Bacteremia is a life-threatening condition for which antibiotics must be prescribed within hours of clinical diagnosis. Since the current gold standard for bacteremia diagnosis is based on conventional methods developed in the mid-1800s—growth on agar or in broth—identification and susceptibility profiling for both Gram-positive and Gram-negative bacterial species requires at least 48–72 h. Recent advancements in accelerated phenotypic antibiotic susceptibility testing have centered on the microscopic growth analysis of small bacterial populations. These approaches are still inherently limited by the bacterial growth rate. Our approach is fundamentally different. By applying environmental stress to bacteria in a microfluidic platform, we can correctly assign antibiotic susceptibility profiles of clinically relevant Gram-negative bacteria within two hours of antibiotic introduction rather than 8–24 h. The substantial expansion to include a number of clinical isolates of important Gram-negative species—Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa—reported here underscores the broad utility of our approach, complementing the method’s proven utility for Gram-positive bacteria. We also demonstrate that the platform is compatible with antibiotics that have varying mechanisms of action—meropenem, gentamicin, and ceftazidime—highlighting the versatility of this platform.
Artemisia tridentata), mountain pasque (Anemone occidentalis), dwarf waterleaf (HydrophyUum capitatum), and juniper (Juniperus occidentalis, Nutt.).' Preparation of extracts. Fresh plants were finely ground with refined silica and a mortar and pestle, and then an equal volume of normal saline was added. This crude mixture was strained through two layers of gauze to remove larger particles, the filtrate being placed in the cold room until used. These suspensions will be referred to as crude saline extracts in the text and will be designated by the number C10 following the plant number, such as, buttercup extract P16C10.
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