Using silicon-based biosensors to detect host protein signatures capable of differentiating between bacterial and viral infection at point-of-care

The World Health Organisation has predicted that the rise of antimicrobial resistance (AMR) will claim up to 10 million lives by the year 2050. One of the key factors driving AMR emergence is the lack of a rapid diagnostic device capable of differentiating between bacterial and viral infection. A bacterial culture test is the current "gold standard", however it presents with various draw backs such as long time-to-positive results and risk of sample contamination. This leads to clinicians either delaying antibiotic treatment as they wait for confirmation or overprescribing broad spectrum antibiotics in cases of severe infection.

The ideal diagnostic device would be rapid and available at point-of-care with high sensitivity and specificity, however challenges with current diagnostics make these characteristics difficult to achieve. Primarily, they mostly rely on optical-based methods of detection which usually require bulky and expensive laboratory equipment and so often makes these assays unavailable at point-of-care. Additionally, direct detection of the causative pathogen may not be possible as some pathogens are incredibly invasive or inaccessible, especially in cases of tuberculosis.

Host protein signatures could bypass all these challenges and various host protein signatures have already been cited in literature. However, it is estimated that over 90% of discovered host biomarkers have not yet been applied successfully at point-of-care.

Combining host protein signatures with already leveraged complementary metal-oxide semiconductor technology (CMOS) (the leading technology used to manufacture everyday electronics) would make such devices incredibly cheap and scalable. CMOS technology is also compatible with ion sensitive field effect transistors (ISFETs), which can be used to detect changes in surface charge due to antigen-antibody binding and hence detect and quantify host proteins in real time.