MP20-10 A BIOSENSOR FOR RAPID AND SIMULTANEOUS UROPATHOGEN IDENTIFICATION AND CIPROFLOXACIN MINIMUM INHIBITORY CONCENTRATION DETERMINATION (2015)

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder II1 Apr 2015MP20-10 A BIOSENSOR FOR RAPID AND SIMULTANEOUS UROPATHOGEN IDENTIFICATION AND CIPROFLOXACIN MINIMUM INHIBITORY CONCENTRATION DETERMINATION Emanuela Altobelli, Ruchika Mohan, Kathleen Mach, Mandy La Yi Sin, Victoria Anikst, Maurizio Buscarini, Pak Kin Wong, Vincent Gau, Niaz Banaei, and Joseph C. Liao Emanuela AltobelliEmanuela Altobelli More articles by this author , Ruchika MohanRuchika Mohan More articles by this author , Kathleen MachKathleen Mach More articles by this author , Mandy La Yi SinMandy La Yi Sin More articles by this author , Victoria AnikstVictoria Anikst More articles by this author , Maurizio BuscariniMaurizio Buscarini More articles by this author , Pak Kin WongPak Kin Wong More articles by this author , Vincent GauVincent Gau More articles by this author , Niaz BanaeiNiaz Banaei More articles by this author , and Joseph C. LiaoJoseph C. Liao More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.982AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Standard urinary tract infection (UTI) diagnosis with culture requires 2–3 days for pathogen identification (ID) and antimicrobial susceptibility testing (AST) expressed as minimum inhibitory concentration (MIC). Members of the Enterobacteriaceae family are the causative pathogen in >80% of UTIs. Increased resistance to trimethoprim/sulfamethoxazole has led to increased use of ciprofloxacin (cipro). More rapid diagnostics will improve antimicrobial stewardship. Here, we further our work on rapid biosensor-based UTI diagnostics by integrating pathogen ID and AST with MIC into a simple biosensor assay with validation using patient samples. METHODS Urine with a single Enterobacteriaceae species and culture negative urine were obtained from Stanford clinical microbiology laboratory between November 2013 and September 2014. Urine was inoculated into media for culture without cipro and with different concentrations of cipro. After 5 hours, cultured urine was directly tested for pathogen ID and cipro MIC in a previously described 1-hour electrochemical biosensor assay. The biosensor array consists of 16 sensors each capable of detecting specific bacterial 16S rRNA through probe hybridization and electrochemical detection. Six of the sensors had probes for pathogen ID, including a universal bacterial probe, Enterobacteriaceae (EB) probe, and specific probes for E. coli, P. mirabilis, P. aeruginosa and E. faecalis. Six sensors were functionalized with the EB probe to measure the magnitude of signal after growth with and without antibiotic. The remaining sensors were negative and positive controls. Signals for pathogen ID at 6 standard deviations over background were considered positive. MIC signal 0.4 log units lower than the no antibiotic control indicated sensitivity. RESULTS Of the 107 urine samples, 84 were confirmed positive for Enterobacteriaceae and 23 negative. For pathogen ID, the biosensor assay demonstrated diagnostic sensitivity of 98.5%, specificity 96.6%, PPV 93.0% and NPV 99.3%. Cipro MIC achieved categorical agreement of 97.6% and essential agreement of 93.8%. CONCLUSIONS This biosensor platform is a promising tool in the management of UTI. By reducing the time for pathogen ID and MIC from 2–3 days to 6 hours, it has the potential to significantly improve clinical management of UTI with objective data. Future studies are needed for expansion to other pathogens-antibiotic combinations and prospectively collected urine samples. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e226-e227 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emanuela Altobelli More articles by this author Ruchika Mohan More articles by this author Kathleen Mach More articles by this author Mandy La Yi Sin More articles by this author Victoria Anikst More articles by this author Maurizio Buscarini More articles by this author Pak Kin Wong More articles by this author Vincent Gau More articles by this author Niaz Banaei More articles by this author Joseph C. Liao More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...