Login Tae Hyun Kim1,2†, Junwon Kang3,4†, Haewook Jang3†, Hyelyn Joo3, Gi Yoon Lee2, Hamin Kim3, Untack Cho5, Hyeeun Bang5, Jisung Jang5, Sangkwon Han5, Dong Young Kim5, Chan Mi Lee6, Chang Kyung Kang6, Pyoeng Gyun Choe6, Nam Joong Kim6, Myoung-don Oh6, Taek Soo Kim7, Inho Kim6*, Wan Beom Park6*, and Sunghoon Kwon1,2,3,5,8*
1Bio-MAX Institute, Seoul National University, Seoul, Korea
2Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea
3Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, Korea
4Integrated Major in Innovative Medical Science, Seoul National University, Seoul, Korea
5QuantaMatrix Inc., Seoul, Korea
6Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
7Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
8Inter-University Semiconductor Research Center, Seoul National University, Seoul, Korea
▶ Link : Blood culture-free ultra-rapid antimicrobial susceptibility testing | Nature
▶ Abstract
Treatment assessment and patient outcome for sepsis depend predominantly on the timely administration of appropriate antibiotics1,2,3. However, the clinical protocols used to stratify and select patient-specific optimal therapy are extremely slow4. In particular, the major hurdle in performing rapid antimicrobial susceptibility testing (AST) remains in the lengthy blood culture procedure, which has long been considered unavoidable due to the limited number of pathogens present in the patient’s blood. Here we describe an ultra-rapid AST method that bypasses the need for traditional blood culture, thereby demonstrating potential to reduce the turnaround time of reporting drug susceptibility profiles by more than 40–60 h compared with hospital AST workflows. Introducing a synthetic beta-2-glycoprotein I peptide, a broad range of microbial pathogens are selectively recovered from whole blood, subjected to species identification or instantly proliferated and phenotypically evaluated for various drug conditions using a low-inoculum AST chip. The platform was clinically evaluated by the enrolment of 190 hospitalized patients suspected of having infection, achieving 100% match in species identification. Among the eight positive cases, six clinical isolates were retrospectively tested for AST showing an overall categorical agreement of 94.90% with an average theoretical turnaround time of 13 ± 2.53 h starting from initial blood processing.