A Biosensor Platform for Rapid Antimicrobial Susceptibility Testing Directly From Clinical Samples

No AccessJournal of UrologyAdult Urology1 Jan 2011A Biosensor Platform for Rapid Antimicrobial Susceptibility Testing Directly From Clinical Samples Kathleen E. Mach, Ruchika Mohan, Ellen Jo Baron, Mei-Chiung Shih, Vincent Gau, Pak Kin Wong, and Joseph C. Liao Kathleen E. MachKathleen E. Mach Department of Urology, Stanford University School of Medicine, Stanford, California , Ruchika MohanRuchika Mohan Department of Urology, Stanford University School of Medicine, Stanford, California , Ellen Jo BaronEllen Jo Baron Department of Pathology, Stanford University School of Medicine, Stanford, California , Mei-Chiung ShihMei-Chiung Shih Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California Veterans Affairs Cooperative Studies Program Coordinating Center, Mountain View, California , Vincent GauVincent Gau GeneFluidics Inc., Monterey Park, California , Pak Kin WongPak Kin Wong Department of Aerospace and Mechanical Engineering, University of Arizona, Tucson, Arizona , and Joseph C. LiaoJoseph C. Liao Department of Urology, Stanford University School of Medicine, Stanford, California Veterans Affairs Palo Alto Health Care System, Palo Alto, California View All Author Informationhttps://doi.org/10.1016/j.juro.2010.09.022AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: A significant barrier to efficient antibiotic management of infection is that the standard diagnostic methodologies do not provide results at the point of care. The delays between sample collection and bacterial culture and antibiotic susceptibility reporting have led to empirical use of antibiotics, contributing to the emergence of drug resistant pathogens. As a key step toward the development of a point of care device for determining the antibiotic susceptibility of urinary tract pathogens, we report on a biosensor based antimicrobial susceptibility test. Materials and Methods: For assay development bacteria were cultured with or without antibiotics, and growth was quantitated by determining viable counts and electrochemical biosensor measurement of bacterial 16S rRNA. To determine antibiotic susceptibility directly from patient samples, urine was cultured on antibiotic plates for 2.5 hours and growth was determined by electrochemical measurement of bacterial 16S rRNA. For assay validation 252 urine samples were collected from patients at the Spinal Cord Injury Service at Veterans Affairs Palo Alto Health Care System. The biosensor based antimicrobial susceptibility test was completed for samples containing gram-negative organisms. Pathogen identification and antibiotic susceptibility results were compared between our assay and standard microbiological analysis. Results: A direct biosensor quantitation of bacterial 16S rRNA can be used to monitor bacterial growth for a biosensor based antimicrobial susceptibility test. Clinical validation of a biosensor based antimicrobial susceptibility test with patient urine samples demonstrated that this test was 94% accurate in 368 pathogen-antibiotic tests compared to standard microbiological analysis. Conclusions: This biosensor based antimicrobial susceptibility test, in concert with our previously described pathogen identification assay, can provide culture and susceptibility information directly from a urine sample within 3.5 hours. References 1 : Performance accuracy of antibacterial and antifungal susceptibility test methods: report from the College of American Pathologists Microbiology Surveys Program. (2001–2003) Arch Pathol Lab Med2006; 130: 767. Google Scholar 2 : Direct comparison of the BD Phoenix system with the MicroScan WalkAway system for identification and antimicrobial susceptibility testing of Enterobacteriaceae and nonfermentative gram-negative organisms. J Clin Microbiol2008; 46: 2327. 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Mach Department of Urology, Stanford University School of Medicine, Stanford, California More articles by this author Ruchika Mohan Department of Urology, Stanford University School of Medicine, Stanford, California More articles by this author Ellen Jo Baron Department of Pathology, Stanford University School of Medicine, Stanford, California Financial interest and/or other relationship with Cepheid, OpGen and AHC Media. More articles by this author Mei-Chiung Shih Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California Veterans Affairs Cooperative Studies Program Coordinating Center, Mountain View, California More articles by this author Vincent Gau GeneFluidics Inc., Monterey Park, California Financial interest and/or other relationship with GeneFluidics. More articles by this author Pak Kin Wong Department of Aerospace and Mechanical Engineering, University of Arizona, Tucson, Arizona More articles by this author Joseph C. Liao Department of Urology, Stanford University School of Medicine, Stanford, California Veterans Affairs Palo Alto Health Care System, Palo Alto, California More articles by this author Expand All Advertisement PDF downloadLoading ...