Interfacial Engineering of Biosensors for Bloodstream Infection Diagnosis

Bloodstream infection (BSI) is a life-threatening systemic disease with rapid onset and high mortality, which calls for rapid and accurate pathogen detection for precision medical care. Conventional diagnostic methods, including blood culture, molecular assays, and mass spectrometry, remain limited by long turnaround time, matrix interference, high cost, or insufficient point-of-care applicability. Biosensor interface engineering provides a promising route to improve pathogen capture, antifouling capability, and signal transduction in complex blood matrices. In this review, we summarize recent advances in biosensing interfaces for BSI diagnosis from three interconnected perspectives: signal transduction strategies, biorecognition elements, and antifouling surface designs. We further discuss direct sensing of intact bacterial cells and indirect sensing of bacterial or host-response biomarkers. Finally, remaining challenges in whole-blood compatibility, device integration, standardization, and clinical validation are highlighted to guide the development of next-generation point-of-care diagnostic platforms.