Rapid Detection
of Urinary Tract Infection in 10 min
by Tracking Multiple Phenotypic Features in a 30 s Large-Volume Scattering
Video of Urine Microscopy
Abstract Rapid point-of-care (POC) diagnosis of bacterial infection diseases provides clinical benefits of prompt initiation of antimicrobial therapy and reduction of the overuse/misuse of unnecessary antibiotics for nonbacterial infections. We present here a POC compatible method for rapid bacterial infection detection in 10 min. We use a large-volume solution scattering imaging (LVSi) system with low magnifications (1–2×) to visualize bacteria in clinical samples, thus eliminating the need for culture-based isolation and enrichment. We tracked multiple intrinsic phenotypic features of individual cells in a short video. By clustering these features with a simple machine learning algorithm, we can differentiate Escherichia coli from similar-sized polystyrene beads, distinguish bacteria with different shapes, and distinguish E. coli from urine particles. We applied the method to detect urinary tract infections in 104 patient urine samples with a 30 s LVSi video, and the results showed 92.3% accuracy compared with the clinical culture results. This technology provides opportunities for rapid bacterial infection diagnosis at POC settings.
Rapid Antimicrobial Susceptibility Testing on Clinical Urine Samples by Video-Based Object Scattering Intensity Detection
This work investigates the use of an intelligent and unobstructive sensing technique for maintaining vehicle cabin’s indoor air quality while simultaneously assessing the driver metabolic rate. CO2 accumulation patterns are of great interest because CO2 can have negative cognitive effects at higher concentrations and also since CO2 accumulation rate can potentially be used to determine a person’s metabolic rate. The management of the vehicle’s ventilation system was controlled by periodically alternating the air recirculation mode within the cabin, which was actuated based on the CO2 levels inside the vehicle’s cabin. The CO2 accumulation periods were used to assess the driver’s metabolic rate, using a model that considered the vehicle’s air exchange rate. In the process of the method optimization, it was found that the vehicle’s air exchange rate (λ [h−1]) depends on the vehicle speeds, following the relationship: λ = 0.060 × (speed) − 0.88 when driving faster than 17 MPH. An accuracy level of 95% was found between the new method to assess the driver’s metabolic rate (1620 ± 140 kcal/day) and the reference method of indirect calorimetry (1550 ± 150 kcal/day) for a total of N = 16 metabolic assessments at various vehicle speeds. The new sensing method represents a novel approach for unobstructive assessment of driver metabolic rate while maintaining indoor air quality within the vehicle cabin.
Direct Antimicrobial Susceptibility Testing on Clinical Urine Samples by Optical Tracking of Single Cell Division Events
Abstract With the increasing prevalence of antibiotic resistance, the need to develop antimicrobial susceptibility testing (AST) technologies is urgent. The current challenge has been to perform the antibiotic susceptibility testing in short time, directly with clinical samples, and with antibiotics over a broad dynamic range of clinically relevant concentrations. Here, a technology for point‐of‐care diagnosis of antimicrobial‐resistant bacteria in urinary tract infections, by imaging the clinical urine samples directly with an innovative large volume solution scattering imaging (LVSi) system and analyzing the image sequences with a single‐cell division tracking method is developed. The high sensitivity of single‐cell division tracking associated with large volume imaging enables rapid antibiotic susceptibility testing directly on the clinical urine samples. The results demonstrate direct detection of bacterial infections in 60 clinical urine samples with a 60 min LVSi video, and digital AST of 30 positive clinical samples with 100% categorical agreement with both the clinical culture results and the on‐site agar plating validation results. This technology provides opportunities for precise antibiotic prescription and proper treatment of the patient within a single clinic visit.
Gradient-Based Rapid Digital Immunoassay for High-Sensitivity Cardiac Troponin T (hs-cTnT) Detection in 1 μL Plasma
This work evaluates the use of a new flow meter to assess exhalation rate. A mobile indirect calorimeter (MIC) was designed and used to measure resting metabolic rate (RMR), which relies on the measure of O2 consumption rate (VO2) and CO2 production rate (VCO2). The device was produced from a commercially available and well-established indirect calorimeter and implemented with a new flow meter for the purpose of this study. VO2 and VCO2 were assessed by measuring exhalation rates using the new flow meter and O2 and CO2 concentrations in breath using the original colorimetric sensors of the indirect calorimeter. The new flow meter was based on a thermal flow meter (TFM) affixed to an orifice with a diameter of 6.8 mm used as a passage for exhaled breath from 16 subjects. The results were compared with a metabolic cart (Medical Graphics), which was connected in series to the modified device. We found that 69% of the results had more than a 10% difference between the modified MIC device and the reference instrument, suggesting that the sensitivity of the thermal flow meter changed over time, which precluded its use as a flow meter for breath flow rate measurement.
Phenotypic Antimicrobial Susceptibility Testing with Deep Learning Video Microscopy