Department of Clinical Diagnosis, Laboratory of Beijing Tiantan Hospital and Capital Medical University, Beijing, China.
Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China; National Engineering Research Center for Beijing Biochip Technology, Beijing 102206, China.
Int J Infect Dis. 2018 May;70:115-120. doi: 10.1016/j.ijid.2018.03.012. Epub 2018 Mar 17.
Post-neurosurgical meningitis (PNM) is one of the most severe hospital-acquired infections worldwide, and a large number of pathogens, especially those possessing multi-resistance genes, are related to these infections. Existing methods for detecting bacteria and measuring their response to antibiotics lack sensitivity and stability, and laboratory-based detection methods are inconvenient, requiring at least 24h to complete. Rapid identification of bacteria and the determination of their susceptibility to antibiotics are urgently needed, in order to combat the emergence of multi-resistant bacterial strains.
This study evaluated a novel, fast, and easy-to-use micro/nanofluidic chip platform (MNCP), which overcomes the difficulties of diagnosing bacterial infections in neurosurgery. This platform can identify 10 genus or species targets and 13 genetic resistance determinants within 1h, and it is very simple to operate. A total of 108 bacterium-containing cerebrospinal fluid (CSF) cultures were tested using the MNCP for the identification of bacteria and determinants of genetic resistance. The results were compared to those obtained with conventional identification and antimicrobial susceptibility testing methods.
For the 108 CSF cultures, the concordance rate between the MNCP and the conventional identification method was 94.44%; six species attained 100% consistency. For the production of carbapenemase- and extended-spectrum beta-lactamase (ESBL)-related antibiotic resistance genes, both the sensitivity and specificity of the MNCP tests were high (>90.0%) and could fully meet the requirements of clinical diagnosis.
The MNCP is fast, accurate, and easy to use, and has great clinical potential in the treatment of post-neurosurgical meningitis.
神经外科术后脑膜炎（PNM）是全球最严重的医院获得性感染之一，大量病原体，尤其是具有多重耐药基因的病原体，与这些感染有关。现有的细菌检测方法和测量抗生素反应的方法缺乏灵敏度和稳定性，基于实验室的检测方法不方便，至少需要 24 小时才能完成。迫切需要快速识别细菌并确定其对抗生素的敏感性，以对抗多耐药菌株的出现。
本研究评估了一种新型、快速、易于使用的微/纳流控芯片平台（MNCP），该平台克服了神经外科细菌感染诊断的困难。该平台可以在 1 小时内识别 10 个属或种目标和 13 个遗传耐药决定因素，操作非常简单。使用 MNCP 对 108 个含细菌的脑脊液（CSF）培养物进行了细菌和遗传耐药决定因素的鉴定，结果与常规鉴定和抗菌药物敏感性测试方法进行了比较。
对于 108 个 CSF 培养物，MNCP 与常规鉴定方法的一致性率为 94.44%；六种菌种达到了 100%的一致性。对于产生碳青霉烯酶和扩展谱β-内酰胺酶（ESBL）相关抗生素耐药基因，MNCP 试验的灵敏度和特异性均较高（>90.0%），完全满足临床诊断的要求。
MNCP 快速、准确、易于使用，在治疗神经外科术后脑膜炎方面具有巨大的临床潜力。
