Rapid bacterial diagnostics at the point of care: emerging electrochemical and Raman-based approaches

Bacterial infections impose a major clinical and economic burden, which is likely to increase further as antimicrobial resistance rises, reinforcing the need for early detection to accelerate and better target therapy. Conventional culture-based diagnostics are well established, but they are too slow to inform early therapeutic decisions. This review frames the growing need for rapid bacterial diagnostics in the context of acute infection, antimicrobial stewardship, and point-of-care testing. We focus on emerging electrochemical biosensing and Raman-based approaches and compare them with established laboratory methods, including culture, MALDI-TOF MS, nucleic acid amplification tests, sequencing, and antimicrobial susceptibility testing, emphasising where central laboratories remain essential and where near-patient testing could alter clinical management. We highlight clinically relevant targets, recognition strategies, signal generation, materials design, manufacturability, and performance in complex biological matrices. Rather than focusing only on analytical sensitivity, we discuss the practical factors that will determine translation, including reproducibility, workflow integration, validation in real samples, and regulatory readiness. Taken together, the most clinically promising rapid bacterial diagnostics are those that deliver reliable, actionable information within the time window in which treatment decisions can still meaningfully influence outcomes. In this context, the most promising point-of-care systems are not those intended to replace central laboratories, but those designed to complement them by enabling earlier, better-targeted, and more judicious antimicrobial therapy.