Instant Antimicrobial Susceptibility Test

即时抗菌药物敏感性测试

• 批准号: 10010469
• 负责人: Pawan Rao
• 金额: $ 25.21万
• 依托单位: LENIMA FIELD DIAGNOSTICS, LLC
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-12 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10010469
• 关键词: Antibiotic Resistance; Antibiotic Therapy; Antibiotics; Antimicrobial susceptibility; Bacteria; Bacterial Antibiotic Resistance; Bacterial Infections; Blood; Catheter-related bloodstream infection; Clostridium difficile; Development; Diagnosis; Diagnostic; Engineering; Equipment; Escherichia coli; Flow Cytometry; Frequencies; Goals; Growth; Health Care Costs; Hospitals; Hour; Incidence; Infection; Klebsiella pneumoniae; Laboratories; Measurement; Mechanics; Metabolic stress; Metabolism; Methods; Microbiology; Minimum Inhibitory Concentration measurement; Monitor; Morbidity - disease rate; Multiple Bacterial Drug Resistance; Patients; Pharmaceutical Preparations; Phase; Productivity; Pseudomonas aeruginosa; Regimen; Resistance; Sepsis; Septic Shock; Septicemia; Shock; Source; Speed; Staphylococcus aureus; Stream; Stress; Surface; System; Test Result; Testing; Thinness; Time; Universities; Width; Work; antibiotic design; antimicrobial; bacterial resistance; base; cell motility; commercialization; cost; design; digital; economic cost; genome sequencing; ineffective therapies; magnetic beads; microcalorimetry; mortality; mortality risk; nanometer; next generation sequencing; novel; programs; prototype; sensor; targeted treatment; vibration; whole genome

In the U.S., each year 2 million people are seriously infected by bacteria resistant to antibiotics designed to treat their infections. The cost of antibiotic resistance was estimated to exceed $35 B. Nosocomial bloodstream infections (BSIs) including catheter-related BSIs, are important causes of patient morbidity and mortality. The annual incidence of BSIs is >750,000 cases with a 30% mortality rate, and the proportion of antibiotic-resistant bacteria causing BSIs is increasing. Increasing rates of multidrug-resistant bacteria require use of broad-spectrum antibiotics to avoid inadequate antibiotic coverage, but these drugs are often expensive, and their use promotes bacterial resistance. Rapid initiation of appropriate antibiotic therapy is strongly associated with decreased mortality rates in BSIs. In contrast, inappropriate antibiotic therapy and 3 hr delay in antibiotic administration after septicemia diagnosis have been associated with higher patient mortality. All antimicrobial stewardship programs (ASPs) today are to place patients with BSIs and other infection types on targeted appropriate antibiotic therapy based on AST results as quickly as possible. Rapid delivery of definitive antimicrobial susceptibility testing (AST) results is key to allow minimal use of broad-spectrum therapy and effective appropriate antibiotic regimen. At Linima Field Diagnostics, we have developed an instant antimicrobial susceptibility test (iAST) using piezoelectric plate sensors (PEPSs) that offers unparalleled speed (in 20 min) and sensitivities. Live bacteria coated on the PEPS surface can instantly broadens the top of the resonance peak of the PEPS due to the metabolic stresses generated by the bacteria, which is instantly reduced by the application of an antibiotic. A novel PEPS iAST was engineered by monitoring the decrease of the width of the top of the resonance peak of live bacteria-coated PEPS with an increasing antibiotic concentration. The goal is to demonstrate PEPS iAST in 20 min to both susceptible and resistant bacteria regardless they are fast or slowing growing. Preliminary results showed that PEPS iAST accurately determined antibiotic minimum inhibitory concentrations (MICs) for both susceptible and resistant Escherichia coli (EC) or Staphylococcus aureus (SA) but also for slow-growing Klebsiella pneumoniae (KP) and in 20 min. It is expected that PEPS iAST when developed will permit early application of appropriate antibiotic therapy to not only save lives and but also decrease antibiotic resistance.

在美国，每年有200万人受到抗性细菌的感染 旨在治疗其感染的抗生素。估计抗生素耐药性的成本为 超过$ 35 B.医院血液感染（BSI），包括导管相关的BSIS，为 患者发病率和死亡率的重要原因。 BSIS的年发病率> 750,000 死亡率为30％的病例，抗生素耐药细菌的比例导致BSIS 正在增加。增加耐多药细菌的速率需要使用宽光谱 抗生素可以避免抗生素覆盖不足，但这些药物通常很昂贵，并且 它们的使用促进了细菌抗性。快速开始适当的抗生素治疗是 与BSI的死亡率降低密切相关。相反，不适当的抗生素 疗程后抗生素诊断后的治疗和3小时的延迟是 与较高的患者死亡率有关。今天所有抗菌管理计划（ASP） 将BSI和其他感染类型的患者放在靶向适当的抗生素上 基于AST结果的治疗尽快。快速递送确定的抗菌剂 敏感性测试（AST）结果是允许最少使用广谱疗法和 有效的适当抗生素方案。 在Linima Field Diagnostics，我们开发了一种瞬时抗菌易感性 使用压电板传感器（PEPSS）的测试（iAST），可提供无与伦比的速度（在20分钟内） 和敏感性。涂在佩普斯表面上的活细菌可以立即拓宽 由于细菌产生的代谢应力引起的PEP的共振峰，这是 通过应用抗生素立即降低。一个小说的peps iast是由 监视活细菌涂层的共振峰顶部宽度的减小 抗生素浓度增加的PEP。目标是在20中展示peps iAST 最小对易感性和抗性细菌的生长快或放缓。 初步结果表明，PEPS IAST准确确定了抗生素的最小抑制作用 易感性和抗性大肠杆菌（EC）或 金黄色葡萄球菌（SA），但也用于缓慢生长的克雷伯氏菌（KP）和20 最小。预计开发时Peps iAST将允许尽早应用适当的 抗生素疗法不仅可以挽救生命，还可以降低抗生素耐药性。