Novel molecular and phenotypic approaches for rapid and cost-effective detection and characterization of clinically relevant bacterial and viral pathogens.

The worldwide spread of multi-drug resistant (MDR) bacteria and antimicrobial resistance mechanisms (AMR) became one of the main healthcare challenges of this century. In this context, a serious challenge is posed by carbapenem-resistant Enterobacterales (CRE). Additionally, the spread of novel viral pathogens (as occurred with SARS-CoV-2) has furtherly posed new concerns and increased the pressure on healthcare systems in both human (rise of mortality and morbidity) and economic (rising costs for prolonged hospitalization and therapies) terms. Time is then a key factor for achieving a prompt identification and characterization of the etiological agent and to provide useful information for the assessment of tailored therapies. Hence, the development of strategies or technologies to provide faster microbiological results is of paramount importance. The aim of this PhD project is to evaluate different methodologies, both molecular and antigen-based, for the rapid and cost-effective detection of bacterial and viral pathogens, in particular CRE and SARS-CoV-2. Moreover, the contribution of specific determinants on antimicrobial resistance was assessed. Results achieved during this PhD project suggest that novel strategies for rapid microbiological diagnostic available could represent a significant step forward. Reduction of turnaround time may also lead to a general saving for healthcare systems, with benefits for patients, workers, and welfare institutions. However, these technologies cannot yet overlap the conventional workflows, but surely can represent a viable support rather than an alternative. Moreover, the field of application of each methodology or device should be tailored on a case-by-case basis.