydrolyse the antibiotic&#46; The procedure consists of suspending the bacterium in a diluent&#46; Next&#44; a few drops of this diluent are deposited on one end of the strip &#40;normally made of nitrocellulose&#41;&#44; and the bacteria move by means of capillarity towards the other end of the strip&#46; If a coloured band appears on the test position of the strip&#44; where an antibody that recognises the antigen of the bacteria is fixed&#44; this means that the test is positive&#46; Two immunochromatography systems that detect OXA-48 and KPC carbapenemases &#40;Coris BioConcept&#41; with a sensitivity and a specificity of practically 100&#37; have been marketed&#46;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">21</span></a> The BinaxNOW PBP2a test &#40;Alere&#41; has been marketed to detect the methicillin resistance of <span class="elsevierStyleItalic">S&#46; aureus</span>&#46; This test shows a sensitivity and a specificity of practically 100&#37;&#46; It was also applied to grown blood culture bottles and offered a sensitivity of 95&#46;4&#37; and a specificity of practically 100&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">3</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Colourimetric methods</span><p id="par0070" class="elsevierStylePara elsevierViewall">Several kits have been marketed to detect carbapenemases&#44; such as the RAPIDEC<span class="elsevierStyleSup">&#174;</span> CARBA NP kit &#40;bioM&#233;rieux&#41; and the Rapid CARB Screen<span class="elsevierStyleSup">&#174;</span> kit &#40;Rosco Diagnostica A&#47;S&#41;&#46; These kits yield results in around 2<span class="elsevierStyleHsp" style=""></span>h with a sensitivity and a specificity very close to 100&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">22</span></a> In these tests&#44; the bacterium is incubated in the presence of the antibiotic&#46; If the bacterium possesses a carbapenemase&#44; the antibiotic is hydrolysed and there is a change in the pH of the medium which is detected through a change in the colour of the indicator&#46; These tests do not characterise the type of carbapenemase&#46; However&#44; in a phenotypic study&#44; they can detect any carbapenemase variant that is being expressed&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Resazurin&#44; added to a bacterial suspension resistant to the antibiotic with which it is incubated&#44; is reduced by the metabolic activity of the bacterium&#46; If the bacterium is sensitive to the antibiotic&#44; its metabolism stops&#44; and consequently resazurin remains in its oxidised form&#46; Given that the reduced form of resazurin is stable and red in colour&#44; and photometrically distinguishable from the oxidised form&#44; which is blue in colour&#44; cell viability may be monitored through spectrophotometry&#44; colourimetry or fluorimetry&#46; In 6<span class="elsevierStyleHsp" style=""></span>h&#44; Coban et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0430"><span class="elsevierStyleSup">23&#44;24</span></a> determined the sensitivity of <span class="elsevierStyleItalic">S&#46; aureus</span> to methicillin and vancomycin&#46; March et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">25&#44;26</span></a> made an antibiogram for staphylococci&#44; enterococci and enterobacteria in 2<span class="elsevierStyleHsp" style=""></span>h&#46; However&#44; the disadvantage of resazurin is that it is not metabolised by non-fermenting Gram-negative bacilli&#46; Another colourimetric method consists of measuring the activity of the bacterial enzyme nitrate reductase&#46; When the bacterium is incubated in the presence of NO<span class="elsevierStyleInf">3</span>&#8722; ions and antibiotic&#44; if the bacterium is resistant to the antibiotic&#44; NO<span class="elsevierStyleInf">2</span>&#8722; ions are going to be generated that&#44; with Griess reagents&#44; yield a compound that is red in colour&#46; In around 6<span class="elsevierStyleHsp" style=""></span>h&#44; this method determines the sensitivity of <span class="elsevierStyleItalic">S&#46; aureus</span> to methicillin and vancomycin&#46;<a class="elsevierStyleCrossRefs" href="#bib0430"><span class="elsevierStyleSup">23&#44;24</span></a> These 2 colourimetric methods have also been applied in mycobacteria and the antibiogram has been obtained in 7&#8211;14 days&#46;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">27</span></a> In all cases&#44; the rate of correlation with the reference methods that was obtained was close to 100&#37;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Imaging methods</span><p id="par0080" class="elsevierStylePara elsevierViewall">Based on grown blood culture bottles&#44; the ACCELERATE pheno&#8482; SYSTEM apparatus &#40;Accelerate Diagnostics&#41; identifies 10 species and 6 genera of bacteria through the fluorescence <span class="elsevierStyleItalic">in situ</span> hybridisation &#40;FISH&#41; technique in 1<span class="elsevierStyleHsp" style=""></span>h&#46; To make the direct antibiogram&#44; the bacterial growth of a strain incubated in the presence of different concentrations of antibiotic is monitored through imaging&#46; Thus&#44; in 5<span class="elsevierStyleHsp" style=""></span>h this piece of equipment reports the MIC and the phenotypes for high-level resistance to gentamicin and streptomycin in enterococci and for induction of clindamycin resistance by erythromycin in staphylococci&#46; Depending on the pathogen studied&#44; the sensitivity obtained has a rate of agreement of 92&#8211;100&#37; with that obtained through broth microdilution&#46;<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">28</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Nephelometry</span><p id="par0085" class="elsevierStylePara elsevierViewall">Nephelometry is a technique that measures the intensity of scattered radiation that is generated when a beam of light passes through a suspension of particles&#46; Given that light diffusion is proportional to particle concentration&#44; this instrument-based technique allows microorganisms to be quantified&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">2</span></a> The Alfred 60 apparatus &#40;Alifax&#41; performs a urine sample screening to diagnose urinary tract infections&#46; To do this&#44; an aliquot of urine is spiked in a tube with liquid enrichment medium and bacterial growth is monitored through nephelometry for 3<span class="elsevierStyleHsp" style=""></span>h&#46; With this piece of equipment&#44; by monitoring bacterial growth in marketed tubes that contained a liquid enrichment medium and antibiotic together with an aliquot of the sample&#44; an antibiogram directly based on urine and bottles of blood culture was made in 5<span class="elsevierStyleHsp" style=""></span>h&#46;<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">29&#44;30</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">MALDI-TOF mass spectrometry</span><p id="par0090" class="elsevierStylePara elsevierViewall">The MALDI-TOF system uses a protein analysis to identify bacteria &#40;including mycobacteria&#41;&#44; yeasts and filamentous moulds in minutes&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">2</span></a> Regarding the rapid antibiogram&#44; the MALDI-TOF system predicts whether the bacteria produce enzymes that hydrolyse the antibiotics&#44; such as carbapenemases and ESBLs&#44; in less than 3<span class="elsevierStyleHsp" style=""></span>h&#46; To do this&#44; the microorganisms are incubated for a while with the antibiotic&#46; Centrifugation is performed and the supernatant obtained is analysed using MALDI-TOF&#46; If the microorganism possesses the enzyme that degrades the antibiotic&#44; the peak corresponding to the antibiotic will be seen to disappear and new peaks corresponding to the metabolites resulting from the rupture of the antibiotic will be seen to appear&#46; If the bacterium does not hydrolyse the antibiotic&#44; only the peak corresponding to the antibiotic will be observed&#46; This methodology has yielded sensitivities of practically 100&#37;&#44; both based on colonies grown on isolation plates<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">31</span></a> and based on grown blood culture bottles from patients&#46;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">32</span></a> It is also possible to predict resistance to chloramphenicol and clindamycin by detecting the 16S ribosomal RNA methylation performed by methyltransferases&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">33</span></a> Moreover&#44; both methicillin-sensitive and methicillin-resistant <span class="elsevierStyleItalic">S&#46; aureus</span> strains have been observed to yield specific identification peaks&#59; thus&#44; from a database that is normally prepared in the laboratory itself&#44; it is possible to distinguish between methicillin-sensitive and methicillin-resistant <span class="elsevierStyleItalic">S&#46; aureus</span> strains in a few minutes based on colonies grown on isolation plates&#46;<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">34</span></a> Similarly&#44; the MALDI-TOF system also discriminates between strains of vancomycin-resistant and vancomycin-sensitive enterococci&#46;<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">35</span></a> Antibiotic sensitivity may also be studied through incubation of microorganisms in the presence of antibiotic in a medium with isotope-marked molecules&#46; If the microorganism is resistant&#44; it will incorporate the marked molecules which may be detected by MALDI-TOF&#46;<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">36</span></a> Jung et al&#46;<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">37</span></a> developed an antibiogram based on a semiquantitative analysis&#46; They incubated an aliquot from the grown blood culture bottle in a liquid medium&#44; both in the presence and in the absence of antibiotic&#46; The latter was the control group&#46; The mass spectra were obtained from the sediments and the relative intensity of the peaks and the area under the curve &#40;AUC&#41; were calculated&#46; For purposes of interpreting the antibiogram&#44; a strain was considered to be resistant to the antibiotic if it yielded a peak intensity and AUC similar to those of the control group when incubated with the antibiotic&#46; By contrast&#44; a strain was considered to be sensitive to the antibiotic if&#44; when incubated with antibiotic&#44; it provided a peak intensity and AUC lower than those of the control group&#46; An antibiogram was thus obtained based on the grown blood culture bottle in 4<span class="elsevierStyleHsp" style=""></span>h&#44; with a 2&#37; discrepancy rate compared to the sensitivity obtained by the E-test&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Flow cytometry</span><p id="par0095" class="elsevierStylePara elsevierViewall">Flow cytometry is a technique based on the formation of a flow of particles &#40;generally cells&#41; arranged in a row with an intensity of 500&#8211;4000<span class="elsevierStyleHsp" style=""></span>particles&#47;second&#46; Thanks to this alignment&#44; the technique allows multiple characteristics of a single cell to be measured simultaneously such that it is possible to characterise&#44; separate and quantify the different cell subpopulations that are included in a set&#46; In addition&#44; various bacterial parameters &#40;membrane potential&#44; cell size&#44; enzyme activity&#44; cell membrane integrity and microbial concentration&#41; which provide information about the sensitivity of microorganisms to antibiotics may be studied using various fluorochromes&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">2</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Through histograms which represented scattered light at a 90-degree angle &#40;side scatter channel &#91;SSC&#93;&#41; to the fluorescence signal&#44; Shrestha et al&#46;<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">38</span></a> managed to distinguish between methicillin-resistant and methicillin-sensitive <span class="elsevierStyleItalic">S&#46; aureus</span> strains following an incubation period of 4<span class="elsevierStyleHsp" style=""></span>h in the presence of the antibiotic&#46; The Sysmex UF-1000i flow cytometry apparatus &#40;Sysmex Corporation&#41; is used in microbiology laboratories to perform a urine screening using the bacterial count&#46; This piece of equipment was used to obtain 2 antibiograms by comparing the counts obtained from strains incubated in a liquid medium with antibiotics to the counts obtained for the same strains incubated without antibiotic &#40;control group&#41;&#46; A strain was considered to be resistant to the antibiotic if it yielded a microbial count very similar to that of the control group when incubated with the antibiotic&#46; By contrast&#44; a strain was considered to be sensitive to the antibiotic if it yielded a microbial count lower than that of the control group when incubated with the antibiotic&#46; Broeren et al&#46;<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">39</span></a> calculated the MIC of amoxicillin&#44; gentamicin and piperacillin in <span class="elsevierStyleItalic">Escherichia coli&#44; Pseudomonas aeruginosa</span> and <span class="elsevierStyleItalic">S&#46; aureus</span>&#46; In 4<span class="elsevierStyleHsp" style=""></span>h they obtained an antibiogram with a rate of agreement of 100&#37; compared to the antibiogram obtained through the VITEK2&#44; E-test and broth macrodilution systems&#46; March et al&#46;<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">40</span></a> made an antibiogram based on 100 grown blood culture bottles and obtained&#44; in just 2<span class="elsevierStyleHsp" style=""></span>h&#44; a rate of agreement of 98&#37; compared to the sensitivity obtained through the E-test&#44; MicroScan and VITEK2 commercial methods&#46; Faria-Ramos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">41</span></a> managed to distinguish between ESBL-producing and non-ESBL-producing strains in less than 3<span class="elsevierStyleHsp" style=""></span>h based on bacteria incubated in the presence of ceftazidime and cefotaxime with and without clavulanic acid&#44; using the fluorochrome DiBAC<span class="elsevierStyleInf">4</span>&#40;3&#41;&#44; which only penetrates non-viable bacteria&#46; Gauthier et al&#46;<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">42</span></a> made an antibiogram through flow cytometry based on urine&#46; They used 2 fluorochromes&#44; DiBAC<span class="elsevierStyleInf">4</span>&#40;3&#41; and propidium iodide&#44; which also only penetrates non-viable bacteria&#46; They analysed 114 urine samples and&#44; by measuring the fluorescence signal after incubating the aliquots of urine for 2<span class="elsevierStyleHsp" style=""></span>h in the presence of different antibiotics&#44; obtained a 2&#37; discrepancy rate compared to the sensitivity obtained through broth microdilution&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">In yeasts&#44; it is possible to obtain an antifungigram in 6<span class="elsevierStyleHsp" style=""></span>h through the use of propidium iodide&#46;<a class="elsevierStyleCrossRefs" href="#bib0530"><span class="elsevierStyleSup">43&#44;44</span></a> In mycobacteria&#44; Pina-Vaz et al&#46;<a class="elsevierStyleCrossRef" href="#bib0540"><span class="elsevierStyleSup">45</span></a> determined the sensitivity of <span class="elsevierStyleItalic">M&#46; tuberculosis</span> to streptomycin&#44; isoniazid&#44; rifampicin and ethambutol&#46; After 3 days of incubation in the presence of the antituberculosis drug in the BACTEC MGIT 960 system &#40;Becton Dickinson&#41;&#44; the microorganisms were stained with the fluorochrome SYTO 16&#44; which only penetrates microorganisms with a cell membrane abnormality&#46; By comparing the intensity of the fluorescence signal obtained from these microorganisms to that obtained from microorganisms incubated during the same time without the presence of the antituberculosis drug&#44; they distinguished between sensitive&#44; intermediate and resistant strains and obtained results that showed excellent agreement with those obtained from 3 weeks of incubation in the BACTEC MGIT 960 system&#46; Kirk et al&#46;<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">46</span></a> determined the sensitivity of <span class="elsevierStyleItalic">M&#46; tuberculosis</span> by studying the capacity of the mycobacteria to hydrolyse&#44; through esterases&#44; the substrate fluorescein diacetate&#44; which turns into fluorescein&#44; a compound which emits fluorescence when it is excited with light from a suitable wavelength&#46; If the mycobacterium is sensitive to the antituberculosis drug&#44; the hydrolytic capacity of the mycobacterium decreases&#44; and therefore the fluorescence signal detected also decreases&#46; By comparing the fluorescence signal and the scattered light at 90 degrees obtained through flow cytometry based on mycobacteria without contact with the antituberculosis drug to the signals obtained from mycobacteria with an incubation period of 24<span class="elsevierStyleHsp" style=""></span>h with isoniazid&#44; ethambutol and rifampicin&#44; they obtained rates of agreement of 95&#37;&#44; 92&#37; and 83&#37;&#44; respectively&#44; compared to the antibiogram obtained through the method of proportions&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Chemiluminescence and bioluminescence</span><p id="par0110" class="elsevierStylePara elsevierViewall">Chemiluminescence is a process of light emission that occurs in certain chemical reactions when excited molecules return to the ground state&#46; To obtain light&#44; menadione must be added to the microorganism culture&#46; The bacterial membrane is permeable to this molecule&#46; Once menadione penetrates the microorganisms&#44; it is reduced and various compounds are generated that diffuse to the extracellular environment where they self-oxidise and light photons are emitted&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">2</span></a> The viability of the microorganisms is established by comparing the chemiluminescence signal of strains incubated with antibiotics to the chemiluminescence signal of the same strains incubated without antibiotics&#46;<a class="elsevierStyleCrossRefs" href="#bib0550"><span class="elsevierStyleSup">47&#8211;50</span></a> If the strain is sensitive to the antibiotic&#44; then the culture incubated with antibiotic will yield a much weaker signal than the culture incubated without antibiotic&#46; If the strain is resistant to the antibiotic&#44; the signals obtained from the cultures incubated in the presence and absence of antibiotic will be very similar&#46; With an incubation period of around 4<span class="elsevierStyleHsp" style=""></span>h&#44; chemiluminescence yields an MIC with a rate of agreement of 88&#8211;100&#37; compared to the MICs obtained through broth macrodilution or microdilution&#46;<a class="elsevierStyleCrossRefs" href="#bib0550"><span class="elsevierStyleSup">47&#44;48&#44;50</span></a> In a period of 8<span class="elsevierStyleHsp" style=""></span>h&#44; it also detects intermediate and vancomycin-heteroresistant strains of <span class="elsevierStyleItalic">S&#46; aureus</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0560"><span class="elsevierStyleSup">49</span></a> Finally&#44; it has been found that chemiluminescence can be used to determine mycobacteria sensitivity in 4 days&#46;<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">51</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Bioluminescence is a form of chemiluminescence that occurs as a result of a chemical reaction that takes place in some living organisms such as fireflies&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">2</span></a> Studies conducted on an antibiogram are based on measuring the levels of bacterial ATP of intracellular origin&#44; extracellular origin or overall&#44; by comparing the bioluminescence signal obtained from microorganisms incubated without the presence of antibiotic &#40;control group&#41; to the signal obtained from the same microorganisms incubated in the presence of antibiotic&#46;<a class="elsevierStyleCrossRefs" href="#bib0575"><span class="elsevierStyleSup">52&#44;53</span></a> Regarding the control group&#44; if the intracellular ATP is measured&#44; the strains that are sensitive to the antibiotic studied will yield a decrease in the bioluminescence signal<a class="elsevierStyleCrossRef" href="#bib0585"><span class="elsevierStyleSup">54</span></a>&#59; if the extracellular ATP of the sensitive strains is measured&#44; they will yield an increase in the signal<a class="elsevierStyleCrossRef" href="#bib0590"><span class="elsevierStyleSup">55</span></a>&#59; and if the total ATP of the sensitive strains is measured&#44; they will yield a decrease in the ATP signal&#46;<a class="elsevierStyleCrossRefs" href="#bib0575"><span class="elsevierStyleSup">52&#44;53&#44;56</span></a> By contrast&#44; if the microorganism is resistant to the antibiotic&#44; the control group measurements will be practically identical to those obtained from the strains incubated with antibiotic&#46; With this methodology&#44; it is possible to obtain a reliable antibiogram in just 2<span class="elsevierStyleHsp" style=""></span>h&#46;<a class="elsevierStyleCrossRef" href="#bib0595"><span class="elsevierStyleSup">56</span></a> In addition&#44; several studies referring to antibiograms obtained through bioluminescence based on a direct sample have been published&#46; Ivancic et al&#46;<a class="elsevierStyleCrossRef" href="#bib0600"><span class="elsevierStyleSup">57</span></a> made an antibiogram based on urine by comparing the ATP signal obtained from an aliquot of urine incubated without antibiotic to the ATP signal from another aliquot of the same urine incubated with antibiotic&#46; In 2<span class="elsevierStyleHsp" style=""></span>h&#44; they achieved a rate of agreement of 91&#37; compared to the MIC obtained from the colony&#46; Dong and Zhao<a class="elsevierStyleCrossRef" href="#bib0605"><span class="elsevierStyleSup">58</span></a> developed a microfluidic simulator with immobilised antibodies through which&#44; based on urine&#44; the identification of 13 species of bacteria and the antibiogram are obtained in 6<span class="elsevierStyleHsp" style=""></span>h&#46; In yeasts and mycobacteria&#44; bioluminescence yields a reliable antibiogram in 6<span class="elsevierStyleHsp" style=""></span>h and 7 days&#44; respectively&#46;<a class="elsevierStyleCrossRefs" href="#bib0610"><span class="elsevierStyleSup">59&#44;60</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Microfluids</span><p id="par0120" class="elsevierStylePara elsevierViewall">Advances in nanotechnology have made it possible to make antibiograms on platforms or chips using small working volumes to carry out multiple assays that provide information on the sensitivity of bacteria to antibiotics&#44; such as cell rupture&#44; bacterial culture and hybridisation and amplification of nucleic acids&#46; Tang et al&#46;<a class="elsevierStyleCrossRef" href="#bib0620"><span class="elsevierStyleSup">61</span></a> developed a platform with which&#44; by measuring pH changes that occur as a result of the accumulation of metabolic products&#44; it is possible to detect bacterial growth in 2<span class="elsevierStyleHsp" style=""></span>h&#46; Mach et al&#46;<a class="elsevierStyleCrossRef" href="#bib0625"><span class="elsevierStyleSup">62</span></a> made an antibiogram directly based on urine samples using a microfluidic system with a built-in electrochemical sensor to quantify 16S ribosomal RNA&#46; In 3<span class="elsevierStyleHsp" style=""></span>h and a half&#44; this group obtained a rate of agreement of 94&#37; compared to the sensitivity obtained through broth microdilution&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Bacterial lysis methods</span><p id="par0125" class="elsevierStylePara elsevierViewall">Another methodology for determining sensitivity consists of detecting bacterial lysis&#46; To do this&#44; the bacterium is incubated in the presence of the antibiotic at the desired concentration&#46; Then&#44; the bacterium is immobilised in an agarose microgel and exposed to a lysis solution that causes DNA release&#46; Subsequently&#44; the preparation is incubated with the fluorochrome SYBR Gold and the integrity of the DNA may be studied through observation under a fluorescence microscope&#46; This methodology yields an antibiogram in less than 2<span class="elsevierStyleHsp" style=""></span>h&#46;<a class="elsevierStyleCrossRef" href="#bib0630"><span class="elsevierStyleSup">63</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">In conclusion&#44; the methodologies described in this review shorten the time needed to determine the sensitivity of bacteria to antibiotics compared to the usual methods&#46; To interpret the antibiogram&#44; it is essential to be familiar with the species of bacteria that is being studied&#46; In this regard&#44; the rapid identification provided by the MALDI-TOF system allows the methodologies by which a rapid antibiogram is made to be implemented&#46; However&#44; to determine whether these techniques yield a sensitivity and a specificity that are acceptable for clinical practice&#44; the number of bacterial strains and antibiotics studied must be increased&#46; Given the significant benefits that derive from obtaining a rapid result for sensitivity of bacteria to antibiotics &#40;increase in survival&#44; reduction in expenses and delay in selection of resistant bacterial strains&#41;&#44; it can be affirmed that the antibiogram in clinical microbiology&#44; far from being definitively established&#44; is continuously evolving&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0135" class="elsevierStylePara elsevierViewall">The author declares that there are no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:19 [
        0 => array:3 [
          "identificador" => "xres820125"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec817060"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres820124"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec817059"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Molecular techniques"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Microarrays"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Commercial antibiogram methods"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Immunochromatographic techniques"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Colourimetric methods"
        ]
        10 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Imaging methods"
        ]
        11 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Nephelometry"
        ]
        12 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "MALDI-TOF mass spectrometry"
        ]
        13 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Flow cytometry"
        ]
        14 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Chemiluminescence and bioluminescence"
        ]
        15 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Microfluids"
        ]
        16 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Bacterial lysis methods"
        ]
        17 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conflicts of interest"
        ]
        18 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-11-22"
    "fechaAceptado" => "2016-12-16"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec817060"
          "palabras" => array:3 [
            0 => "Rapid antibiotic susceptibility test"
            1 => "Direct antibiotic susceptibility test"
            2 => "Susceptibility"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec817059"
          "palabras" => array:3 [
            0 => "Antibiograma r&#225;pido"
            1 => "Antibiograma directo"
            2 => "Sensibilidad"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The most widely used antibiotic susceptibility testing methods in Clinical Microbiology are based on the phenotypic detection of antibiotic resistance by measuring bacterial growth in the presence of the antibiotic being tested&#46; These conventional methods take typically 24<span class="elsevierStyleHsp" style=""></span>h to obtain results&#46; Here we review the main techniques for rapid determination of antibiotic susceptibility&#46; Data obtained with different methods such as molecular techniques&#44; microarrays&#44; commercial methods used in work routine&#44; immunochromatographic methods&#44; colorimetric methods&#44; image methods&#44; nephelometry&#44; MALDI-TOF mass spectrometry&#44; flow cytometry&#44; chemiluminescence and bioluminescence&#44; microfluids and methods based on cell disruption are analysed in detail&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los m&#233;todos m&#225;s frecuentemente utilizados en Microbiolog&#237;a Cl&#237;nica para la determinaci&#243;n de la sensibilidad de las bacterias a los antibi&#243;ticos se basan en un estudio fenot&#237;pico&#44; observando el crecimiento bacteriano de una cepa incubada en presencia del antibi&#243;tico a estudiar&#46; Estos m&#233;todos requieren normalmente un tiempo de unas 24<span class="elsevierStyleHsp" style=""></span>h para la obtenci&#243;n de resultados&#46; En esta revisi&#243;n se exponen el fundamento y los resultados de las principales t&#233;cnicas instrumentales que proporcionan un antibiograma r&#225;pido&#46; De manera pormenorizada se exponen datos relativos a t&#233;cnicas moleculares&#44; <span class="elsevierStyleItalic">microarrays</span>&#44; m&#233;todos comerciales utilizados en el trabajo de rutina&#44; t&#233;cnicas inmunocromatogr&#225;ficas&#44; m&#233;todos colorim&#233;tricos&#44; m&#233;todos de imagen&#44; nefelometr&#237;a&#44; espectrometr&#237;a de masas MALDI-TOF&#44; citometr&#237;a de flujo&#44; quimioluminiscencia y bioluminiscencia&#44; microfluidos y m&#233;todos de lisis bacteriana&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; March-Rossell&#243; GA&#46; M&#233;todos r&#225;pidos para la detecci&#243;n de la resistencia bacteriana a antibi&#243;ticos&#46; Enferm Infecc Microbiol Clin&#46; 2017&#59;35&#58;182&#8211;188&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:63 [
            0 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available from&#58; <span class="elsevierStyleInterRef" id="intr0010" href="http://www.fda.gov/ohrms/dockets/98fr/000109gd.pdf">http&#58;&#47;&#47;www&#46;fda&#46;gov&#47;ohrms&#47;dockets&#47;98fr&#47;000109gd&#46;pdf</span> &#91;accessed 15&#46;11&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidance on Review Criteria for Assessment of Antimicrobial Susceptibility Devices"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Food and Drug Administration &#40;FDA&#41;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "1991"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antibiograma r&#225;pido en Microbiolog&#237;a Cl&#237;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;A&#46; March Rossell&#243;"
                            1 => "M&#46;A&#46; Bratos P&#233;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eimc.2014.11.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "2016"
                        "volumen" => "34"
                        "paginaInicial" => "61"
                        "paginaFinal" => "68"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25559705"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic assays for identification of microorganisms and antimicrobial resistance determinants directly from positive blood culture broth"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;A&#46; Pence"
                            1 => "E&#46; McElvania TeKippe"
                            2 => "C&#46;A&#46; Burnham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cll.2013.03.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Lab Med"
                        "fecha" => "2013"
                        "volumen" => "33"
                        "paginaInicial" => "651"
                        "paginaFinal" => "684"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23931843"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of gram-negative bacteria and genetic resistance determinants from positive blood culture broths by use of the Verigene Gram-Negative Blood Culture Multiplex Microarray-Based molecular assay"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;A&#46; Ledeboer"
                            1 => "B&#46;K&#46; Lopansri"
                            2 => "N&#46; Dhiman"
                            3 => "R&#46; Cavagnolo"
                            4 => "K&#46;C&#46; Carroll"
                            5 => "P&#46; Granato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.00581-15"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2015"
                        "volumen" => "53"
                        "paginaInicial" => "2460"
                        "paginaFinal" => "2472"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25994165"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Direct detection of <span class="elsevierStyleItalic">Staphylococcus</span> osteoarticular infections by use of Xpert MRSA&#47;SA SSTI real-time PCR"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Dubouix-Bourandy"
                            1 => "A&#46; de Ladoucette"
                            2 => "V&#46; Pietri"
                            3 => "N&#46; Mehdi"
                            4 => "D&#46; Benzaquen"
                            5 => "R&#46; Guinand"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.00334-11"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2011"
                        "volumen" => "49"
                        "paginaInicial" => "4225"
                        "paginaFinal" => "4230"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21998420"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative study of GeneXpert with ZN stain and culture in samples of suspected pulmonary tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Agrawal"
                            1 => "A&#46; Bajaj"
                            2 => "V&#46; Bhatia"
                            3 => "S&#46; Dutt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7860/JCDR/2016/19958.8339"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Diagn Res"
                        "fecha" => "2016"
                        "volumen" => "10"
                        "paginaInicial" => "DC09"
                        "paginaFinal" => "DC12"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27656437"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection of carbapenemases in Enterobacteriaceae&#58; a challenge for diagnostic microbiological laboratories"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Hrabak"
                            1 => "E&#46; Chudackova"
                            2 => "C&#46;C&#46; Papagiannitsis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1469-0691.12678"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Microbiol Infect"
                        "fecha" => "2014"
                        "volumen" => "20"
                        "paginaInicial" => "839"
                        "paginaFinal" => "853"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24813781"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of the New NucliSENS EasyQ KPC test for rapid detection of <span class="elsevierStyleItalic">Klebsiella pneumoniae</span> carbapenemase genes &#40;blaKPC&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Spanu"
                            1 => "B&#46; Fiori"
                            2 => "T&#46; d&#8217;Inzeo"
                            3 => "G&#46; Canu"
                            4 => "S&#46; Campoli"
                            5 => "T&#46; Giani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.00284-12"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2012"
                        "volumen" => "50"
                        "paginaInicial" => "2783"
                        "paginaFinal" => "2785"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22622445"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of three commercial assays for rapid detection of genes encoding clinically relevant carbapenemases in cultured bacteria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Findlay"
                            1 => "K&#46;L&#46; Hopkins"
                            2 => "D&#46; Meunier"
                            3 => "N&#46; Woodford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/jac/dku571"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2015"
                        "volumen" => "70"
                        "paginaInicial" => "1338"
                        "paginaFinal" => "1342"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25630646"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extended-spectrum beta-lactamase &#40;ESBL&#41; detection directly from urine samples with the rapid isothermal amplification-based eazyplex&#40;R&#41; SuperBug CRE assay&#58; proof of concept"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46; Hinic"
                            1 => "J&#46; Ziegler"
                            2 => "C&#46; Straub"
                            3 => "D&#46; Goldenberger"
                            4 => "R&#46; Frei"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.mimet.2015.10.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Microbiol Methods"
                        "fecha" => "2015"
                        "volumen" => "119"
                        "paginaInicial" => "203"
                        "paginaFinal" => "205"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26506282"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of the AID ESBL line probe assay for rapid detection of extended-spectrum beta-lactamase &#40;ESBL&#41; and KPC carbapenemase genes in Enterobacteriaceae"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46;V&#46; Bloemberg"
                            1 => "S&#46; Polsfuss"
                            2 => "V&#46; Meyer"
                            3 => "E&#46;C&#46; Bottger"
                            4 => "M&#46; Hombach"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/jac/dkt345"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2014"
                        "volumen" => "69"
                        "paginaInicial" => "85"
                        "paginaFinal" => "90"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24004861"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of a novel procedure for rapid detection of carbapenemase-producing Enterobacteriaceae &#40;CPE&#41; using the LightMix<span class="elsevierStyleSup">&#174;</span> modular carbapenemase kits"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Oviano"
                            1 => "I&#46; Torres"
                            2 => "M&#46; Gonzalez"
                            3 => "G&#46; Bou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/jac/dkw356"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2016"
                        "volumen" => "71"
                        "paginaInicial" => "3420"
                        "paginaFinal" => "3423"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27566313"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of a commercial real-time PCR for the detection of extended spectrum beta-lactamase genes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46; Willemsen"
                            1 => "L&#46; Hille"
                            2 => "A&#46; Vrolijk"
                            3 => "A&#46; Bergmans"
                            4 => "J&#46; Kluytmans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1099/jmm.0.070110-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Microbiol"
                        "fecha" => "2014"
                        "volumen" => "63"
                        "paginaInicial" => "540"
                        "paginaFinal" => "543"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24473202"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Probe ligation and real-time detection of KPC&#44; OXA-48&#44; VIM&#44; IMP&#44; and NDM carbapenemase genes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Cuzon"
                            1 => "T&#46; Naas"
                            2 => "P&#46; Bogaerts"
                            3 => "Y&#46; Glupczynski"
                            4 => "P&#46; Nordmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.diagmicrobio.2013.05.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diagn Microbiol Infect Dis"
                        "fecha" => "2013"
                        "volumen" => "76"
                        "paginaInicial" => "502"
                        "paginaFinal" => "505"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23791387"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid screening for carbapenem resistant organisms&#58; current results and future approaches"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Anandan"
                            1 => "S&#46; Damodaran"
                            2 => "R&#46; Gopi"
                            3 => "Y&#46;D&#46; Bakthavatchalam"
                            4 => "B&#46; Veeraraghavan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7860/JCDR/2015/14708.6623"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Diagn Res"
                        "fecha" => "2015"
                        "volumen" => "9"
                        "paginaInicial" => "DM01"
                        "paginaFinal" => "DM03"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26557523"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection of carbapenemase-producing Enterobacteriaceae with a commercial DNA microarray"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;C&#46; Stuart"
                            1 => "G&#46; Voets"
                            2 => "J&#46; Scharringa"
                            3 => "A&#46;C&#46; Fluit"
                            4 => "M&#46;A&#46; Leverstein-van Hall"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1099/jmm.0.041673-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Microbiol"
                        "fecha" => "2012"
                        "volumen" => "61"
                        "paginaInicial" => "809"
                        "paginaFinal" => "812"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22383444"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of a DNA microarray for the rapid detection of extended-spectrum beta-lactamases &#40;TEM&#44; SHV and CTX-M&#41;&#44; plasmid-mediated cephalosporinases &#40;CMY-2-like&#44; DHA&#44; FOX&#44; ACC-1&#44; ACT&#47;MIR and CMY-1-like&#47;MOX&#41; and carbapenemases &#40;KPC&#44; OXA-48&#44; VIM&#44; IMP and NDM&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Cuzon"
                            1 => "T&#46; Naas"
                            2 => "P&#46; Bogaerts"
                            3 => "Y&#46; Glupczynski"
                            4 => "P&#46; Nordmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/jac/dks156"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2012"
                        "volumen" => "67"
                        "paginaInicial" => "1865"
                        "paginaFinal" => "1869"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22604450"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0405"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of a DNA microarray for rapid detection of the most prevalent extended-spectrum beta-lactamases&#44; plasmid-mediated cephalosporinases and carbapenemases in <span class="elsevierStyleItalic">Enterobacteriaceae</span>&#44; <span class="elsevierStyleItalic">Pseudomonas</span> and <span class="elsevierStyleItalic">Acinetobacter</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Bogaerts"
                            1 => "G&#46; Cuzon"
                            2 => "S&#46; Evrard"
                            3 => "M&#46; Hoebeke"
                            4 => "T&#46; Naas"
                            5 => "Y&#46; Glupczynski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijantimicag.2016.05.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Antimicrob Agents"
                        "fecha" => "2016"
                        "volumen" => "48"
                        "paginaInicial" => "189"
                        "paginaFinal" => "193"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27374747"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0410"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Direct testing of bronchoalveolar lavages from ventilator-associated pneumonia patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Boyer"
                            1 => "J&#46; Medrano"
                            2 => "F&#46; Mzali"
                            3 => "C&#46;C&#46; Balick-Weber"
                            4 => "E&#46; Bess&#232;de"
                            5 => "W&#46; Picard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.diagmicrobio.2012.02.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diagn Microbiol Infect Dis"
                        "fecha" => "2012"
                        "volumen" => "73"
                        "paginaInicial" => "107"
                        "paginaFinal" => "110"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22483191"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0415"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Direct E-test &#40;AB Biodisk&#41; of respiratory samples improves antimicrobial use in ventilator-associated pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Bouza"
                            1 => "M&#46;V&#46; Torres"
                            2 => "C&#46; Radice"
                            3 => "E&#46; Cercenado"
                            4 => "R&#46; de Diego"
                            5 => "C&#46; S&#225;nchez-Carrillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/510587"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2007"
                        "volumen" => "44"
                        "paginaInicial" => "382"
                        "paginaFinal" => "387"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17205445"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0420"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of two new commercial immunochromatographic assays for the rapid detection of OXA-48 and KPC carbapenemases from cultured bacteria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Glupczynski"
                            1 => "S&#46; Evrard"
                            2 => "I&#46; Ote"
                            3 => "P&#46; Mertens"
                            4 => "T&#46;D&#46; Huang"
                            5 => "T&#46; Leclipteux"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/jac/dkv472"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2016"
                        "volumen" => "71"
                        "paginaInicial" => "1217"
                        "paginaFinal" => "1222"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26825120"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0425"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of the RAPIDEC<span class="elsevierStyleSup">&#174;</span> CARBA NP&#44; the Rapid CARB Screen<span class="elsevierStyleSup">&#174;</span> and the Carba NP test for biochemical detection of carbapenemase-producing Enterobacteriaceae"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Dortet"
                            1 => "A&#46; Agathine"
                            2 => "T&#46; Naas"
                            3 => "G&#46; Cuzon"
                            4 => "L&#46; Poirel"
                            5 => "P&#46; Nordmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/jac/dkv213"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2015"
                        "volumen" => "70"
                        "paginaInicial" => "3014"
                        "paginaFinal" => "3022"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26260131"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0430"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid determination of methicillin resistance among <span class="elsevierStyleItalic">Staphylococcus aureus</span> clinical isolates by colorimetric methods"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;Y&#46; Coban"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.00471-12"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2012"
                        "volumen" => "50"
                        "paginaInicial" => "2191"
                        "paginaFinal" => "2193"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22518854"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0435"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Two new colorimetric methods for early detection of vancomycin and oxacillin resistance in <span class="elsevierStyleItalic">Staphylococcus aureus</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;Y&#46; Coban"
                            1 => "B&#46; Bozdogan"
                            2 => "C&#46;C&#46; Cihan"
                            3 => "E&#46; Cetinkaya"
                            4 => "K&#46; Bilgin"
                            5 => "O&#46; Darka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.44.2.580-582.2006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2006"
                        "volumen" => "44"
                        "paginaInicial" => "580"
                        "paginaFinal" => "582"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16455915"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0440"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A two-hour procedure for determining the susceptibility of enterococci and staphylococci to antibiotics by a colourimetric method"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46;A&#46; March-Rossello"
                            1 => "M&#46;P&#46; Gutierrez-Rodriguez"
                            2 => "M&#46; Simarro-Grande"
                            3 => "A&#46; Orduna-Domingo"
                            4 => "M&#46;A&#46; Bratos-Perez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Quimioter"
                        "fecha" => "2015"
                        "volumen" => "28"
                        "paginaInicial" => "247"
                        "paginaFinal" => "255"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26437755"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0445"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available from <span class="elsevierStyleInterRef" id="intr0015" href="http://seimc.org/contenidos/congresosyeventos/seimcanteriores/seimc-EIMC-2015.pdf">http&#58;&#47;&#47;seimc&#46;org&#47;contenidos&#47;congresosyeventos&#47;seimcanteriores&#47;seimc-EIMC-2015&#46;pdf</span> &#91;accessed 15&#46;11&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antibiograma r&#225;pido en enterobacterias mediante un m&#233;todo colorim&#233;trico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46;A&#46; March"
                            1 => "M&#46;P&#46; Guti&#233;rrez"
                            2 => "M&#46; Simarro"
                            3 => "A&#46; Ordu&#241;a"
                            4 => "M&#46;A&#46; Bratos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "Comunicaci&#243;n 605&#46; XIX Congreso de la Sociedad Espa&#241;ola de Enfermedades Infecciosas y Microbiolog&#237;a Cl&#237;nica &#40;SEIMC&#41;"
                        "serieFecha" => "2015"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0450"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of nitrate reduction assay&#44; resazurin microtiter assay and microscopic observation drug susceptibility assay for first line antitubercular drug susceptibility testing of clinical isolates of <span class="elsevierStyleItalic">M&#46; tuberculosis</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Dixit"
                            1 => "U&#46; Singh"
                            2 => "P&#46; Sharma"
                            3 => "A&#46; Jain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.mimet.2011.11.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Microbiol Methods"
                        "fecha" => "2012"
                        "volumen" => "88"
                        "paginaInicial" => "122"
                        "paginaFinal" => "126"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22133919"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0455"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multiplexed automated digital microscopy for rapid identification and antimicrobial susceptibility testing of bacteria and yeast directly from clinical samples"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Chantell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Microbiol Newsl"
                        "fecha" => "2015"
                        "volumen" => "37"
                        "paginaInicial" => "161"
                        "paginaFinal" => "167"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0460"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antibiotic susceptibility tests directly on urine samples using Uro-Quick&#44; a rapid automated system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Roveta"
                            1 => "A&#46; Marchese"
                            2 => "E&#46;A&#46; Debbia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1179/joc.2006.18.1.12"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Chemother"
                        "fecha" => "2006"
                        "volumen" => "18"
                        "paginaInicial" => "12"
                        "paginaFinal" => "19"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16572888"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0465"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "New method for rapid susceptibility testing on blood culture with HB&#38;L system&#58; preliminary data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46; Rondinelli"
                            1 => "S&#46; Giglio"
                            2 => "R&#46; Masciari"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Microbiol Med"
                        "fecha" => "2010"
                        "volumen" => "25"
                        "paginaInicial" => "238"
                        "paginaFinal" => "243"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0470"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficient detection of carbapenemase activity in enterobacteriaceae by matrix-assisted laser desorption ionization-time of flight mass spectrometry in less than 30 minutes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Lasserre"
                            1 => "L&#46; de Saint Martin"
                            2 => "G&#46; Cuzon"
                            3 => "P&#46; Bogaerts"
                            4 => "E&#46; Lamar"
                            5 => "Y&#46; Glupczynski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.03467-14"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2015"
                        "volumen" => "53"
                        "paginaInicial" => "2163"
                        "paginaFinal" => "2171"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25926485"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0475"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid detection of Enterobacteriaceae producing extended spectrum beta-lactamases directly from positive blood cultures by matrix-assisted laser desorption ionization-time of flight mass spectrometry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Oviano"
                            1 => "B&#46; Fernandez"
                            2 => "A&#46; Fernandez"
                            3 => "M&#46;J&#46; Barba"
                            4 => "C&#46; Mourino"
                            5 => "G&#46; Bou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1469-0691.12729"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Microbiol Infect"
                        "fecha" => "2014"
                        "volumen" => "20"
                        "paginaInicial" => "1146"
                        "paginaFinal" => "1157"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24942177"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0480"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Determination of the target nucleosides for members of two families of 16S rRNA methyltransferases that confer resistance to partially overlapping groups of aminoglycoside antibiotics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Savic"
                            1 => "J&#46; Lovric"
                            2 => "T&#46;I&#46; Tomic"
                            3 => "B&#46; Vasiljevic"
                            4 => "G&#46;L&#46; Conn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/nar/gkp575"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nucleic Acids Res"
                        "fecha" => "2009"
                        "volumen" => "37"
                        "paginaInicial" => "5420"
                        "paginaFinal" => "5431"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19589804"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0485"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of <span class="elsevierStyleItalic">Staphylococcus aureus</span> and determination of its methicillin resistance by matrix-assisted laser desorption&#47;ionization time-of-flight mass spectrometry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Z&#46; Du"
                            1 => "R&#46; Yang"
                            2 => "Z&#46; Guo"
                            3 => "Y&#46; Song"
                            4 => "J&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anal Chem"
                        "fecha" => "2002"
                        "volumen" => "74"
                        "paginaInicial" => "5487"
                        "paginaFinal" => "5491"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12433077"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0490"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of matrix-assisted laser desorption ionization-time of flight mass spectrometry to identify vancomycin-resistant enterococci and investigate the epidemiology of an outbreak"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;M&#46; Griffin"
                            1 => "G&#46;R&#46; Price"
                            2 => "J&#46;M&#46; Schooneveldt"
                            3 => "S&#46; Schlebusch"
                            4 => "M&#46;H&#46; Tilse"
                            5 => "T&#46; Urbanski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.01000-12"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2012"
                        "volumen" => "50"
                        "paginaInicial" => "2918"
                        "paginaFinal" => "2931"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22740710"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0495"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Establishing drug resistance in microorganisms by mass spectrometry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46;A&#46; Demirev"
                            1 => "N&#46;S&#46; Hagan"
                            2 => "M&#46;D&#46; Antoine"
                            3 => "J&#46;S&#46; Lin"
                            4 => "A&#46;B&#46; Feldman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s13361-013-0609-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Mass Spectrom"
                        "fecha" => "2013"
                        "volumen" => "24"
                        "paginaInicial" => "1194"
                        "paginaFinal" => "1201"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23568030"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0500"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of a semi-quantitative MALDI-TOF MS method for rapid antimicrobial susceptibility testing of positive blood cultures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;S&#46; Jung"
                            1 => "C&#46; Hamacher"
                            2 => "B&#46; Gross"
                            3 => "K&#46; Sparbier"
                            4 => "C&#46; Lange"
                            5 => "M&#46; Kostrzewa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.01131-16"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2016"
                        "volumen" => "54"
                        "paginaInicial" => "2820"
                        "paginaFinal" => "2824"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27629893"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0505"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid differentiation of methicillin-resistant and methicillin-susceptible <span class="elsevierStyleItalic">Staphylococcus aureus</span> by flow cytometry after brief antibiotic exposure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46;K&#46; Shrestha"
                            1 => "N&#46;M&#46; Scalera"
                            2 => "D&#46;A&#46; Wilson"
                            3 => "G&#46;W&#46; Procop"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.02548-10"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2011"
                        "volumen" => "49"
                        "paginaInicial" => "2116"
                        "paginaFinal" => "2120"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21471343"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0510"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antimicrobial susceptibility testing in 90<span class="elsevierStyleHsp" style=""></span>min by bacterial cell count monitoring"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;A&#46; Broeren"
                            1 => "Y&#46; Maas"
                            2 => "E&#46; Retera"
                            3 => "N&#46;L&#46; Arents"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1469-0691.2012.03800.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Microbiol Infect"
                        "fecha" => "2013"
                        "volumen" => "19"
                        "paginaInicial" => "286"
                        "paginaFinal" => "291"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22390723"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0515"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A new approach to determine the susceptibility of bacteria to antibiotics directly from positive blood culture bottles in two hours"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46;A&#46; March"
                            1 => "M&#46;C&#46; Garcia-Loygorri"
                            2 => "M&#46; Simarro"
                            3 => "M&#46;P&#46; Gutierrez"
                            4 => "A&#46; Orduna"
                            5 => "M&#46;A&#46; Bratos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.mimet.2014.12.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Microbiol Methods"
                        "fecha" => "2015"
                        "volumen" => "109"
                        "paginaInicial" => "49"
                        "paginaFinal" => "55"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25529277"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0520"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A novel flow cytometric assay for rapid detection of extended-spectrum beta-lactamases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Faria-Ramos"
                            1 => "M&#46;J&#46; Espinar"
                            2 => "R&#46; Rocha"
                            3 => "J&#46; Santos-Antunes"
                            4 => "A&#46;G&#46; Rodrigues"
                            5 => "R&#46; Cant&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1469-0691.2012.03986.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Microbiol Infect"
                        "fecha" => "2013"
                        "volumen" => "19"
                        "paginaInicial" => "E8"
                        "paginaFinal" => "E15"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23145853"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0525"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid antimicrobial susceptibility testing of urinary tract isolates and samples by flow cytometry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Gauthier"
                            1 => "Y&#46; St-Pierre"
                            2 => "R&#46; Villemur"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1099/0022-1317-51-3-192"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Microbiol"
                        "fecha" => "2002"
                        "volumen" => "51"
                        "paginaInicial" => "192"
                        "paginaFinal" => "200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11871613"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0530"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Flow cytometry antifungal susceptibility testing of pathogenic yeasts other than <span class="elsevierStyleItalic">Candida albicans</span> and comparison with the NCCLS broth microdilution test"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Ramani"
                            1 => "V&#46; Chaturvedi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "2000"
                        "volumen" => "44"
                        "paginaInicial" => "2752"
                        "paginaFinal" => "2758"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10991856"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0535"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A flow cytometry method for testing the susceptibility of <span class="elsevierStyleItalic">Cryptococcus</span> spp&#46; to amphotericin B"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Benaducci"
                            1 => "M&#46;T&#46; Matsumoto"
                            2 => "J&#46;C&#46; Sardi"
                            3 => "A&#46;M&#46; Fusco-Almeida"
                            4 => "M&#46;J&#46; Mendes-Giannini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.riam.2014.06.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Iberoam Micol"
                        "fecha" => "2015"
                        "volumen" => "32"
                        "paginaInicial" => "159"
                        "paginaFinal" => "163"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25639695"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib0540"
              "etiqueta" => "45"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safe susceptibility testing of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> by flow cytometry with the fluorescent nucleic acid stain SYTO 16"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Pina-Vaz"
                            1 => "S&#46; Costa-de-Oliveira"
                            2 => "A&#46;G&#46; Rodrigues"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1099/jmm.0.45627-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Microbiol"
                        "fecha" => "2005"
                        "volumen" => "54"
                        "paginaInicial" => "77"
                        "paginaFinal" => "81"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15591259"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib0545"
              "etiqueta" => "46"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Flow cytometric testing of susceptibilities of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> isolates to ethambutol&#44; isoniazid&#44; and rifampin in 24 hours"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;M&#46; Kirk"
                            1 => "R&#46;F&#46; Schell"
                            2 => "A&#46;V&#46; Moore"
                            3 => "S&#46;M&#46; Callister"
                            4 => "G&#46;H&#46; Mazurek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "1998"
                        "volumen" => "36"
                        "paginaInicial" => "1568"
                        "paginaFinal" => "1573"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9620378"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib0550"
              "etiqueta" => "47"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of a novel automated chemiluminescent assay system for antimicrobial susceptibility testing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46; Manome"
                            1 => "M&#46; Ikedo"
                            2 => "Y&#46; Saito"
                            3 => "K&#46;K&#46; Ishii"
                            4 => "M&#46; Kaku"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2003"
                        "volumen" => "41"
                        "paginaInicial" => "279"
                        "paginaFinal" => "284"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12517861"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib0555"
              "etiqueta" => "48"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A rapid antimicrobial susceptibility test based on chemiluminescence assay and its application to screening of genotypes in vancomycin-resistant enterococci"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Z&#46; Nagasawa"
                            1 => "I&#46; Manome"
                            2 => "A&#46; Nagayama"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10156-004-0329-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect Chemother"
                        "fecha" => "2004"
                        "volumen" => "10"
                        "paginaInicial" => "220"
                        "paginaFinal" => "226"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15365863"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib0560"
              "etiqueta" => "49"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid detection of <span class="elsevierStyleItalic">Staphylococcus aureus</span> strains having reduced susceptibility to vancomycin using a chemiluminescence-based drug-susceptibility test"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Tajima"
                            1 => "M&#46; Komatsu"
                            2 => "T&#46; Ito"
                            3 => "K&#46; Hiramatsu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.mimet.2007.05.020"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Microbiol Methods"
                        "fecha" => "2007"
                        "volumen" => "70"
                        "paginaInicial" => "434"
                        "paginaFinal" => "441"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17655957"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib0565"
              "etiqueta" => "50"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Menadione-catalyzed luminol chemiluminescent assay for the viability of <span class="elsevierStyleItalic">Escherichia coli</span> ATCC 25922"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Yamashoji"
                            1 => "M&#46; Takeda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Microbiol Immunol"
                        "fecha" => "2001"
                        "volumen" => "45"
                        "paginaInicial" => "737"
                        "paginaFinal" => "741"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11791666"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib0570"
              "etiqueta" => "51"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Menadione-catalyzed luminol chemiluminescent assay for viability of <span class="elsevierStyleItalic">Mycobacterium bovis</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Yamashoji"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Microbiol Immunol"
                        "fecha" => "2002"
                        "volumen" => "46"
                        "paginaInicial" => "571"
                        "paginaFinal" => "573"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12363021"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib0575"
              "etiqueta" => "52"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid antibiotic susceptibility tests on Enterobacteriaceae by ATP bioluminescence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46;F&#46; Wheat"
                            1 => "J&#46;G&#46; Hastings"
                            2 => "R&#46;C&#46; Spencer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1099/00222615-25-2-95"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Microbiol"
                        "fecha" => "1988"
                        "volumen" => "25"
                        "paginaInicial" => "95"
                        "paginaFinal" => "99"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3276899"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib0580"
              "etiqueta" => "53"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A novel luminometer for rapid antimicrobial susceptibility tests on gram-positive cocci by ATP bioluminescence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46;F&#46; Wheat"
                            1 => "R&#46;C&#46; Spencer"
                            2 => "J&#46;G&#46; Hastings"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1099/00222615-29-4-277"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Microbiol"
                        "fecha" => "1989"
                        "volumen" => "29"
                        "paginaInicial" => "277"
                        "paginaFinal" => "282"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2760913"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib0585"
              "etiqueta" => "54"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of ampicillin on intracellular levels of adenosine triphosphate in bacterial cultures related to antibiotic susceptibility"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Thore"
                            1 => "L&#46; Nilsson"
                            2 => "H&#46; Hojer"
                            3 => "S&#46; Ansehn"
                            4 => "L&#46; Brote"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Pathol Microbiol Scand B"
                        "fecha" => "1977"
                        "volumen" => "85"
                        "paginaInicial" => "161"
                        "paginaFinal" => "166"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/324235"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib0590"
              "etiqueta" => "55"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A rapid bioluminescent method for the detection of methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus colonies</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;P&#46; Barton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "1985"
                        "volumen" => "15"
                        "paginaInicial" => "61"
                        "paginaFinal" => "67"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3844404"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib0595"
              "etiqueta" => "56"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A two-hour antibiotic susceptibility test by ATP-bioluminescence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46;A&#46; March Rossello"
                            1 => "M&#46;C&#46; Garcia-Loygorri Jordan de Urries"
                            2 => "M&#46;P&#46; Gutierrez Rodriguez"
                            3 => "M&#46; Simarro Grande"
                            4 => "A&#46; Orduna Domingo"
                            5 => "M&#46;A&#46; Bratos Perez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eimc.2015.03.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "2016"
                        "volumen" => "34"
                        "paginaInicial" => "334"
                        "paginaFinal" => "339"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25979598"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib0600"
              "etiqueta" => "57"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid antimicrobial susceptibility determination of uropathogens in clinical urine specimens by use of ATP bioluminescence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Ivancic"
                            1 => "M&#46; Mastali"
                            2 => "N&#46; Percy"
                            3 => "J&#46; Gornbein"
                            4 => "J&#46;T&#46; Babbitt"
                            5 => "Y&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.02036-07"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "2008"
                        "volumen" => "46"
                        "paginaInicial" => "1213"
                        "paginaFinal" => "1219"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18272708"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib0605"
              "etiqueta" => "58"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid identification and susceptibility testing of uropathogenic microbes via immunosorbent ATP-bioluminescence assay on a microfluidic simulator for antibiotic therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46; Dong"
                            1 => "X&#46; Zhao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1021/ac504428t"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anal Chem"
                        "fecha" => "2015"
                        "volumen" => "87"
                        "paginaInicial" => "2410"
                        "paginaFinal" => "2418"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25584656"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib0610"
              "etiqueta" => "59"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid detection of susceptibility to fluconazole in <span class="elsevierStyleItalic">Candida species</span> by a bioluminescence assay of intracellular ATP"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Kretschmar"
                            1 => "T&#46; Nichterlein"
                            2 => "P&#46; Kuntz"
                            3 => "H&#46; Hof"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Diagn Microbiol Infect Dis"
                        "fecha" => "1996"
                        "volumen" => "25"
                        "paginaInicial" => "117"
                        "paginaFinal" => "121"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8902406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            59 => array:3 [
              "identificador" => "bib0615"
              "etiqueta" => "60"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of techniques for antimicrobial susceptibility testing of mycobacteria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;I&#46; Limb"
                            1 => "P&#46;F&#46; Wheat"
                            2 => "R&#46;C&#46; Spencer"
                            3 => "G&#46;S&#46; Harris"
                            4 => "A&#46;B&#46; Rayner"
                            5 => "B&#46; Watt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Pathol"
                        "fecha" => "1993"
                        "volumen" => "46"
                        "paginaInicial" => "403"
                        "paginaFinal" => "407"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8320319"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            60 => array:3 [
              "identificador" => "bib0620"
              "etiqueta" => "61"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid antibiotic susceptibility testing in a microfluidic pH sensor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Tang"
                            1 => "L&#46; Zhen"
                            2 => "J&#46; Liu"
                            3 => "J&#46; Wu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1021/ac303282j"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anal Chem"
                        "fecha" => "2013"
                        "volumen" => "85"
                        "paginaInicial" => "2787"
                        "paginaFinal" => "2794"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23360389"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            61 => array:3 [
              "identificador" => "bib0625"
              "etiqueta" => "62"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A biosensor platform for rapid antimicrobial susceptibility testing directly from clinical samples"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;E&#46; Mach"
                            1 => "R&#46; Mohan"
                            2 => "E&#46;J&#46; Baron"
                            3 => "M&#46;C&#46; Shih"
                            4 => "V&#46; Gau"
                            5 => "P&#46;K&#46; Wong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.juro.2010.09.022"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Urol"
                        "fecha" => "2011"
                        "volumen" => "185"
                        "paginaInicial" => "148"
                        "paginaFinal" => "153"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21074208"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            62 => array:3 [
              "identificador" => "bib0630"
              "etiqueta" => "63"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A rapid in situ procedure for determination of bacterial susceptibility or resistance to antibiotics that inhibit peptidoglycan biosynthesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Santiso"
                            1 => "M&#46; Tamayo"
                            2 => "J&#46; Gosalvez"
                            3 => "G&#46; Bou"
                            4 => "M&#46;C&#46; Fernandez"
                            5 => "J&#46;L&#46; Fernandez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2180-11-191"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Microbiol"
                        "fecha" => "2011"
                        "volumen" => "11"
                        "paginaInicial" => "191"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21867549"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/2529993X/0000003500000003/v1_201703250110/S2529993X17300606/v1_201703250110/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "64519"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Continuing medical education&#58; Methods of rapid diagnosis"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/2529993X/0000003500000003/v1_201703250110/S2529993X17300606/v1_201703250110/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X17300606?idApp=UINPBA00004N"
]

Article information

ISSN: 2529993X
Original language: English

DOI:10.1016/j.eimce.2017.02.007

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 October	522	49	571
2024 September	710	99	809
2024 August	571	50	621
2024 July	670	47	717
2024 June	673	93	766
2024 May	765	98	863
2024 April	752	79	831
2024 March	1148	67	1215
2024 February	978	65	1043
2024 January	804	73	877
2023 December	579	94	673
2023 November	871	88	959
2023 October	931	60	991
2023 September	653	63	716
2023 August	430	41	471
2023 July	451	42	493
2023 June	485	52	537
2023 May	688	43	731
2023 April	480	54	534
2023 March	432	54	486
2023 February	278	33	311
2023 January	294	26	320
2022 December	195	30	225
2022 November	335	55	390
2022 October	244	45	289
2022 September	290	47	337
2022 August	228	45	273
2022 July	220	57	277
2022 June	235	54	289
2022 May	240	76	316
2022 April	200	42	242
2022 March	208	62	270
2022 February	174	34	208
2022 January	164	59	223
2021 December	180	53	233
2021 November	235	67	302
2021 October	439	58	497
2021 September	448	66	514
2021 August	201	57	258
2021 July	197	59	256
2021 June	221	46	267
2021 May	389	55	444
2021 April	448	81	529
2021 March	235	87	322
2021 February	199	47	246
2021 January	160	26	186
2020 December	134	27	161
2020 November	174	22	196
2020 October	90	17	107
2020 September	100	25	125
2020 August	120	22	142
2020 July	102	25	127
2020 June	122	31	153
2020 May	102	18	120
2020 April	127	32	159
2020 March	150	32	182
2020 February	144	17	161
2020 January	123	15	138
2019 December	165	34	199
2019 November	99	15	114
2019 October	105	12	117
2019 September	93	28	121
2019 August	60	14	74
2019 July	63	28	91
2019 June	117	48	165
2019 May	228	136	364
2019 April	93	62	155
2019 March	49	22	71
2019 February	38	24	62
2019 January	24	13	37
2018 December	16	10	26
2018 November	31	5	36
2018 October	42	10	52
2018 September	21	14	35
2018 August	24	18	42
2018 July	17	17	34
2018 June	22	14	36
2018 May	20	13	33
2018 April	32	19	51
2018 March	26	9	35
2018 February	16	4	20
2018 January	22	2	24
2017 December	20	3	23
2017 November	24	6	30
2017 October	17	3	20
2017 September	21	2	23
2017 August	1	0	1
2017 April	17	0	17

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter