Towards real-time in vitro Enterobacteriaceae beta-lactamase quantification using iridium oxide-based biosensors

The increasing prevalence of beta-lactamase-producing Enterobacteriaceae presents a critical challenge in clinical microbiology, complicating infection management due to resistance to most first- and second-line beta-lactam antibiotics. Current antimicrobial susceptibility testing (AST) approaches may not reliably detect and rapidly characterise beta-lactamase production, potentially leading to suboptimal treatment. In this study, we introduce a novel iridium oxide-based biosensor that detects in vitro beta-lactamase production in Escherichia coli (E.coli) type strains and genetically modified E.coli isolates within 10 min. The biosensor demonstrated high reproducibility (6.88% coefficient of variation). Clinical validation using 26 E. coli isolates from urinary tract infection patients showed a sensitivity of 100%, specificity of 57%, and accuracy of 88%. This biosensor-based method offers a rapid, reproducible, and cost-effective method for phenotypic detection of antimicrobial resistance, with the potential to significantly reduce diagnostic turnaround times and support individualised AST strategies.