Rapid Identification of Pathogenic Bacteria and Sepsis Diagnosis

描述（由申请方提供）：脓毒症是一种常见且经常致命的疾病，严重感染患者的死亡率为20%至50%。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，也是总体死亡的第十大原因。它是一个快速增长的健康问题，特别是对于老年人，免疫功能低下或重症患者。用自动液体培养系统进行的血液培养是用于鉴定脓毒症中涉及的病原菌的标准测试，但是其对于缓慢生长的细菌或用抗生素预处理的患者是缓慢的并且不够敏感。iSense，LLC拥有一种新型传感器技术，可以通过检测代谢挥发物同时检测和识别致病细菌，并且在血液培养孵育4小时后即可完成：大大缩短了诊断时间。iSense与斯坦福大学医学院合作，评估了新型纳米多孔色素比色传感器阵列检测和识别培养皿中培养的33种不同微生物的能力，这些微生物来自14种临床相关病原体的参考菌株和临床分离株。在培养皿中的固体培养基上进行了超过400次实验，物种鉴定的准确率达到99%。我们建议适应这个传感器矩阵开发一个原型系统，可用于检测和识别血培养瓶中的致病菌。如果成功，iSense技术可以彻底改变脓毒症诊断方法，大大提高医疗质量，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型的高维比色传感器阵列技术，用于检测和鉴定导致脓毒症的细菌。如果成功，拟议的努力将产生败血症的快速诊断工具，允许及时提供适当的抗生素治疗并降低医疗保健成本。

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.