Instant Antimicrobial Susceptibility Test

在美国，每年有200万人严重感染耐药细菌， 用来治疗感染的抗生素抗生素耐药性的成本估计为 超过35 B美元。医院内血流感染（BSI），包括导管相关的BSI， 患者发病率和死亡率的重要原因。BSI的年发病率> 75万 死亡率为30%的病例，以及引起BSI的耐药细菌的比例 正在增加。多重耐药细菌的增加需要使用广谱抗生素。 抗生素，以避免抗生素覆盖不足，但这些药物往往是昂贵的， 它们的使用促进细菌抗性。迅速开始适当的抗生素治疗是 与BSI的死亡率下降密切相关。相反，不适当的抗生素 治疗和3小时延迟抗生素给药后，败血症诊断已被 与较高的患者死亡率相关。今天的所有抗菌药物管理计划（ASP） 是让患有BSI和其他感染类型的患者服用有针对性的适当抗生素 尽快根据AST结果进行治疗。快速递送确定性抗菌剂 药敏试验（AST）结果是允许最小限度使用广谱治疗的关键， 有效适当的抗生素方案。 在Linima Field Diagnostics，我们已经开发出一种即时抗菌敏感性 使用压电板传感器（PEPS）的iAST测试，提供无与伦比的速度（20分钟） 和敏感性。涂在PEPS表面的活菌可以立即扩大顶部， 由于细菌产生的代谢应力，PEPS的共振峰， 通过应用抗生素立即减少。一种新型PEPS iAST由 监测包被活细菌的共振峰顶部宽度的减小 抗生素浓度增加的PEPS。目标是在20分钟内演示PEPS iAST 无论是快速生长还是缓慢生长，对敏感细菌和耐药细菌的作用均为最小。 初步结果表明，PEPS iAST可准确测定抗生素最小抑菌浓度， 敏感和耐药大肠杆菌（EC）的MIC，或 金黄色葡萄球菌（SA），但也为缓慢生长的肺炎克雷伯菌（KP）和20 分钟预计PEPS iAST开发后将允许早期应用适当的 抗生素治疗不仅可以挽救生命，还可以减少抗生素耐药性。

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.