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cAST: Capillary-Based Platform for Real-Time Phenotypic Antimicrobial Susceptibility Testing
Ruisheng Wang1, Sasank Vemulapati2, Lars F Westblade3,4
1Meinig School of Biomedical Engineering , Cornell University , Ithaca , New York 14853 , United States.
Abstract:
Antimicrobial resistance is recognized as one of the greatest emerging threats to public health. Antimicrobial resistant (AMR) microorganisms affect nearly 2 million people a year in the United States alone and place an estimated $20 billion burden on the healthcare system. The rise of AMR microorganisms can be attributed to a combination of overprescription of antimicrobials and a lack of accessible diagnostic methods. Delayed diagnosis is one of the primary reasons for empiric therapy, and diagnostic methods that enable rapid and accurate results are highly desirable to facilitate evidence-based treatment. This is particularly true for clinical situations at the point-of-care where access to state-of-the-art diagnostic equipment is scarce. Here, we present a capillary-based antimicrobial susceptibility testing platform (cAST), a unique approach that offers accelerated assessment of antimicrobial susceptibility in a low-cost and simple testing format. cAST delivers an expedited time-to-readout by means of optical assessment of bacteria incubated in a small capillary form factor along with a resazurin dye. cAST was designed using a combination of off-the-shelf and custom 3D-printed parts, making it extremely suitable for use in resource-limited settings. We demonstrate that growth of bacteria in cAST is approximately 25% faster than in a conventional microplate, further validate the diagnostic performance with clinical isolates, and show that cAST can deliver accurate antimicrobial susceptibility test results within 4-8 h.
Insights
Antimicrobial resistance (AMR) poses a major public health threat. A new capillary-based antimicrobial susceptibility testing (cAST) platform provides rapid, low-cost results within 4-8 hours, aiding evidence-based treatment.
Area of Science:
- Microbiology
- Public Health
- Medical Diagnostics
Background:
- Antimicrobial resistance (AMR) is a significant global health concern, causing millions of infections and substantial healthcare costs.
- Overprescription of antimicrobials and limited diagnostic tools contribute to the rise of AMR.
- Rapid and accurate diagnostics are crucial for timely, evidence-based treatment, especially in resource-limited point-of-care settings.
Purpose of the Study:
- To develop and validate a novel capillary-based antimicrobial susceptibility testing (cAST) platform.
- To provide a low-cost, simple, and rapid diagnostic method for AMR detection.
- To enable point-of-care testing in resource-limited environments.
Main Methods:
- Development of a capillary-based platform (cAST) using off-the-shelf and 3D-printed components.
- Utilized optical assessment of bacteria incubated with resazurin dye in capillaries.
- Compared bacterial growth rates and diagnostic performance against conventional microplate methods using clinical isolates.
Main Results:
- The cAST platform demonstrated a 25% faster bacterial growth rate compared to conventional microplates.
- Accurate antimicrobial susceptibility test results were achieved within 4-8 hours.
- The platform's design is suitable for resource-limited settings.
Conclusions:
- The capillary-based antimicrobial susceptibility testing (cAST) platform offers a rapid, low-cost, and accessible solution for AMR diagnostics.
- cAST facilitates expedited, evidence-based treatment decisions at the point-of-care.
- This technology has the potential to mitigate the impact of antimicrobial resistance in diverse healthcare settings.
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