Rhode Island Hospital, Alpert Medical School and Brown University, Providence, RI, United States.
BioMEMS Resource Center, Center for Engineering in Medicine and Surgical Services, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
Front Cell Infect Microbiol. 2019 Feb 12;9:27. doi: 10.3389/fcimb.2019.00027. eCollection 2019.
Systemic infections remain a leading cause of nosocomial infections in the United States and worldwide. Many challenges remain in achieving rapid, direct diagnosis of fungal bloodstream infections due to limitations of conventional diagnostic methods that continue to demonstrate poor sensitivity, prolonged culture times that lead to delayed treatment, and detection variability between tests that compromises result reproducibility. Despite advancements in technology, mortality, and cost of care presented by blood stream infection with spp. (candidemia) continues to rise and there is an urgent need for the development of novel methods to accurately detect species present within the blood. This is especially true when patients are infected with drug resistant strains of where accurate and immediate therapeutic treatment is of the importance. This study presents a method of separating fungal cells from lysed blood using inertial forces applied through microfluidics in order to abbreviate the time required to achieve a diagnosis by mitigating the need to grow blood cultures. We found that can segregate into a focused stream distinct from white blood cells isolated within the Inertial Fungal Focuser (IFF) after red blood cell lysis. As a result of the focusing process, the collected cells are also concentrated 2.86 times. The same IFF device is applicable to non- species: , and , providing both isolation from lysed blood and a reduction in solution volume. Thus, the devised platform provides a means to isolate medically significant fungal cells from blood and concentrate the cells for further interrogation.
系统性感染仍然是美国和全球医院获得性感染的主要原因。由于常规诊断方法的局限性,真菌性血流感染的快速直接诊断仍然面临许多挑战,这些方法的敏感性仍然较差,培养时间延长导致治疗延迟,并且检测之间的变异性会影响结果的可重复性。尽管技术有所进步,但由于 spp.(念珠菌血症)引起的血流感染的死亡率和治疗费用仍在不断上升,迫切需要开发新的方法来准确检测血液中的 物种。当患者感染耐药菌株时尤其如此,因为准确和即时的治疗非常重要。本研究提出了一种使用微流控技术通过惯性力从裂解的血液中分离真菌细胞的方法,以缩短通过减轻培养血液的需求来实现诊断所需的时间。我们发现,在红细胞裂解后, 可以通过惯性真菌聚焦器(IFF)分离成与白细胞分离的集中流。由于聚焦过程,收集的细胞也被浓缩了 2.86 倍。相同的 IFF 设备适用于非 物种: 、 和 ,既能从裂解的血液中分离出来,又能减少溶液体积。因此,该设计的平台提供了一种从血液中分离具有医学意义的真菌细胞并浓缩细胞进行进一步检测的方法。