Frugal Innovation in Bioengineering for the Detection of Infectious Diseases by Arvind K. Chavali & Ramesh Ramji

Author:Arvind K. Chavali & Ramesh Ramji
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Different strains of sepsis-causing bacteria/fungi may require different treatments for effective therapies for right antibiotic administration. Recently, a novel microfluidic chip that could discriminate microbial pathogens, particularly for Salmonella enterica (S. enterica) serovars derived from whole blood of septic mice, was reported [21]. This microfluidic device supported isothermal amplification of S. enterica serovars’ genomic material. A microfluidic-based detection system for cell lysis and DNA extraction of Gram-positive and Gram-negative bacteria was also developed where the steps for DNA extraction, amplification, and even mixing are integrated into a single chip capable of detecting as low as ten colony-forming unit (CFU) of bacteria [22]. This is an improvement from a similar work where the limit of quantification was 100 CFU of bacteria [23]. Commercially available lab-on-chip system for DNA-based detection of ten sepsis-causing bacteria as well as methicillin-resistant strains of Staphylococcus aureus (S. aureus) from positive blood culture samples was also developed by ST Electronics [24].

Making use of mannose-binding lectin (MBL)-coated magnetic beads and subsequent magnetic flux concentrator, Candida albicans (C. albicans) fungi (99%) were captured in a microfluidic device to optimize optical imaging [25]. This strategy was also used to image E. coli using the shadow-based lens-free imaging platform [26]. The incorporation of magnetic markers with magnetoresistive sensors in microfluidic device for diagnosis of sepsis was also reported to detect for C. albicans [27].

Several groups have also capitalized on the biochemical composition in septic patients for diagnostics and monitoring. Evidence shows that excessive nitric oxide (NO) production plays a key role in the cardiovascular manifestations of severe sepsis [28]. An amperometric NO microfluidic sensor was fabricated to monitor changes in blood NO levels rapidly in small sample volumes [29]. Embedded magnetoresistive sensors were also created using magnetic coils and functionalized surfaces to detect four sepsis-related cytokines from 5 μL of whole blood quantification [30]. Another reported technique was using chemiluminiscent enzyme-linked immunosorbent assays (ELISAs) to detect for IL-8 [31].

As conventional antibiotic susceptibility tests usually require a few days, single-bacteria time-lapse imaging in a microfluidic channel was employed to determine the minimal inhibitory concentrations for each strain of S. aureus [32]. A gradient microfluidic that tested the inhibitory effects of antibiotics on bacterial growth was also developed to relate bacteria cell morphologies with their antibiotic response [33]. A size-exclusion microfilter to separate blood cells from bacteria that preserved 100% cell viability was also reported [34]. As it can be important to differentiate live from dead bacteria to prevent unnecessary administration of antibiotics, one group designed a microfluidic system based on ethidium monoazide-based assay and polymerase chain reaction (PCR) to probe for live bacteria from fluid isolated from periprosthetic joint infection with reported sensitivity of 104 CF/mL of joint fluid [35].

Sepsis can be associated with the systemic intravascular activation of coagulation [36]. Hence, it is crucial to understand the spatial distribution and location of tissue factor (TF), as well as the geometry of the vasculature that regulates coagulation. These factors can be useful means to determine the severity of sepsis. Shen et al.

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