Rapid microfluidic diagnostic tools for fighting antimicrobial resistance

Antimicrobial resistance (AMR) has been identified as the biggest societal challenge, being directly linked to the chronic over-consumption of antibiotics. It is believed that between 50-70% of antibiotics prescribed are likely to be unnecessary, due to reasons spanning from cultural to clinical factors. Firstly, it is clinically very difficult to differentiate bacterial from viral infections, as these have similar symptoms (however antibiotics have no action over virus particles), so selection of antibiotic type and dose is currently done empirically. Secondly, antibiotics are cheap, and patients often expect coming out from an appointment with a prescription. About 80-90% of antibiotics are prescribed within the primary care setting, which includes GPs and pharmacies. In some countries patients have direct access to antibiotics without prescription, which further eases the access to the drugs. Thirdly, the current gold-standard diagnostic tests for identification of bacterial infections and minimum inhibitory concentration testing relies on old fashion microbiological testing, which often requires 48-72hr.

This project will look at novel microfluidic diagnostic strategies that can help speeding up future development of rapid, point-of-care (POC) tests for fighting AMR. Two novel, fluoropolymer microfluidic platforms recently developed in Dr Reis lab will be explored for the development of new disruptive diagnostic devices. In particular the Lab-on-a-stick which uses dipstick multiplex strips for the identification of bacteria and performing antibiotic susceptibility testing, and the Lab-in-a-briefcase capable of measuring multiple protein biomarkers. New microbiological and bio-sensing protocols will be developed using techniques such as fluorescence and colorimetric detection. There is the opportunity to integrate these with various methods, for e.g. enzymes, quantum dots, fluorescence nanoparticles, modern optical cell sensing techniques and modern isothermal nucleic acid amplification. Chemical engineering concepts such as mass transfer, kinetics and fluid mechanics will be fundamental for development of the new microfluidic tests and will be modelled with numerical simulation and computational fluid dynamic tools e.g. COMSOL, ANSYS Fluent and MATLAB.

The market introduction of new medicines is not sufficient to keep up with the increase in drug resistance. Diagnosing and prescribing the right drug early on will slow the rise of drug resistance and also limit the transmission of infections. As defined by WHO, the ideal diagnostic test should meet the ASSURED policy (affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free and delivered) to reach the international standard for POC testing. POC tests will allow for reliable results in clinical and environmental settings, including developing countries who face challenges due to remote and low-resource settings.

This project is funded by the EPSRC who are engaging researchers in tackling AMR through a multidisciplinary approach. Within this scope, this project will be focused on the development of the next generation of innovative POC diagnostics to improve the stewardship of antibiotics.