Types of diagnostic testing: ID & AST/ART
Antimicrobial Susceptibility
Identification of the presence
of a microbe(s) in a patient
specimen
Testing (Phenotypic testing)
• detect susceptibility of a pathogen to different antimicrobial
agents
• requires a pure culture of the pathogen before AST can be
performed
• susceptibility can be quantitative
Antimicrobial Resistance
Testing (Genotypic testing)
• detect the presence of resistance genes in the microbial
genome
• presence of a resistant gene may not imply the pathogen
is resistant to antimicrobials as the resistance gene may
not be expressed
Genotypic (ART) vs Phenotypic (AST)

Genotypic testing Phenotypic testing

• Detect resistance genes • Shows overall phenotype

• Sensitive • Can detect new and emerging mechanisms

• Fast – results can be available in hours • Long time to result

• Genes can be present but not expressed • Results can be difficult to interprete when
multiple resistance mechanisms are present
• Can only detect known resistance genes

Genotypic testing can tell Phenotypic testing can tell a

a clinician what not to prescribe clinician what antibiotic to prescribe