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Multiplex antibiotic susceptibility testing of urinary tract infections using an electrochemical lab-on-a-chip
Benjamin Crane1, Alex Iles2,3, Craig E Banks1
1Department of Natural Sciences, Manchester Metropolitan University, Manchester, UK.
Abstract:
Urinary tract infections (UTIs) represent the most prevalent type of outpatient infection, with significant adverse health and economic burdens. Current culture-based antibiotic susceptibility testing can take up to 72 h resulting in ineffective prescription of broad-spectrum antibiotics, poor clinical outcomes and development of further antibiotic resistance. We report an electrochemical lab-on-a-chip (LOC) for testing samples against seven clinically-relevant antibiotics. The LOC contained eight chambers, each housing an antibiotic-loaded hydrogel (cephalexin, ceftriaxone, colistin, gentamicin, piperacillin, trimethoprim, vancomycin) or antibiotic-free control, alongside a resazurin bulk-modified screen-printed electrode for electrochemical detection of metabolically active bacteria using differential pulse voltammetry. Antibiotic susceptibility in simulated UTI samples or donated human urine with either Escherichia coli or Klebsiella pneumoniae could be established within 85 min. Incorporating electrochemical detection onto a LOC provides an inexpensive, simple method for the sensitive determination of antibiotic susceptibility that is significantly faster than using a culture-based approach.
Insights
A new electrochemical lab-on-a-chip (LOC) rapidly determines antibiotic susceptibility for urinary tract infections (UTIs). This method provides results in 85 minutes, significantly faster than traditional culture-based testing.
Area of Science:
- Biomedical Engineering
- Analytical Chemistry
- Microbiology
Background:
- Urinary tract infections (UTIs) are common outpatient infections with substantial health and economic impacts.
- Current culture-based antibiotic susceptibility testing (AST) is time-consuming (up to 72 hours), leading to broad-spectrum antibiotic use, poor outcomes, and resistance.
- Rapid AST is crucial for effective UTI treatment and antimicrobial stewardship.
Purpose of the Study:
- To develop and validate an electrochemical lab-on-a-chip (LOC) device for rapid antibiotic susceptibility testing (AST) of UTIs.
- To assess the performance of the LOC device using common UTI pathogens like Escherichia coli and Klebsiella pneumoniae.
- To provide a faster, more efficient alternative to conventional culture-based AST methods.
Main Methods:
- An electrochemical lab-on-a-chip (LOC) device with eight chambers was designed.
- Each chamber contained an antibiotic-loaded hydrogel (cephalexin, ceftriaxone, colistin, gentamicin, piperacillin, trimethoprim, vancomycin) or a control.
- Resazurin-modified screen-printed electrodes were used for electrochemical detection of bacterial metabolic activity via differential pulse voltammetry.
Main Results:
- The LOC device successfully determined antibiotic susceptibility within 85 minutes using simulated and real human urine samples.
- The method demonstrated sensitivity in detecting bacterial activity and susceptibility to seven key antibiotics.
- Results were obtained significantly faster than the 72-hour turnaround time of traditional culture-based methods.
Conclusions:
- Electrochemical detection integrated onto a LOC offers a rapid, inexpensive, and sensitive method for UTI antibiotic susceptibility testing.
- This technology has the potential to improve clinical outcomes and combat antibiotic resistance by enabling timely, targeted treatment.
- The developed LOC device represents a significant advancement over conventional culture-based AST for managing UTIs.
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