Recent Advances in the Race to Design a Rapid Diagnostic Test for Antimicrobial Resistance

Abstract

Even with advances in antibiotic therapies, bacterial infections persistently plague society and have amounted to one of the most prevalent issues in healthcare today. Moreover, the improper and excessive administration of antibiotics has led to resistance of many pathogens to prescribed therapies, rendering such antibiotics ineffective against infections. While the identification and detection of bacteria in a patient's sample is critical for point-of-care diagnostics and in a clinical setting, the consequent determination of the correct antibiotic for a patienttailored therapy is equally crucial. As a result, many recent research efforts have been focused on the development of sensors and systems that correctly guide a physician to the best antibiotic to prescribe for an infection, which can in turn, significantly reduce the instances of antibiotic resistance and the evolution of bacteria "superbugs." This review details the advantages and shortcomings of the recent advances (focusing from 2016 and onward) made in the developments of antimicrobial susceptibility testing (AST) measurements. Detection of antibiotic resistance by genomic AST techniques relies on the prediction of antibiotic resistance via extracted bacterial DNA content, while phenotypic determinations typically track physiological changes in cells and/ or populations exposed to antibiotics. Regardless of the method used for AST, factors such as cost, scalability, and assay time need to be weighed into their design. With all of the expansive innovation in the field, which technology and sensing systems demonstrate the potential to detect antimicrobial resistance in a clinical setting?

A fast impedance-based antimicrobial susceptibility test

“…Consequently, AST methods that rely on cell growth or metabolic activity do not report results in <6 h 12 , 13 . To address this, several rapid AST assays have been developed 13 – 15 . Flow cytometry has been widely proposed for rapid ASTs: antibiotic exposure leads to changes in susceptible strains of bacteria that can be measured by (label-free) light scatter and/or fluorescent viability markers 16 .…”

Fluorescent Sensor Arrays Can Predict and Quantify the Composition of Multicomponent Bacterial Samples

“…Currently used methods are mostly based on PCR and mass-spectroscopy techniques, are time-consuming, and equipment-demanding (Váradi et al, 2017). Some rapid detection approaches reported in recent years use antibodies or aptamers to provide selectivity and specificity (Kubicek-Sutherland et al, 2017;Leonard et al, 2018). Sensor arrays are cross-reactive and not intrinsically selective, but they are often based on stable small molecules and provide more flexibility (Geng et al, 2019;Li et al, 2019).…”

Sticky Situations: Bacterial Attachment Deciphered by Interferometry of Silicon Microstructures

“…[3,4] It has been reported that surface-associated bacterial networks are more resistant to environmental stresses, such as antibiotics, than their free-floating planktonic counterpart cells. [5] Thus, elucidating and quantifying the attachment behavior of bacterial cells to their substrates and development of biofilms is crucial to mediating problems of deadly infections, [6] understanding of fragile ecosystems, biofouling, and even the design of synthetic microbial populations. [7][8][9][10] Although, traditionally, the behavior of microbes has been successfully studied in pure liquid cultures, new methods and materials for quantitatively examining bacterial attachment and colony formation on surfaces have recently emerged.…”