Many of the human infectious pathogens - especially the zoonotic or vector-borne bacteria - are fastidious organisms which are difficult to cultivate because of their strong adaption to the infected host culminating in their near complete physiological dependence on this environment. These bacterial species exhibit reduced multiplication rates once they are removed from their optimal ecological niche. This fact complicates the laboratory diagnosis of the disease and hinders the detection and further characterization of the underlying organisms, e.g. at the level of their resistance to antibiotics due to their slow growth. Here, we describe the current state of microbiological diagnostics for five genera of human pathogens with a fastidious laboratory lifestyle. For Anaplasma spp., Bartonella spp., Coxiella burnetii, Orientia spp., and Rickettsia spp. we will summarize the existing diagnostic protocols, the specific limitations for implementation of novel diagnostic approaches, and the need for further optimization or expansion of the diagnostic armamentarium. We will reflect upon the diagnostic opportunities provided by new technologies including mass spectrometry and next-generation nucleic acid sequencing. Finally, we will review the (im)possibilities of rapidly developing new in vitro diagnostic tools for diseases of which the causative agents are fastidiously growing and therefore hard to detect.

中文翻译：

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对属于无形体属、巴尔通体属、柯克氏菌属、东方菌属和立克次氏体属的医学相关挑剔微生物的现代诊断

许多人类传染性病原体——尤其是人畜共患病或媒介传播的细菌——是难以培养的挑剔生物，因为它们对受感染宿主的强烈适应最终导致它们对这种环境几乎完全生理依赖。这些细菌物种一旦从其最佳生态位中移除，就会表现出降低的繁殖率。这一事实使疾病的实验室诊断复杂化，并阻碍了潜在生物体的检测和进一步表征，例如，由于它们的缓慢生长，它们对抗生素的抗性水平。在这里，我们描述了具有挑剔的实验室生活方式的五种人类病原体的微生物诊断的现状。对于 Anaplasma spp.、Bartonella spp.、Coxiella burnetii、Orientia spp.、和立克次体属。我们将总结现有的诊断方案、实施新诊断方法的具体限制以及进一步优化或扩展诊断设备的需要。我们将反思包括质谱和下一代核酸测序在内的新技术提供的诊断机会。最后，我们将回顾快速开发新的体外诊断工具的可能性，这些工具的病原体正在迅速增长，因此难以检测。我们将反思包括质谱和下一代核酸测序在内的新技术提供的诊断机会。最后，我们将回顾快速开发新的体外诊断工具的可能性，这些工具的病原体正在迅速增长，因此难以检测。我们将反思包括质谱和下一代核酸测序在内的新技术提供的诊断机会。最后，我们将回顾快速开发新的体外诊断工具的可能性，这些工具的病原体正在迅速增长，因此难以检测。