Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract Infections
Current methods for the diagnosis of urinary tract infections with antimicrobial susceptibility testing take 2–3 days and require a clinical laboratory. The lack of a rapid, point-of-care antibiotic susceptibility test (AST) has contributed to the misuse of antibiotics when treating urinary tract in...
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| Language: | English |
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MDPI AG
2021-09-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/10/1168 |
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| author | Eleonora Nicolai Massimo Pieri Enrico Gratton Guido Motolese Sergio Bernardini |
| author_facet | Eleonora Nicolai Massimo Pieri Enrico Gratton Guido Motolese Sergio Bernardini |
| author_sort | Eleonora Nicolai |
| collection | DOAJ |
| description | Current methods for the diagnosis of urinary tract infections with antimicrobial susceptibility testing take 2–3 days and require a clinical laboratory. The lack of a rapid, point-of-care antibiotic susceptibility test (AST) has contributed to the misuse of antibiotics when treating urinary tract infections (UTIs) and consequently to the rise of multi-drug-resistant organisms. The current clinical approach has led to reduced treatment options and increased costs of diagnosis and therapy. To address this issue, novel diagnostics are needed for the timely determination of antimicrobial susceptibility. We present a rapid, point-of-care, phenotypic AST device that can report the antibiotic susceptibility/resistance of a uropathogen to a panel of antibiotics in as few as 3 h by utilizing fluorescent-labelling chemistry and a highly sensitive particle-counting instrument. We analysed 744 urine samples from the outpatients and inpatients of two Italian hospitals. The 130 UTI-positive patient urine samples we found were measured using a panel of six common UTI antibiotics plus a growth control. By comparing our results to hospital laboratory urine cultures, we obtained an overall sensitivity = 81%, a specificity = 83%, an SPV (sensitivity predicted value) = 95%, and an RPV (resistance predicted value) = 54%. According to our preliminary data, the sensitivity predicted value for a single antibiotic agent was 95%, thus allowing (in the vast majority of cases) an early (within 3 h) recognition of an effective agent for a single patient. |
| first_indexed | 2024-03-10T06:46:38Z |
| format | Article |
| id | doaj.art-c0a15f932e924a15b524f5a464925fb1 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T06:46:38Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-c0a15f932e924a15b524f5a464925fb12023-11-22T17:13:07ZengMDPI AGAntibiotics2079-63822021-09-011010116810.3390/antibiotics10101168Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract InfectionsEleonora Nicolai0Massimo Pieri1Enrico Gratton2Guido Motolese3Sergio Bernardini4Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, ItalyDepartment of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, ItalyLaboratory for Fluorescence Dynamics, Department of Biomedical Engineering, University of California-Irvine, Irvine, CA 92697, USAASI srl, Via Carroccio 12, 20123 Milan, ItalyDepartment of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, ItalyCurrent methods for the diagnosis of urinary tract infections with antimicrobial susceptibility testing take 2–3 days and require a clinical laboratory. The lack of a rapid, point-of-care antibiotic susceptibility test (AST) has contributed to the misuse of antibiotics when treating urinary tract infections (UTIs) and consequently to the rise of multi-drug-resistant organisms. The current clinical approach has led to reduced treatment options and increased costs of diagnosis and therapy. To address this issue, novel diagnostics are needed for the timely determination of antimicrobial susceptibility. We present a rapid, point-of-care, phenotypic AST device that can report the antibiotic susceptibility/resistance of a uropathogen to a panel of antibiotics in as few as 3 h by utilizing fluorescent-labelling chemistry and a highly sensitive particle-counting instrument. We analysed 744 urine samples from the outpatients and inpatients of two Italian hospitals. The 130 UTI-positive patient urine samples we found were measured using a panel of six common UTI antibiotics plus a growth control. By comparing our results to hospital laboratory urine cultures, we obtained an overall sensitivity = 81%, a specificity = 83%, an SPV (sensitivity predicted value) = 95%, and an RPV (resistance predicted value) = 54%. According to our preliminary data, the sensitivity predicted value for a single antibiotic agent was 95%, thus allowing (in the vast majority of cases) an early (within 3 h) recognition of an effective agent for a single patient.https://www.mdpi.com/2079-6382/10/10/1168antibiotic susceptibility testurinary tract infectionfluorescencepoint-of-care diagnosisrapid diagnostic testing |
| spellingShingle | Eleonora Nicolai Massimo Pieri Enrico Gratton Guido Motolese Sergio Bernardini Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract Infections Antibiotics antibiotic susceptibility test urinary tract infection fluorescence point-of-care diagnosis rapid diagnostic testing |
| title | Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract Infections |
| title_full | Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract Infections |
| title_fullStr | Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract Infections |
| title_full_unstemmed | Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract Infections |
| title_short | Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract Infections |
| title_sort | bacterial infection diagnosis and antibiotic prescription in 3 h as an answer to antibiotic resistance the case of urinary tract infections |
| topic | antibiotic susceptibility test urinary tract infection fluorescence point-of-care diagnosis rapid diagnostic testing |
| url | https://www.mdpi.com/2079-6382/10/10/1168 |
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