Rapid Identification of Pathogenic Bacteria and Sepsis Diagnosis

描述(由申请人提供)：败血症是一种常见且经常致命的疾病，严重患者的死亡率从20%到50%不等。它是美国非冠状动脉重症监护病房患者的第二大死亡原因，也是第十大死亡原因。这是一个迅速增长的健康问题，特别是对老年、免疫功能低下或危重患者。全自动液体培养系统血液培养是鉴定败血症病原菌的标准检测方法，但对生长缓慢的细菌或使用抗生素的患者来说，检测速度慢且不够敏感。ISense，LLC拥有一项新颖的传感器技术，可以通过感应代谢挥发物同时检测和识别致病细菌，并且只需四个小时的血液培养培养就能做到这一点：大大缩短了诊断时间。ISense与斯坦福医学院合作，评估了新的基于纳米多孔色素的比色传感器阵列检测和识别33种不同微生物的能力，这些微生物培养在培养皿中，从14种临床相关病原体的参考菌株和临床分离株中提取。在培养皿中的固体介质上进行了400多次实验，获得了99%的物种鉴定准确率。我们建议采用这个传感器矩阵来开发一个原型系统，该系统可以用于检测和鉴定血培养瓶中的致病菌。如果成功，iSense技术可能会彻底改变脓毒症的诊断方法，极大地提高医疗保健的质量，同时降低成本。 公共卫生相关性：拟议的研究工作将开发和测试一种新的高维比色传感器阵列技术，用于检测和鉴定导致败血症的细菌。拟议的努力如果成功，将产生一种脓毒症的快速诊断工具，使适当的抗生素治疗能够迅速提供，并降低卫生保健成本。

DESCRIPTION (provided by applicant): Sepsis is a common and frequently fatal condition with a mortality rate that ranges from 20% to 50% for severely affected patients. It is the second leading cause of death in the U.S. among patients in non-coronary intensive care units and the 10th leading cause of death overall. It is a rapidly increasing health concern, especially for elderly, immune-compromised, or critically ill patients. Blood culturing with automated liquid culture systems is the standard test for identifying the pathogenic bacteria involved in sepsis, but it is slow and insufficiently sensitive for slow- growing bacteria or in patients pretreated wih antibiotics. iSense, LLC has a novel sensor technology that can simultaneously detect and identify the causative bacteria by sensing metabolic volatiles, and do so after only four hours of blood culture incubation: a substantial improvement in time to diagnosis. In collaboration with the Stanford School of Medicine, iSense has evaluated the new nanoporous pigment-based colorimetric sensor array's ability to detect and identify 33 different microorganisms cultured in Petri dishes and drawn from reference strains and clinical isolates from 14 clinically relevant pathogen species. Over 400 experiments were performed on solid media in Petri dish, yielding 99% accuracy for species identification. We propose to adapt this sensor matrix to develop a prototype system that can be used to detect and identify causative bacteria in blood culture bottles. If successful, iSense technology could revolutionize the sepsis diagnostic method, dramatically improving the quality of health care while reducing its cost. PUBLIC HEALTH RELEVANCE: The proposed research effort will develop and test a novel high-dimensional colorimetric sensor array technology for the detection and identification of bacteria responsible for sepsis. The proposed effort, if successful, will yield a rapid diagnostic tool for sepsis, allowing prompt delivery of appropriate antibiotic treatment and reduced health care costs.