Point-counterpoint: The MERINO trial and what it should imply for future treatment of ESBL bacteremia

Innovative approaches in phenotypic beta-lactamase detection for personalised infection management

Beta-lactamase-producing Enterobacteriaceae present a significant therapeutic challenge. Current developments in phenotypic diagnostics focus primarily on rapid minimum inhibitory concentration (MIC) determination. There is a requirement for rapid phenotypic diagnostics to improve antimicrobial susceptibility tests (AST) and aid prescribing decisions. Phenotypic AST are limited in their ability to characterise beta-lactamase-producing Enterobacteriaceae in detail. Despite advances in rapid AST, gaps and opportunities remain for developing additional diagnostic approaches that facilitate personalised antimicrobial prescribing. In this perspective, we highlight the state-of-the-art in beta-lactamase detection, identify gaps in current practice, and discuss barriers for innovation within this field.