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High-throughput and automated diagnosis of antimicrobial resistance using a cost-effective cellphone-based micro-plate reader
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High-throughput and automated diagnosis of antimicrobial resistance using a cost-effective cellphone-based micro-plate reader
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Journal Article
High-throughput and automated diagnosis of antimicrobial resistance using a cost-effective cellphone-based micro-plate reader
2016
Overview
Routine antimicrobial susceptibility testing (AST) can prevent deaths due to bacteria and reduce the spread of multi-drug-resistance, but cannot be regularly performed in resource-limited-settings due to technological challenges, high-costs, and lack of trained professionals. We demonstrate an automated and cost-effective cellphone-based 96-well microtiter-plate (MTP) reader, capable of performing AST without the need for trained diagnosticians. Our system includes a 3D-printed smartphone attachment that holds and illuminates the MTP using a light-emitting-diode array. An inexpensive optical fiber-array enables the capture of the transmitted light of each well through the smartphone camera. A custom-designed application sends the captured image to a server to automatically determine well-turbidity, with results returned to the smartphone in ~1 minute. We tested this mobile-reader using MTPs prepared with 17 antibiotics targeting Gram-negative bacteria on clinical isolates of
Klebsiella pneumoniae,
containing highly-resistant antimicrobial profiles. Using 78 patient isolate test-plates, we demonstrated that our mobile-reader meets the FDA-defined AST criteria, with a well-turbidity detection accuracy of 98.21%, minimum-inhibitory-concentration accuracy of 95.12%, and a drug-susceptibility interpretation accuracy of 99.23%, with no very major errors. This mobile-reader could eliminate the need for trained diagnosticians to perform AST, reduce the cost-barrier for routine testing, and assist in spatio-temporal tracking of bacterial resistance.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Accuracy
/ Anti-Bacterial Agents - pharmacology
/ Bacteria
/ Gram-Negative Bacteria - drug effects
/ Gram-Negative Bacteria - isolation & purification
/ Gram-Negative Bacterial Infections - diagnosis
/ Gram-Negative Bacterial Infections - microbiology
/ High-Throughput Screening Assays
/ Humanities and Social Sciences
/ Humans
/ Klebsiella pneumoniae - drug effects
/ Klebsiella pneumoniae - isolation & purification
/ Microarray Analysis - economics
/ Microarray Analysis - instrumentation
/ Microarray Analysis - methods
/ Microbial Sensitivity Tests - economics
/ Microbial Sensitivity Tests - instrumentation
/ Microbial Sensitivity Tests - methods
/ Nephelometry and Turbidimetry
/ Science
