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EBioMedicine. 2018 Oct;36:73-82. doi: 10.1016/j.ebiom.2018.09.001. Epub 2018 Sep 20.

Smartphone-based pathogen diagnosis in urinary sepsis patients.

Author information

1
Department of Molecular, Cellular, and Developmental Biology, Center for Nanomedicine, University of California, Santa Barbara, CA 93106, USA.
2
Department of Materials and Department of Mechanical Engineering, University of California, Santa Barbara, CA 93106, USA.
3
Department of Medical Education and Division of Infectious Diseases, Santa Barbara Cottage Hospital, Santa Barbara, CA 93105, USA.
4
Department of Microbiology, Pacific Diagnostic Laboratories, Santa Barbara, CA 93111, USA.
5
Department of Molecular, Cellular, and Developmental Biology, Center for Nanomedicine, University of California, Santa Barbara, CA 93106, USA; Sanford Burnham Prebys Medical Discovery Institute, Cancer Research Center, La Jolla, CA 92037, USA.
6
Department of Pulmonary and Critical Care Medicine, Santa Barbara Cottage Hospital, Santa Barbara, CA 93105, USA.
7
Department of Electrical Engineering and Department of Radiology, Stanford University, Stanford, CA 94305, USA. Electronic address: tsoh@stanford.edu.
8
Department of Molecular, Cellular, and Developmental Biology, Center for Nanomedicine, University of California, Santa Barbara, CA 93106, USA. Electronic address: michael.mahan@lifesci.ucsb.edu.

Abstract

BACKGROUND:

There is an urgent need for rapid, sensitive, and affordable diagnostics for microbial infections at the point-of-care. Although a number of innovative systems have been reported that transform mobile phones into potential diagnostic tools, the translational challenge to clinical diagnostics remains a significant hurdle to overcome.

METHODS:

A smartphone-based real-time loop-mediated isothermal amplification (smaRT-LAMP) system was developed for pathogen ID in urinary sepsis patients. The free, custom-built mobile phone app allows the phone to serve as a stand-alone device for quantitative diagnostics, allowing the determination of genome copy-number of bacterial pathogens in real time.

FINDINGS:

A head-to-head comparative bacterial analysis of urine from sepsis patients revealed that the performance of smaRT-LAMP matched that of clinical diagnostics at the admitting hospital in a fraction of the time (~1 h vs. 18-28 h). Among patients with bacteremic complications of their urinary sepsis, pathogen ID from the urine matched that from the blood - potentially allowing pathogen diagnosis shortly after hospital admission. Additionally, smaRT-LAMP did not exhibit false positives in sepsis patients with clinically negative urine cultures.

INTERPRETATION:

The smaRT-LAMP system is effective against diverse Gram-negative and -positive pathogens and biological specimens, costs less than $100 US to fabricate (in addition to the smartphone), and is configurable for the simultaneous detection of multiple pathogens. SmaRT-LAMP thus offers the potential to deliver rapid diagnosis and treatment of urinary tract infections and urinary sepsis with a simple test that can be performed at low cost at the point-of-care. FUND: National Institutes of Health, Chan-Zuckerberg Biohub, Bill and Melinda Gates Foundation.

KEYWORDS:

Smartphone-based pathogen diagnosis; Urinary diagnostic test; Urinary sepsis; Urinary tract infection

PMID:
30245056
PMCID:
PMC6197494
DOI:
10.1016/j.ebiom.2018.09.001
[Indexed for MEDLINE]
Free PMC Article

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