Phenotypic microbial response to antimicrobial exposure conditions with a molecular analysis quantification of species-specific 16S rRNA content.

The emergence and rapid spread of resistant bacteria has become a serious public health concern worldwide. Delayed antimicrobial therapy significantly increases mortality in high-risk infections with a particularly strong association with septic shock. Therefore, antimicrobial agents are often injudiciously used without any evidence-based microbiological confirmation. Antimicrobial consumption is strongly linked to the emergence and dissemination of antimicrobial-resistant bacteria strains in several epidemiological studies. According to CDC's recent publication, an estimated 30% of outpatient oral antimicrobial prescriptions may have been inappropriate. A compact and rapid pathogen identification (ID) and antimicrobial susceptibility testing (AST) can assist to address both the unnecessary use and overuse of antimicrobials, and therefore effectively reduce antimicrobial resistance. The overall goal of these AST protocols is to deliver a molecular diagnostic platform that is capable of profiling the antimicrobial susceptibility of causative pathogens in hours, not days. The presented AST utilizes an electrochemical sensor to quantify the microbial changes of 16S rRNA after exposure to various antimicrobial conditions either from clinical isolates or directly from unprocessed clinical specimens such as urine and blood. These protocols can be performed by our robotic lab automation systems or manual benchtop assays with associated reagent kits, AST stripwells and sensor chips.•A rapid, quantifiable antimicrobial efficacy profiling comparable to traditional AST reporting.•Customized antimicrobials and dilution ranges tailored to unique specifications for research and development.•Direct antimicrobial susceptibility of viable pathogen from whole blood, urine, or subculture.