Droplet microfluidics with image texture quantification for detection of rare antibiotic-resistant subpopulations from bloodstream infections

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Heteroresistance (HR) is an antibiotic resistance phenotype characterized by the presence of rare resistant subpopulations (frequency ≈ 10to 10) within a main susceptible bacterial population. During antibiotic exposure, these subpopulations can be enriched and cause treatment failure. Standard antibiotic susceptibility testing (AST) often fails to detect HR, and the current gold-standard population analysis profile (PAP) test is labor-intensive and time-consuming. We present a digital phenotyping approach combining droplet microfluidics with image texture to detect HR from clinical isolates, including Gram-negative () and Gram-positive () bacteria isolated from bloodstream infections. Our method achieves detection at subpopulation frequencies as low as 10in 12 to 30 h, depending on bacterial species, which is faster than the PAP test, together with single-cell resolution and high-throughput. This computationally assisted microfluidic platform enables rapid and accurate identification of HR, representing a step toward targeted antibiotic therapy in critical infections. Abs1