1. Rapid personalized AMR diagnostics using two-dimensional antibiotic resistance profiling strategy employing a thermometric NDM-1 biosensor.
- Author
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Meng, Qinglai, Liu, Shichao, Meng, Jinhua, Feng, Jiao, Mecklenburg, Michael, Zhu, Lei, Zhou, Lifang, Bülow, Leif, Liu, Jianyi, Song, Dewei, Wu, Changxin, and Xie, Bin
- Subjects
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DRUG resistance in bacteria , *BIOSENSORS , *ANTIBIOTICS , *PHYSICIANS , *BETA lactam antibiotics , *CARBAPENEMASE , *DRUG resistance in microorganisms , *BETA-lactamase inhibitors - Abstract
Antimicrobial resistance (AMR) threatens global public health and modern surgical medicine. Expression of β-lactamase genes is the major mechanism by which pathogens become antibiotic resistant. Pathogens expressing extended spectrum β-lactamases (ESBL) and carbapenemases (CP) are especially difficult to treat and are associated with increased hospitalization and mortality rates. Despite considerable effort, identification of ESBLs and CPs in a clinically relevant timeframe remains challenging. In this study, a two-dimensional AMR profiling assay strategy was developed employing panels of antibiotics (penicillins, cephamycins, oximino-cephalosporins and carbapenems) and β-lactamases inhibitors (avibactam and EDTA). The assay required the development of a novel biosensor that employed New Delhi metallo-β-lactamase-1 (NDM-1) as the sensing element. Functionally probing β-lactamase activity using substrates and inhibitors combinatorically increased the informational content that enabled the development of assays capable of simultaneous, differential identification of multiple β-lactamases expressed in a single bacterial isolate. More specifically, the assay enabled the simultaneous identification of ESBL and CP in mock samples, as well as in an engineered construct which co-expressed these β-lactamases. The NDM-1 biosensor assay was 16 times and 8 times more sensitive than the ESBL Nordmann/Dortet/Poirel (NDP) and Carba Nordmann/Poirel (NP) assays, respectively. In a retrospective study, NDM-1 biosensor assays were able to differentially identify ESBLs, metallo-CPs and serine-CPs β-lactamases in 23 clinical isolates with 100% accuracy. An assay algorithm was developed which accelerated data analytics reducing turnaround to <1 h. The assay strategy integrated with AI-based data analytics has the potential to provide physicians with a comprehensive readout of patient AMR status. [Display omitted] • Two-dimensional antibiotic/inhibitor profiling creates a universal AMR detection strategy. • Elimination of culturing and sample pretreatment simplifies assay & lowers costs. • 2D profiling enables simultaneous differential determination of multiple β-lactamases. • Patient AMR β-lactamase status determined in 60 min enables personalized treatment. • Validated using clinical bacterial isolates expressing ESBL and/or carbapenemase. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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