Magnetic nanoparticle-based method for microorganism concentration in sterile body fluids: Validation and clinical...

Rapid and accurate detection of microorganisms in sterile body fluids, particularly cerebrospinal fluid (CSF), is crucial for effective diagnosis and treatment. Conventional methods, such as centrifugation, may result in low microbial recovery and false negatives, limiting diagnostic accuracy. An alternative, efficient, and accessible microbial concentration method is needed. This study evaluates a nanoparticle-based microbial concentration method to enhance pathogen recovery from CSF. The method was optimized for interaction time (1 min) and nanoparticle dosage (0.01 g/mL) using standard microbial strains, including Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans. Its clinical performance was assessed using 800 CSF samples, and microbial identification was confirmed via MALDI-TOF MS. The method significantly improved microbial recovery across 10^-2-10^-9 CFU/mL concentrations, achieving a detection limit as low as 2 CFU/mL. Clinical validation demonstrated 100% sensitivity and specificity, detecting 15 additional true-positive cases missed by centrifugation. While centrifugation fails to detect bacteria below 10^-7 CFU/mL, our method reliably detects even at 10^-9 CFU/mL, demonstrating superior microbial enrichment, especially in low-biomass samples. This method enhances diagnostic accuracy by reducing false negatives and expediting pathogen detection. Its resource-conscious, low-cost and equipment-free nature makes it particularly beneficial for resource-limited laboratories, offering a scalable alternative for microbial concentration in CSF diagnostics.