Multiplexed paper-based assay for personalized antimicrobial susceptibility profiling of Carbapenem-resistant Enterobacterales performed in a rechargeable coffee mug

Abstract

The increasing prevalence of antibiotic resistance threatens to make currently treatable bacterial diseases deadly again. As drug resistance rises, antibiotic susceptibility testing needs to adapt to allow for widespread, individualized testing. Paper-based diagnostics offer low-cost, disposable alternatives to traditional time consuming and costly in-house methods. Here, we describe a paper-based microfluidic device, called the Bac-PAC, capable of categorizing the antibiotic susceptibly of individual strains of Carbapenem-resistant Enterobacterales. Each chip provides a colored readout with actionable susceptibility classification of three antibiotics, thus maximizing the chances of identifying a viable therapy. We verified the technology on thirty bacterial strains with two dyes using six clinically relevant antibiotics. We demonstrated that the dried tests are stable for one month and can be incubated in a rechargeable coffee mug that reduces the need for external infrastructure.

A Review of Carbapenem Resistance in Enterobacterales and Its Detection Techniques

“…Further, the LAMP method, using hydroxy naphtol blue dye (LAMP-HNB) and microarray techniques, detects genes encoding carbapenemase with higher specificity and sensitivity at 100% and >90%, respectively [ 99 , 108 , 142 , 143 ]. Multiplexed paper-based Bac-PAC is another assay used to categorize the AMR profile of individual strains of CRE by providing a colorimetric readout [ 145 ]. The RNA-targeted molecular approach, NucliSENS EasyQKPC test, has also been used for detecting bla KPC variants within 2 h, at a 93.3% sensitivity and 99% specificity [ 146 ].…”