Blood culture-free ultra-rapid antimicrobial susceptibility testing

Tae Hyun Kim, Junwon Kang, Haewook Jang, Hyelyn Joo, Gi Yoon Lee, Hamin Kim, Untack Cho, Hyeeun Bang, Jisung Jang, Sangkwon Han, Dong Young Kim, Chan Mi Lee, Chang Kyung Kang, Pyoeng Gyun Choe, Nam Joong Kim, Myoung-don Oh, Taek Soo Kim, Inho Kim (), Wan Beom Park () and Sunghoon Kwon ()
Additional contact information
Tae Hyun Kim: Seoul National University
Junwon Kang: Seoul National University
Haewook Jang: Seoul National University
Hyelyn Joo: Seoul National University
Gi Yoon Lee: Seoul National University
Hamin Kim: Seoul National University
Untack Cho: QuantaMatrix Inc.
Hyeeun Bang: QuantaMatrix Inc.
Jisung Jang: QuantaMatrix Inc.
Sangkwon Han: QuantaMatrix Inc.
Dong Young Kim: QuantaMatrix Inc.
Chan Mi Lee: Seoul National University College of Medicine
Chang Kyung Kang: Seoul National University College of Medicine
Pyoeng Gyun Choe: Seoul National University College of Medicine
Nam Joong Kim: Seoul National University College of Medicine
Myoung-don Oh: Seoul National University College of Medicine
Taek Soo Kim: Seoul National University College of Medicine
Inho Kim: Seoul National University College of Medicine
Wan Beom Park: Seoul National University College of Medicine
Sunghoon Kwon: Seoul National University

Nature, 2024, vol. 632, issue 8026, 893-902

Abstract: Abstract Treatment assessment and patient outcome for sepsis depend predominantly on the timely administration of appropriate antibiotics1–3. 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.

Date: 2024
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DOI: 10.1038/s41586-024-07725-1

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