Biosensors and Point‐of‐Care Devices for Bacterial Detection: Rapid Diagnostics Informing Antibiotic Therapy

2021 ◽  
pp. 2101546
Author(s):  
Ashna Gopal ◽  
Li Yan ◽  
Saima Kashif ◽  
Tasnim Munshi ◽  
Roy AL Vellaisamy ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Point Of Care ◽  
Rapid Diagnostics ◽  
Bacterial Detection

scholarly journals Rapid Diagnostics for Blood Cultures: Supporting Decisions for Antimicrobial Therapy and Value-Based Care

2019 ◽  
Vol 3 (4) ◽  
pp. 686-697 ◽  
Author(s):  
Donna M Wolk ◽  
J Kristie Johnson
Keyword(s):  
Critical Care ◽  
Antibiotic Therapy ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Rapid Diagnostics ◽  
Clinical Practices ◽  
Critical Care Units ◽  
The Us ◽  
Causes Of Mortality ◽  
Value Based Care

Abstract Bacteremia and sepsis are critically important syndromes with high mortality, morbidity, and associated costs. Bloodstream infections and sepsis are among the top causes of mortality in the US, with >600 deaths each day. Most septic patients can be found in emergency medicine departments or critical care units, settings in which rapid administration of targeted antibiotic therapy can reduce mortality. Unfortunately, routine blood cultures are not rapid enough to aid in the decision of therapeutic intervention at the onset of bacteremia. As a result, empiric, broad-spectrum treatment is common—a costly approach that may fail to target the correct microbe effectively, may inadvertently harm patients via antimicrobial toxicity, and may contribute to the evolution of drug-resistant microbes. To overcome these challenges, laboratorians must understand the complexity of diagnosing and treating septic patients, focus on creating algorithms that rapidly support decisions for targeted antibiotic therapy, and synergize with existing emergency department and critical care clinical practices put forth in the Surviving Sepsis Guidelines.

scholarly journals 1124. Evaluation of the Use and Impact of the BioFire FilmArray® Respiratory Panel on Diagnosis and Treatment of Pedidatric Respiratory Infections: A Quality Improvement Project

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S653-S654
Author(s):  
Ian McVinney ◽  
Holly Maples
Keyword(s):  
Antibiotic Therapy ◽  
Respiratory Illness ◽  
Respiratory Pathogen ◽  
Age Group ◽  
Rapid Diagnostics ◽  
Free Standing ◽  
Improvement Project ◽  
Empiric Antibiotics ◽  
Bacterial Cultures ◽  
Outpatient Group

Abstract Background The BioFire FilmArray® Respiratory Panel is a respiratory pathogen PCR that is used to detect the presence of 20 different infectious organisms that cause respiratory illness. Young children are prone to viral upper respiratory illness and represent an age group most likely to receive an antibiotic. As rapid diagnostics evolve, utilizing these tools within antimicrobial stewardship programs to improve utilization of antimicrobials is ideal. The purpose of this study was to assess how the BioFire FilmArray® Respiratory Panel is being used in practice and optimize its use in a large, free-standing, academic children’s hospital. Methods Retrospective chart review evaluating all patients (inpatient and outpatient) that received the BioFire FilmArray® Respiratory Panel from December 1, to December 10, 2019. Patients were evaluated based on where the panel was administered, results of the panel, results of other cultures, utilization of antibiotics, and overall hospital course. Data was collected from the electronic medical record and entered into a REDCap database and then analyzed descriptively. Results 151 patients were included with an average age of 2.6 years with 78 (51.7%) being < 1 year of age. 105 (70%) were administered in either the clinic or ED. In the < 1 year group, 29 (37%) received antibiotic therapy, with 20 having positive viral panels and 11 had positive bacterial cultures. In the ≥ 1 year of age group, 38 (52%) received antibiotic therapy, with 28 having positive viral panels and 9 had positive bacterial cultures. In the outpatient group, 33/105 (31%) were given empiric antibiotics of which 66% had positive viral panels. In the inpatient group, 28/46 (61%) were given empiric antibiotics of which 68% had positive viral panels. Conclusion The BioFire FilmArray® Respiratory Panel was found to be primarily utilized in the young child and outpatient/ED setting. With approximately 67% of children who received empiric antibiotics having a positive viral panel, and the majority of these not having positive bacterial cultures, work can be done to decrease the initiation of empiric antibiotics or earlier discontinuation. Further studies are needed in order to determine the optimal strategy for using the viral panel to de-escalate and escalate antimicrobial therapy in practice. Disclosures All Authors: No reported disclosures

scholarly journals Impact of rapid susceptibility testing and antibiotic selection strategy on the emergence and spread of antibiotic resistance in gonorrhea

2017 ◽  
Author(s):  
Ashleigh R Tuite ◽  
Thomas L Gift ◽  
Harrell W Chesson ◽  
Katherine Hsu ◽  
Joshua A Salomon ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Susceptibility ◽  
Point Of Care ◽  
Treatment Options ◽  
The United States ◽  
Selection Strategy ◽  
Rapid Diagnostics ◽  
Fitness Costs ◽  
Single Sex ◽  
Resistant Strains

AbstractBackgroundIncreasing antibiotic resistance limits treatment options for gonorrhea. We examined the extent to which a hypothetical point-of-care (POC) test reporting antibiotic susceptibility profiles could slow the spread of resistance.MethodsWe developed a deterministic compartmental model describing gonorrhea transmission in a single-sex population with three antibiotics available to treat infections. Probabilities of resistance emergence on treatment and fitness costs associated with resistance were based on characteristics of ciprofloxacin, azithromycin, and ceftriaxone. We evaluated time to 1% and 5% prevalence of resistant strains among all isolates with: (1) empiric treatment (azithromycin plus ceftriaxone), and treatment guided by POC tests determining susceptibility to (2) ciprofloxacin only and (3) all three antibiotics.FindingsBased on current gonococcal susceptibility patterns in the United States, the model indicated that continued empiric dual antibiotic treatment without POC testing resulted in >5% of isolates being resistant to both azithromycin and ceftriaxone within 15 years. When either POC test was used in 10% of identified cases, this was delayed by 5 years. The three antibiotic POC test delayed the time to reach 1% prevalence of triply-resistant strains by 6 years, while the ciprofloxacin-only test resulted in no delay. Results were less sensitive to assumptions about fitness costs and test characteristics with increasing test uptake. The main limitation of this study is that we made simplifying assumptions to describe gonorrhea transmission and the emergence and spread of resistance in the population.ConclusionsRapid diagnostics that report antibiotic susceptibility have the potential to extend the usefulness of existing antibiotics for treatment of gonorrhea. Monitoring resistance patterns will be critical with the introduction of such tests.

scholarly journals High-yield paper-based quantitative blood separation system

Lab on a Chip ◽  
2018 ◽  
Vol 18 (24) ◽  
pp. 3865-3871 ◽  
Author(s):  
Zhengda Lu ◽  
Elizabeth Rey ◽  
Sasank Vemulapati ◽  
Balaji Srinivasan ◽  
Saurabh Mehta ◽  
...  
Keyword(s):  
Whole Blood ◽  
Point Of Care ◽  
Cross Flow ◽  
High Yield ◽  
Rapid Diagnostics ◽  
Separation System ◽  
Blood Separation ◽  
Cross Flow Filtration ◽  
System P ◽  
Flow Filtration

HYPER platform: affordable whole blood separation with unique cross-flow filtration that makes rapid diagnostics at point-of-care available.

scholarly journals Antibodies and antibody-derived analytical biosensors

2016 ◽  
Vol 60 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Shikha Sharma ◽  
Hannah Byrne ◽  
Richard J. O'Kennedy
Keyword(s):  
Illicit Drugs ◽  
Point Of Care ◽  
High Specificity ◽  
Biological Warfare ◽  
Rapid Diagnostics ◽  
Timely Initiation ◽  
Specificity And Sensitivity ◽  
Appropriate Treatment ◽  
Biological Warfare Agents ◽  
Warfare Agents

The rapid diagnosis of many diseases and timely initiation of appropriate treatment are critical determinants that promote optimal clinical outcomes and general public health. Biosensors are now being applied for rapid diagnostics due to their capacity for point-of-care use with minimum need for operator input. Antibody-based biosensors or immunosensors have revolutionized diagnostics for the detection of a plethora of analytes such as disease markers, food and environmental contaminants, biological warfare agents and illicit drugs. Antibodies are ideal biorecognition elements that provide sensors with high specificity and sensitivity. This review describes monoclonal and recombinant antibodies and different immobilization approaches crucial for antibody utilization in biosensors. Examples of applications of a variety of antibody-based sensor formats are also described.

scholarly journals Identification of volatile compounds from bacteria by spectrometric methods in medicine diagnostic and other areas: current state and perspectives

2021 ◽  
Vol 105 (16-17) ◽  
pp. 6245-6255
Author(s):  
Nils Kunze-Szikszay ◽  
Maximilian Euler ◽  
Thorsten Perl
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infections ◽  
Point Of Care ◽  
Empiric Antibiotic Therapy ◽  
Current State ◽  
Point Of Care Diagnostics ◽  
Microbiological Methods ◽  
Empiric Antibiotic ◽  
Delayed Initiation ◽  
Species Specific

Abstract Diagnosis of bacterial infections until today mostly relies on conventional microbiological methods. The resulting long turnaround times can lead to delayed initiation of adequate antibiotic therapy and prolonged periods of empiric antibiotic therapy (e.g., in intensive care medicine). Therewith, they contribute to the mortality of bacterial infections and the induction of multidrug resistances. The detection of species specific volatile organic compounds (VOCs) emitted by bacteria has been proposed as a possible diagnostic approach with the potential to serve as an innovative point-of-care diagnostic tool with very short turnaround times. A range of spectrometric methods are available which allow the detection and quantification of bacterial VOCs down to a range of part per trillion. This narrative review introduces the application of spectrometric analytical methods for the purpose of detecting VOCs of bacterial origin and their clinical use for diagnosing different infectious conditions over the last decade. Key Points • Detection of VOCs enables bacterial differentiation in various medical conditions. • Spectrometric methods may function as point-of-care diagnostics in near future.

scholarly journals Electrical Characterization of Cellulose-Based Membranes towards Pathogen Detection in Water

Biosensors ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 57
Author(s):  
Grégoire Le Brun ◽  
Margo Hauwaert ◽  
Audrey Leprince ◽  
Karine Glinel ◽  
Jacques Mahillon ◽  
...  
Keyword(s):  
Pathogen Detection ◽  
Point Of Care ◽  
Electrical Characterization ◽  
Public Healthcare ◽  
Electrical Detection ◽  
Electrical Measurements ◽  
Experimental Proof ◽  
Bacterial Detection ◽  
Plate Electrode ◽  
Emergency Situations

Paper substrates are promising for development of cost-effective and efficient point-of-care biosensors, essential for public healthcare and environmental diagnostics in emergency situations. Most paper-based biosensors rely on the natural capillarity of paper to perform qualitative or semi-quantitative colorimetric detections. To achieve quantification and better sensitivity, technologies combining paper-based substrates and electrical detection are being developed. In this work, we demonstrate the potential of electrical measurements by means of a simple, parallel-plate electrode setup towards the detection of whole-cell bacteria captured in nitrocellulose (NC) membranes. Unlike current electrical sensors, which are mostly integrated, this plug and play system has reusable electrodes and enables simple and fast bacterial detection through impedance measurements. The characterized NC membrane was subjected to (i) a biofunctionalization, (ii) different saline solutions modelling real water samples, and (iii) bacterial suspensions of different concentrations. Bacterial detection was achieved in low conductivity buffers through both resistive and capacitive changes in the sensed medium. To capture Bacillus thuringiensis, the model microorganism used in this work, the endolysin cell-wall binding domain (CBD) of Deep-Blue, a bacteriophage targeting this bacterium, was integrated into the membranes as a recognition bio-interface. This experimental proof-of-concept illustrates the electrical detection of 107 colony-forming units (CFU) mL−1 bacteria in low-salinity buffers within 5 min, using a very simple setup. This offers perspectives for affordable pathogen sensors that can easily be reconfigured for different bacteria. Water quality testing is a particularly interesting application since it requires frequent testing, especially in emergency situations.

scholarly journals A novel RT-LAMP workflow for rapid salivary diagnostics of COVID-19 and effects of age, gender and time from symptom onset

2021 ◽  
Author(s):  
Gerson Shigeru Kobayashi ◽  
Luciano Abreu Brito ◽  
Danielle De Paula Moreira ◽  
Angela May Suzuki ◽  
Gabriella Shih Ping Hsia ◽  
...  
Keyword(s):  
Viral Load ◽  
Symptom Onset ◽  
Clinical Performance ◽  
Point Of Care ◽  
Rapid Diagnostics ◽  
Rt Pcr ◽  
Point Of Care Testing ◽  
Viral Loads ◽  
Peak Viral Load ◽  
Salivary Diagnostics

Objectives: Rapid diagnostics is pivotal to curb SARS-CoV-2 transmission, and saliva has emerged as a practical alternative to naso/oropharyngeal (NOP) specimens. We aimed to develop a direct RT-LAMP workflow for viral detection in saliva, and to provide more information regarding its potential in COVID-19 diagnostics. Methods: Clinical and contrived specimens were used to screen/optimize formulations and sample processing protocols. Salivary viral load was determined in symptomatic patients to evaluate clinical performance (n = 90) and to characterize saliva based on age, gender and time from onset of symptoms (n = 49). Results: The devised workflow achieved 93.2% sensitivity, 97% specificity, and 0.895 Kappa for salivas containing >102 copies/μL. Further analyses in saliva showed peak viral load in the first days of symptoms and lower viral loads in females, particularly among young individuals (<38 years). NOP RT-PCR data did not yield relevant associations. Conclusions: This novel saliva RT-LAMP workflow can be applied to point-of-care testing. This work reinforces that saliva better correlates with transmission dynamics than NOP specimens, and reveals gender differences that may reflect higher transmission by males. To maximize detection, testing should be done immediately after symptom onset, especially in females.

scholarly journals Understanding complexities in the uptake of indigenously developed rapid point-of-care diagnostics for containment of antimicrobial resistance in India

2021 ◽  
Vol 6 (9) ◽  
pp. e006628
Author(s):  
Monica Sharma ◽  
Raman R Gangakhedkar ◽  
Sanjay Bhattacharya ◽  
Kamini Walia
Keyword(s):  
Health Care ◽  
Antimicrobial Resistance ◽  
Healthcare System ◽  
Health Care System ◽  
Point Of Care ◽  
Rapid Diagnostics ◽  
Inappropriate Use ◽  
The Government ◽  
Funding Opportunities ◽  
Care System

A good point-of-care diagnostic test holds a promise to reduce inappropriate use of antibiotics by enabling early detection of the pathogen and facilitating rapid testing of antimicrobial susceptibility. India has taken many initiatives in the recent past to augment the development and deployment of diagnostics in Indian health care system. Funding opportunities to promote innovation in diagnostics development were started in early 2000s through various ministries and departments. India released National Essential Diagnostics List which enlists essential tests and there is now Free Diagnostics Service Initiative of Government of India under National Health Mission that mandates to provide all essential tests free of cost. We wanted to understand how these initiatives have impacted the diagnostics that could be of use in containment of antimicrobial resistance (AMR) and whether there is a smooth process for bringing indigenously developed products relevant to AMR into the healthcare system. We conducted a longitudinal survey (January 2019 and January 2021) to understand the availability of market ready indigenous rapid diagnostics for AMR in the country and their progress towards introduction in the private market or uptake in healthcare system. We found that many innovators and developers are working towards development of rapid tests that can be useful in the containment of AMR in India. While there are many promising diagnostics on the horizon, the pathway for uptake of indigenously developed diagnostics in healthcare system remains disjointed and needs to be harmonised for the investments made towards development to translate as tangible gains. Since most of these efforts are government funded, it is incumbent upon the government to also provide a seamless pathway to make these diagnostics available in health care system. In absence of this guidance, most of these diagnostics will sit with the innovators/developers and will never be used for the purpose they were intended to serve.

Sign in / Sign up

Export Citation Format

Share Document