Needs Sarah Helen, Dönmez Sultan İlayda, Edwards Alexander Daniel
School of Pharmacy, University of Reading UK
RSC Adv. 2021 Nov 29;11(60):38258-38263. doi: 10.1039/d1ra06867a. eCollection 2021 Nov 23.
Rapid and portable direct tests for antibiotic resistance in human clinical samples such as urine could reduce misuse of precious antimicrobials, by allowing treatment decisions to be informed by microfluidic diagnostic tests. We demonstrate that the variable composition of human urine can significantly affect the antibiotic minimum inhibitory concentration (MIC) measured using microfluidic devices. The urine sample matrix interference was not observed in pooled normal urine, emphasising the critical importance of assessing matrix interference with a wide range of individual urine samples, rather than a few standardised or pooled controls. Both dilution into assay medium and inclusion of buffer could reduce the matrix interference, but dilution may affect analytical sensitivity by increasing the minimum bacterial cell density needed in a sample for growth to be detected, especially for miniaturised devices that test small sample volumes. We conclude it is vital to fully assess and optimise novel analytical microbiology tools using multiple individual urine samples, otherwise the high variation in matrix interference will compromise the clinical performance of these rapid diagnostics that are urgently needed to tackle the global threat of antimicrobial resistance.
针对尿液等人体临床样本中的抗生素耐药性进行快速且便携的直接检测，通过微流控诊断测试为治疗决策提供依据，可减少珍贵抗菌药物的滥用。我们证明，人类尿液的可变成分会显著影响使用微流控设备测得的抗生素最低抑菌浓度（MIC）。在混合的正常尿液中未观察到尿液样本基质干扰，这强调了评估大量个体尿液样本而非少数标准化或混合对照的基质干扰的至关重要性。稀释到测定培养基中以及加入缓冲液都可以减少基质干扰，但稀释可能会通过增加样本中检测生长所需的最小细菌细胞密度来影响分析灵敏度，特别是对于测试小样本量的小型化设备。我们得出结论，使用多个个体尿液样本全面评估和优化新型分析微生物学工具至关重要，否则基质干扰的高度变异性将损害这些快速诊断方法的临床性能，而这些方法对于应对全球抗生素耐药性威胁至关重要。
