Abstract
Bacterial antibiotic resistance is an important challenge that the healthcare system is continually battling and a major problem in the treatment of musculoskeletal infections such as periprosthetic joint infections. Current methods to identify infectious microbes and define susceptibility to antibiotics require two to ten days from isolation to the establishment of an antibiogram. This slow process limits advances in antimicrobial drug discovery and, in the clinical context, delays the delivery of targeted treatments, with potentially devastating outcomes for patients. With this in mind, we strived to establish a quicker and more sensitive method to deliver antibiotic susceptibility profiles of clinically relevant microbes using Scattered Light Integrated Collector (SLIC) technology. We established antibiotic panels to obtain an approximate identification of a wide variety of microbes linked to periprosthetic joint infections and determine their susceptibility to antibiotics. We challenged microbes isolated from patients with our tailored antibiotic panels and found that SLIC detects perturbations in bacterial growth accurately and reproducibly within minutes of culture. Indeed, we could show that SLIC can be used to measure the dose-dependent inhibitory or bacteriolytic activity of broad classes of antibiotics. Our panel design enabled us to establish a profile similar to an antibiogram for the tested bacteria within 90 min. Our method can provide information on the class of bacteria tested and potential treatment avenues in parallel. Our proof-of-principle experiments using isolated clinical strains of bacteria demonstrate that SLIC, together with our specifically designed antibiotic panels, could be used to rapidly provide information on the identity of an infecting microbe, such as those associated with periprosthetic joint infections, and guide physicians to prescribe targeted antibiotic treatment early-on. The constant emergence of resistant strains of bacteria pushes the pharmaceutical industry to develop further effective drugs. Our optimized method could significantly accelerate this work by characterizing the efficacy of new classes of compounds against bacterial viability within minutes, a timeframe far shorter than the current standards.