TEXAS: Towards next-generation AMR surveillance: Assessment of novel technologies with high-throughput and multiplexing potential

越来越多的人认识到，减少全球AMR需要对临床相关标志物进行综合监测（例如，与特定耐药病原体相关的基因，“药物-细菌”组合）。然而，对于哪些标记物是目标，哪些暴露是安全的，或者什么技术最适合监测选定的标记物，没有达成共识。拟议的TEXAS项目将定义一套最能描述目标位置AMR状态的遗传标记，并使用不需要培养细菌的新技术将它们整合到多路复用平台中。数字液滴PCR（ddPCR）平台（适用于高收入地区）将量化各种环境中的临床相关标志物，生成可用于比较AMR状态的大型同步数据集，促进对不同One Health部门AMR的理解。串联，电化学生物传感器将提供用于高通量现场监测选定AMR标志物的手段。该生物传感器不需要特殊设备或训练有素的操作人员，因此可以应用于缺乏先进基础设施的低收入地区。多学科的德克萨斯州联盟包括电力和水工程，基因组流行病学，分子微生物生态学，公共卫生和政策指导方面的专家。因此，我们相信，该项目将产生可实施的技术解决方案，可供利益相关者采用，用于对减少全球AMR至关重要的综合监测。

There is growing recognition that reducing global AMR requires integrated surveillance of clinically relevant markers (e.g., genes associated with specific resistant pathogens, "drug-bug" combinations). However, there is no consensus regarding which markers to target and what exposures are safe, or what technologies are most suitable for monitoring the selected markers. The proposed TEXAS project will define a suite of geneticmarkers that best describe AMR status of a targeted location, and integrate them into multiplexed platforms using new technologies that do not require cultivation of bacteria. A digital droplet PCR (ddPCR) platform (suitable for high income regions) will quantify clinically relevant markers in a diverse range of environments, generating large and synchronized datasets that can be exploited for comparative AMR status, facilitatingunderstanding of AMR across different One Health sectors. In tandem, an electrochemical biosensor will provide a means for high-throughput on-site monitoring of selected AMR markers. The biosensor does not require special equipment or trained operators, and thus can be applied in low income regions that lack sophisticated infrastructure. The multidisciplinary TEXAS consortium includes experts in electrical and water engineering, genomic epidemiology, molecular microbial ecology, public health, and policy guidance. Consequently, we are confident that the project will generate implementable technological solutions that can be adopted by stakeholders for integrated surveillance that will be fundamental to reducing global AMR.