Separation of Escherichia coli bacteria from peripheral blood mononuclear cells using standing surface acoustic waves

Advances in Host Depletion and Pathogen Enrichment Methods for Rapid Sequencing-Based Diagnosis of Bloodstream Infection

Bloodstream infection is a major cause of morbidity and death worldwide. Timely and appropriate treatment can reduce mortality among critically ill patients. Current diagnostic methods are too slow to inform precise antibiotic choice, leading to the prescription of empirical antibiotics, which may fail to cover the resistance profile of the pathogen, risking poor patient outcomes. Additionally, overuse of broad-spectrum antibiotics may lead to more resistant organisms, putting further pressure on the dwindling pipeline of antibiotics, and risk transmission of these resistant organisms in the health care environment. Therefore, rapid diagnostics are urgently required to better inform antibiotic choice early in the course of treatment. Sequencing offers great promise in reducing time to microbiological diagnosis; however, the amount of host DNA compared with the pathogen in patient samples presents a significant obstacle. Various host-depletion and bacterial-enrichment strategies have been used in samples, such as saliva, urine, or tissue. However, these methods have yet to be collectively integrated and/or extensively explored for rapid bloodstream infection diagnosis. Although most of these workflows possess individual strengths, their lack of analytical/clinical sensitivity and/or comprehensiveness demands additional improvements or synergistic application. This review provides a distinctive classification system for various methods based on their working principles to guide future research, and discusses their strengths and limitations and explores potential avenues for improvement to assist the reader in workflow selection.

Exploring operational boundaries for acoustic concentration of cell suspensions

The development of a standardized, generic method for concentrating suspensions in continuous flow is challenging. In this study, we developed and tested a device capable of concentrating suspensions with an already high cell concentration to meet diverse industrial requirements. To address typical multitasking needs, we concentrated suspensions with high solid content under a variety of conditions. Cells from Saccharomyces cerevisiae, Escherichia coli, and Chinese hamster ovary cells were effectively focused in the center of the main channel of a microfluidic device using acoustophoresis. The main channel bifurcates into three outlets, allowing cells to exit through the central outlet, while the liquid evenly exits through all outlets. Consequently, the treatment separates cells from two-thirds of the surrounding liquid. We investigated the complex interactions between parameters. Increasing the channel depth results in a decrease in process efficiency, attributed to a decline in acoustic energy density. The study also revealed that different cell strains exhibit distinct acoustic contrast factors, originating from differences in dimensions, compressibility, and density values. Finally, a combination of high solid content and flow rate leads to an increase in diffusion through a phenomenon known as shear-induced diffusion. KEY POINTS: • Acoustic focusing in a microchannel was used to concentrate cell suspensions • The parameters influencing focusing at high concentrations were studied • Three different cell strains were successfully concentrated.

EchoGrid: High-Throughput Acoustic Trapping for Enrichment of Environmental Microplastics

The health hazards of micro- and nanoplastic contaminants in drinking water has recently emerged as an area of concern to policy makers and industry. Plastic contaminants range in size from micro- (5 mm to 1 μm) to nanoplastics (<1 μm). Microfluidics provides many tools for particle manipulation at the microscale, particularly in diagnostics and biomedicine, but has in general a limited capacity to process large volumes. Drinking water and environmental samples with low-level contamination of microplastics require processing of deciliter to liter sample volumes to achieve statistically relevant particle counts. Here, we introduce the EchoGrid, an acoustofluidics device for high throughput continuous flow particle enrichment into a robust array of particle clusters. The EchoGrid takes advantage of highly efficient particle capture through the integration of a micropatterned transducer for surface displacement-based acoustic trapping in a glass and polymer microchannel. Silica seed particles were used as anchor particles to improve capture performance at low particle concentrations and high flow rates. The device was able to maintain the silica grids at a flow rate of 50 mL/min. In terms of enrichment, the device is able to double the final pellet's microplastic concentration every 78 s for 23 μm particles and every 51 s for 10 μm particles at a flow rate of 5 mL/min. In conclusion, we demonstrate the usefulness of the EchoGrid by capturing microplastics in challenging conditions, such as large sample volumes with low microparticle concentrations, without sacrificing the potential of integration with downstream analysis for environmental monitoring.

Acoustofluidic Actuation of Living Cells

Acoutofluidics is an increasingly developing and maturing technical discipline. With the advantages of being label-free, non-contact, bio-friendly, high-resolution, and remote-controllable, it is very suitable for the operation of living cells. After decades of fundamental laboratory research, its technical principles have become increasingly clear, and its manufacturing technology has gradually become popularized. Presently, various imaginative applications continue to emerge and are constantly being improved. Here, we introduce the development of acoustofluidic actuation technology from the perspective of related manipulation applications on living cells. Among them, we focus on the main development directions such as acoustofluidic sorting, acoustofluidic tissue engineering, acoustofluidic microscopy, and acoustofluidic biophysical therapy. This review aims to provide a concise summary of the current state of research and bridge past developments with future directions, offering researchers a comprehensive overview and sparking innovation in the field.

Integrated Rayleigh wave streaming-enhanced sensitivity of shear horizontal surface acoustic wave biosensors

Shear horizontal surface acoustic wave (SH-SAW) sensors are regarded as a promising alternative for label-free, sensitive, real time and low-cost detection. Nevertheless, achieving high sensitivity with SH-SAW has approached its limit imposed by the mass transport and probe-target affinity. We present here an SH-SAW biosensor accompanied by a unique Rayleigh wave-based actuator. The platform assembled on an ST-quartz substrate consists of dual-channel SH-SAW delay lines fabricated along a 90°-rotated direction, whilst another interdigital electrode (IDT) is orthogonally placed to generate Rayleigh waves so as to induce favourable streaming in the bio-chamber, enhancing the binding efficiency of the bio-target. Theoretical foundation and simulation have shown that Rayleigh acoustic streaming generates a level of agitation that accelerates the mass transport of the biomolecules to the surface. A fourfold improvement in sensitivity is achieved compared with conventional SH-SAW biosensors by means of complementary DNA hybridization with the aid of the Rayleigh wave device, giving a sensitivity level up to 6.15 Hz/(ng/mL) and a limit of detection of 0.617 ng/mL. This suggests that the proposed scheme could improve the sensitivity of SAW biosensors in real-time detection.

Bipolar Electrode-based Sheath-Less Focusing and Continuous Acoustic Sorting of Particles and Cells in an Integrated Microfluidic Device

Sheath-less focusing and sorting of cells or particles is an important preprocessing step in a variety of biochemical applications. Most of the previous sorting methods depend on the use of sheath flows to realize efficient cell focusing. The sheath flow dilutes the sample and requires precise flow control via additional channels. We, for the first time, reported a method of bipolar electrode (BPE)-based sheath-less focusing, switching, and tilted-angle standing surface acoustic wave-based sorting of cells and particles in continuous flow. The device consists of a piezoelectric substrate with a pair of BPEs for focusing and switching, and a pair of interdigitated transducers for cell sorting. Smaller cells experience a weak acoustic force and reach the lower outlet, whereas larger cells are subjected to a strong acoustic force such that they are propelled toward the upper outlet. We first validate the device functionality by sorting 5 and 8 μm PS beads with a high sorting efficiency. The working and deflection regions were increased by propelling the particle beam toward the bottom edge of BPE via changing the applied voltage of BPE, further improving the sorting performance with high efficiency (94%) and purity (92%). We then conducted a verification for sorting THP-1 and yeast cells, and the efficiency and purity reached 90.7 and 91.5%, respectively. This integrated device eliminates the requirement of balancing the flow of several sheath inlets and provides a robust and unique approach for cell sorting applications, showing immense promise in various applications, such as medical diagnosis, drug delivery, and personalized medicine.

A review of acoustofluidic separation of bioparticles

Acoustofluidics is an emerging interdisciplinary research field that involves the integration of acoustics and microfluidics to address challenges in various scientific areas. This technology has proven to be a powerful tool for separating biological targets from complex fluids due to its label-free, biocompatible, and contact-free nature. Considering a careful designing process and tuning the acoustic field particles can be separated with high yield. Recently the advancement of acoustofluidics led to the development of point-of-care devices for separations of micro particles which address many of the limitations of conventional separation tools. This review article discusses the working principles and different approaches of acoustofluidic separation and provides a synopsis of its traditional and emerging applications, including the theory and mechanism of acoustofluidic separation, blood component separation, cell washing, fluorescence-activated cell sorting, circulating tumor cell isolation, and exosome isolation. The technology offers great potential for solving clinical problems and advancing scientific research.

A multiplex Taqman PCR assay for MRSA detection from whole blood

Methicillin-resistant Staphylococcus aureus (MRSA) causes a wide range of hospital and community-acquired infections worldwide. MRSA is associated with worse clinical outcomes that can lead to multiple organ failure, septic shock, and death, making timely diagnosis of MRSA infections very crucial. In the present work, we develop a method that enables the positive enrichment of bacteria from spiked whole blood using protein coated magnetic beads, followed by their lysis, and detection by a real-time multiplex PCR directly. The assay targeted bacterial 16S rRNA, S. aureus (spa) and methicillin resistance (mecA). In addition, an internal control (lambda phage) was added to determine the assay's true negative. To validate this assay, staphylococcal and non-staphylococcal bacterial strains were used. The three-markers used in this study were detected as expected by monomicrobial and poly-microbial models of the S. aureus and coagulase-negative staphylococci (CoNS). The thermal cycling completed within 30 mins, delivering 100% specificity. The detection LoD of the pre-processing step was ∼ 1 CFU/mL from 2-5mL of whole blood and that of PCR was ∼ 1pg of NA. However, the combined protocol led to a lower detection limit of 100-1000 MRSA CFUs/mL. The main issue with the method developed is in the pre-processing of blood which will be the subject of our future study.

Development of an Optically Induced Dielectrophoresis (ODEP) Microfluidic System for High-Performance Isolation and Purification of Bacteria

For the rapid detection of bacteria in a blood sample, nucleic acid amplification-based assays are believed to be promising. Nevertheless, the nucleic acids released from the dead blood cells or bacteria could affect the assay performance. This highlights the importance of the isolation of live bacteria from blood samples. To address this issue, this study proposes a two-step process. First, a blood sample was treated with the immuno-magnetic microbeads-based separation to remove the majority of blood cells. Second, an optically induced dielectrophoresis (ODEP) microfluidic system with an integrated dynamic circular light image array was utilized to further isolate and purify the live bacteria from the remaining blood cells based on their size difference. In this work, the ODEP microfluidic system was developed. Its performance for the isolation and purification of bacteria was evaluated. The results revealed that the method was able to harvest the live bacteria in a high purity (90.5~99.2%) manner. Overall, the proposed method was proven to be capable of isolating and purifying high-purity live bacteria without causing damage to the co-existing cells. This technical feature was found to be valuable for the subsequent nucleic-acid-based bacteria detection, in which the interferences caused by the nontarget nucleic acids could be eliminated.

A discussion about the velocity distribution commonly used as the boundary condition in surface acoustic wave numerical simulations

Surface acoustic waves in combination with microfluidics has become an attractive research field regarding its various medical and biological applications. It is sometimes preferred to solve just the fluid domain and apply some boundary conditions to represent other components rather than performing a coupled numerical solution. To account for the piezoelectric actuation, a conventional velocity distribution built by superposing the left-going and right-going surface waves is commonly used as the boundary condition, its correctness is assessed here by comparing it to a coupled solution. It was shown that the actual leaky surface acoustic wave in coupled solution has different wavelengths in its real and imaginary parts, sometimes gets out of being sinusoidal, and has a different form compared to the superposed formula. For the phase differences other than 0 and π between the left and right electrodes, the distance between the electrodes affects the streaming and acoustic fields in the microchannel thereby leading to deviations in particle traces. Furthermore, the ratio of the horizontal to vertical components of the surface wave was extracted from the coupled solutions and compared to its previously reported values. The sensitivity analysis showed that for small particles, this ratio does not affect the streaming pattern but changes its velocity magnitude causing a time lag. For larger particles, the ratio altered the movement direction. This study suggests not replacing the piezoelectric actuation with the boundary condition to avoid inaccuracy in resulting fields that are being used in calculations of particle tracing and acoustic radiation forces.

Migration Study of Dielectrophoretically Manipulated Red Blood Cells in Tapered Aluminium Microelectrode Array: A Pilot Study

Dielectrophoresis (DEP) is one of the microfluid-based techniques that can manipulate the red blood cells (RBC) for blood plasma separation, which is used in many medical screening/diagnosis applications. The tapered aluminium microelectrode array (TAMA) is fabricated for potential sensitivity enhancement of RBC manipulation in lateral and vertical directions. In this paper, the migration properties of dielectrophoretically manipulated RBC in TAMA platform are studied at different peak-to-peak voltage (Vpp) and duration supplied onto the microelectrodes. Positive DEP manipulation is conducted at 440 kHz with the RBC of 4.00 ± 0.2 µm average radius attracted to the higher electric field intensity regions, which are the microelectrodes. High percentage of RBC migration occurred at longer manipulation time and high electrode voltage. During DEP manipulation, the RBC are postulated to levitate upwards, experience the electro-orientation mechanism and form the pearl chains before migrating to the electrodes. The presence of external forces other than the dielectrophoretic force may also affect the migration response of RBC. The safe operating limit of 10 Vpp and manipulation duration of ≤50 s prevent RBC rupture while providing high migration percentage. It is crucial to define the safe working region for TAMA devices that manipulate small RBC volume (~10 µL).

High-gradient magnetophoretic bead trapping for enhanced electrochemical sensing and particle manipulation

Magnetic particles are routinely used in many biochemical techniques. As such, the manipulation of these particles is of paramount importance for proper detection and assay preparation. This paper describes a magnetic manipulation and detection paradigm that allows sensing and handling highly sensitive magnetic bead-based assays. The simple manufacturing process presented in this manuscript employs a CNC machining technique and an iron microparticle-doped PDMS (Fe-PDMS) compound to create magnetic microstructures that enhance magnetic forces for magnetic bead confinement. Said confinement, generates increases in local concentrations at the detection site. Higher local concentrations increase the magnitude of the detection signal, leading to higher assay sensitivity and lower limit of detection (LOD). Furthermore, we demonstrate this characteristic signal enhancement in both fluorescence and electrochemical detection techniques. We expect this new technique to allow users to design fully integrated magnetic bead-based microfluidic devices with the goal of preventing sample losses and enhancing signal magnitudes in biological experiments and assays.

Acoustofluidics - changing paradigm in tissue engineering, therapeutics development, and biosensing

For more than 70 years, acoustic waves have been used to screen, diagnose, and treat patients in hundreds of medical devices. The biocompatible nature of acoustic waves, their non-invasive and contactless operation, and their compatibility with wide visualization techniques are just a few of the many features that lead to the clinical success of sound-powered devices. The development of microelectromechanical systems and fabrication technologies in the past two decades reignited the spark of acoustics in the discovery of unique microscale bio applications. Acoustofluidics, the combination of acoustic waves and fluid mechanics in the nano and micro-realm, allowed researchers to access high-resolution and controllable manipulation and sensing tools for particle separation, isolation and enrichment, patterning of cells and bioparticles, fluid handling, and point of care biosensing strategies. This versatility and attractiveness of acoustofluidics have led to the rapid expansion of platforms and methods, making it also challenging for users to select the best acoustic technology. Depending on the setup, acoustic devices can offer a diverse level of biocompatibility, throughput, versatility, and sensitivity, where each of these considerations can become the design priority based on the application. In this paper, we aim to overview the recent advancements of acoustofluidics in the multifaceted fields of regenerative medicine, therapeutic development, and diagnosis and provide researchers with the necessary information needed to choose the best-suited acoustic technology for their application. Moreover, the effect of acoustofluidic systems on phenotypic behavior of living organisms are investigated. The review starts with a brief explanation of acoustofluidic principles, the different working mechanisms, and the advantages or challenges of commonly used platforms based on the state-of-the-art design features of acoustofluidic technologies. Finally, we present an outlook of potential trends, the areas to be explored, and the challenges that need to be overcome in developing acoustofluidic platforms that can echo the clinical success of conventional ultrasound-based devices.

Recent microfluidic advances in submicron to nanoparticle manipulation and separation

Manipulation and separation of submicron and nanoparticles are indispensable in many chemical, biological, medical, and environmental applications. Conventional technologies such as ultracentrifugation, ultrafiltration, size exclusion chromatography, precipitation and immunoaffinity capture are limited by high cost, low resolution, low purity or the risk of damage to biological particles. Microfluidics can accurately control fluid flow in channels with dimensions of tens of micrometres. Rapid microfluidics advancement has enabled precise sorting and isolating of nanoparticles with better resolution and efficiency than conventional technologies. This paper comprehensively studies the latest progress in microfluidic technology for submicron and nanoparticle manipulation. We first summarise the principles of the traditional techniques for manipulating nanoparticles. Following the classification of microfluidic techniques as active, passive, and hybrid approaches, we elaborate on the physics, device design, working mechanism and applications of each technique. We also compare the merits and demerits of different microfluidic techniques and benchmark them with conventional technologies. Concurrently, we summarise seven standard post-separation detection techniques for nanoparticles. Finally, we discuss current challenges and future perspectives on microfluidic technology for nanoparticle manipulation and separation.

Optimization Analysis of Particle Separation Parameters for a Standing Surface Acoustic Wave Acoustofluidic Chip

Microparticle separation technology is an important technology in many biomedical and chemical engineering applications from sample detection to disease diagnosis. Although a variety of microparticle separation techniques have been developed thus far, surface acoustic wave (SAW)-based microfluidic separation technology shows great potential because of its high throughput, high precision, and integration with polydimethylsiloxane (PDMS) microchannels. In this work, we demonstrate an acoustofluidic separation chip that includes a piezoelectric device that generates tilted-angle standing SAWs and a permanently bonded PDMS microchannel. We established a mathematical model of particle motion in the microchannel, simulated the particle trajectory through finite element simulation and numerical simulation, and then verified the validity of the model through acoustophoresis experiments. To improve the performance of the separation chip, the influences of particle size, flow rate, and input power on the particle deflection distance were studied. These parameters are closely related to the separation purity and separation efficiency. By optimizing the control parameters, the separation of micron and submicron particles under different throughput conditions was achieved. Moreover, the separation samples were quantitatively analyzed by digital light scattering technology and flow cytometry, and the results showed that the maximum purity of the separated particles was ∼95%, while the maximum efficiency was ∼97%.

Droplet transportation by adjusting the temporal phase shift of surface acoustic waves in the exciter-exciter mode

Droplet actuation using Surface Acoustic Wave (SAW) technology has been widely employed in 'lab-on-a-chip' applications, such as for on-chip Polymerase Chain Reactions. The current strategy uses the exciter-absorber mode (exciting a single InterDigital Transducer, IDT) to form a pure Travelling Surface Acoustic Wave (TSAW) and to actuate the droplet, where the velocity and direction of the droplet can be adjusted by controlling the on-off and amplitude of the excitation signals applied to a pair of IDTs. Herein, in a way that is different from using the exciter-absorber mode, we propose a method of actuating droplets by using the exciter-exciter mode (exciting a pair of IDTs simultaneously), where the velocity and directional adjustment of the droplet can be realized by changing only one excitation parameter for the signals (the temporal phase shift, θ), and the droplet velocity can also be significantly improved. Specifically, we report for the first time the equation of the vibration of the mixed waves (TSAW and Standing Surface Acoustic Wave (SSAW)) formed on the substrate surface using the exciter-exciter mode. This is analyzed theoretically, where it is shown in this work that the amplitude and direction of the TSAW component of the mixed waves can be adjusted by changing θ. Following that, the velocity and directional adjustment of the droplet has been realized by changing θ and the improvement of the droplet velocity has been verified on a one-dimensional SAW device, using this exciter-exciter mode. Moreover a series of experiments on droplet transportation, along different trajectories in an x-y plane, has been carried out using a two-dimensional SAW device and this has demonstrated the effectiveness of the θ changing-based approach. Here this exciter-exciter mode provides an alternative method for the transportation of droplets in 'lab-on-a-chip' applications.

Acoustofluidic cell micro-dispenser for single cell trajectory control

The precise manipulation of individual cells is a key capability for the study of single cell physiological characteristics or responses to stimuli. Currently, only large cell populations can be transferred with certainty using expensive and laborious flow cytometry platforms. However, when approaching small populations of cells, this task becomes increasingly challenging. Here, we report an effective acoustofluidic micro-dispenser, utilising surface acoustic waves (SAWs), with the ability to trap and release cells on demand, which when combined with an external valve can guide the trajectory of individual cells. We demonstrate single cell trap and release with a single cell trapping effectiveness of 74%, enabling the capability of dispensing a highly controlled amount of cells without any harmful effects. This device has the potential to be easily integrated into a wide range of analytical platforms for applications such as single cell fluorescent imaging and single cell proteomic studies.

Active cell capturing for organ-on-a-chip systems: a review

Organ-on-a-chip (OOC) is an emerging technology that has been proposed as a new powerful cell-based tool to imitate the pathophysiological environment of human organs. For most OOC systems, a pivotal step is to culture cells in microfluidic devices. In active cell capturing techniques, external actuators, such as electrokinetic, magnetic, acoustic, and optical forces, or a combination of these forces, can be applied to trap cells after ejecting cell suspension into the microchannel inlet. This review paper distinguishes the characteristics of biomaterials and evaluates microfluidic technology. Besides, various types of OOC and their fabrication techniques are reported and various active cell capture microstructures are analyzed. Furthermore, their constraints, challenges, and future perspectives are provided.

Recent advances in acoustofluidic separation technology in biology

Acoustofluidic separation of cells and particles is an emerging technology that integrates acoustics and microfluidics. In the last decade, this technology has attracted significant attention due to its biocompatible, contactless, and label-free nature. It has been widely validated in the separation of cells and submicron bioparticles and shows great potential in different biological and biomedical applications. This review first introduces the theories and mechanisms of acoustofluidic separation. Then, various applications of this technology in the separation of biological particles such as cells, viruses, biomolecules, and exosomes are summarized. Finally, we discuss the challenges and future prospects of this field.

Acoustic sorting of airborne particles by a phononic crystal waveguide

A two-dimensional phononic crystal linear defect waveguide is utilized for size-based sorting of millimeter-sized solid particles in the air through acoustic radiation force. The waveguide channels ultrasonic waves at 20 kHz, as calculated through Finite-Element Method simulations. Spherical solid particles released from rest at the top of the vertically aligned waveguide experience the combined effect of the acoustic radiation, gravity, and drag forces. When the particles are released from the symmetry plane of the waveguide, they follow straight paths where the ones with radii smaller than a threshold value are trapped at the waveguide nodal planes, whereas larger particles are let pass through. This requires input sound pressure levels between 173 dB and 177 dB. Moreover, such particles can also be differentiated with respect to density. Alternatively, the release of particles with a slight offset from the symmetry center induces unbalanced acoustic radiation potential, and thus uneven radiation force, resulting in the initiation of horizontal displacement whose extent depends on particle radius. Thus, both simulation results and experimental findings suggest that this scheme can be employed in size-based particle separation. Sorting of spherical glass particles with 0.5 mm and 1.0 mm radii are experimentally demonstrated for low ultrasonic transducer acoustic power output up to 90 W. The proposed approach can be utilized in applications where contact-free separation of airborne particles is required.

A Digital Microfluidic Device Integrated with Electrochemical Impedance Spectroscopy for Cell-Based Immunoassay

The dynamic immune response to various diseases and therapies has been considered a promising indicator of disease status and therapeutic effectiveness. For instance, the human peripheral blood mononuclear cell (PBMC), as a major player in the immune system, is an important index to indicate a patient's immune function. Therefore, establishing a simple yet sensitive tool that can frequently assess the immune system during the course of disease and treatment is of great importance. This study introduced an integrated system that includes an electrochemical impedance spectroscope (EIS)-based biosensor in a digital microfluidic (DMF) device, to quantify the PBMC abundance with minimally trained hands. Moreover, we exploited the unique droplet manipulation feature of the DMF platform and conducted a dynamic cell capture assay, which enhanced the detection signal by 2.4-fold. This integrated system was able to detect as few as 104 PBMCs per mL, presenting suitable sensitivity to quantify PBMCs. This integrated system is easy-to-operate and sensitive, and therefore holds great potential as a powerful tool to profile immune-mediated therapeutic responses in a timely manner, which can be further evolved as a point-of-care diagnostic device to conduct near-patient tests from blood samples.

Diagnosis of Bloodstream Infections: An Evolution of Technologies towards Accurate and Rapid Identification and Antibiotic Susceptibility Testing

Bloodstream infections (BSI) are a leading cause of death worldwide. The lack of timely and reliable diagnostic practices is an ongoing issue for managing BSI. The current gold standard blood culture practice for pathogen identification and antibiotic susceptibility testing is time-consuming. Delayed diagnosis warrants the use of empirical antibiotics, which could lead to poor patient outcomes, and risks the development of antibiotic resistance. Hence, novel techniques that could offer accurate and timely diagnosis and susceptibility testing are urgently needed. This review focuses on BSI and highlights both the progress and shortcomings of its current diagnosis. We surveyed clinical workflows that employ recently approved technologies and showed that, while offering improved sensitivity and selectivity, these techniques are still unable to deliver a timely result. We then discuss a number of emerging technologies that have the potential to shorten the overall turnaround time of BSI diagnosis through direct testing from whole blood-while maintaining, if not improving-the current assay's sensitivity and pathogen coverage. We concluded by providing our assessment of potential future directions for accelerating BSI pathogen identification and the antibiotic susceptibility test. While engineering solutions have enabled faster assay turnaround, further progress is still needed to supplant blood culture practice and guide appropriate antibiotic administration for BSI patients.

Acoustic Biosensors and Microfluidic Devices in the Decennium: Principles and Applications

Lab-on-a-chip (LOC) technology has gained primary attention in the past decade, where label-free biosensors and microfluidic actuation platforms are integrated to realize such LOC devices. Among the multitude of technologies that enables the successful integration of these two features, the piezoelectric acoustic wave method is best suited for handling biological samples due to biocompatibility, label-free and non-invasive properties. In this review paper, we present a study on the use of acoustic waves generated by piezoelectric materials in the area of label-free biosensors and microfluidic actuation towards the realization of LOC and POC devices. The categorization of acoustic wave technology into the bulk acoustic wave and surface acoustic wave has been considered with the inclusion of biological sample sensing and manipulation applications. This paper presents an approach with a comprehensive study on the fundamental operating principles of acoustic waves in biosensing and microfluidic actuation, acoustic wave modes suitable for sensing and actuation, piezoelectric materials used for acoustic wave generation, fabrication methods, and challenges in the use of acoustic wave modes in biosensing. Recent developments in the past decade, in various sensing potentialities of acoustic waves in a myriad of applications, including sensing of proteins, disease biomarkers, DNA, pathogenic microorganisms, acoustofluidic manipulation, and the sorting of biological samples such as cells, have been given primary focus. An insight into the future perspectives of real-time, label-free, and portable LOC devices utilizing acoustic waves is also presented. The developments in the field of thin-film piezoelectric materials, with the possibility of integrating sensing and actuation on a single platform utilizing the reversible property of smart piezoelectric materials, provide a step forward in the realization of monolithic integrated LOC and POC devices. Finally, the present paper highlights the key benefits and challenges in terms of commercialization, in the field of acoustic wave-based biosensors and actuation platforms.

A microfluidic chip with a serpentine channel enabling high-throughput cell separation using surface acoustic waves

As an acute inflammatory response, sepsis may cause septic shock and multiple organ failure. Rapid and reliable detection of pathogens from blood samples can promote early diagnosis and treatment of sepsis. However, traditional pathogen detection methods rely on bacterial blood culture, which is complex and time-consuming. Although pre-separation of bacteria from blood can help with the identification of pathogens for diagnosis, the required low-velocity fluid environment of most separation techniques greatly limits the processing capacity for blood samples. Here, we present an acoustofluidic device for high-throughput bacterial separation from human blood cells. Our device utilizes a serpentine microfluidic design and standing surface acoustic waves (SSAWs), and separates bacteria from blood cells effectively based on their size difference. The serpentine microstructure allows the operating distance of the acoustic field to be multiplied in a limited chip size via the "spatial multiplexing" and "pressure node matching" of SSAW field. Microscopic observation and flow cytometry analysis shows that the device is helpful in improving the flow rate (2.6 μL min^-1 for blood samples; the corresponding velocity is ∼3 cm s^-1) without losing separation purity or cell recovery. The serpentine microfluidic design provides a compatible solution for high-throughput separation, which can synergize with other functional designs to improve device performance. Further, its advantages such as low cost, high biocompatibility, label-free separation and ability to integrate with on-chip biosensors are promising for clinical utility in point-of-care diagnostic platforms.

Integrated Point-of-Care Molecular Diagnostic Devices for Infectious Diseases

The global outbreaks of deadly infectious diseases caused by pathogenic microorganisms have threatened public health worldwide and significantly motivated scientists to satisfy an urgent need for a rapid and accurate detection of pathogens. Traditionally, the culture-based technique is considered as the gold standard for pathogen detection, yet it has a long turnaround time due to the overnight culturing and pathogen isolation. Alternatively, nucleic acid amplification tests provide a relatively shorter turnaround time to identify whether pathogens exist in individuals with high sensitivity and high specificity. In most cases, nucleic acid amplification tests undergo three steps: sample preparation, nucleic acid amplification, and signal transduction. Despite the explosive advancement in nucleic acid amplification and signal transduction technologies, the complex and labor-intensive sample preparation steps remain a bottleneck to create a transformative integrated point-of-care (POC) molecular diagnostic device. Researchers have attempted to simplify and integrate the sample preparations for nucleic acid-based molecular diagnostic devices with innovative progress in integration strategies, engineered materials, reagent storages, and fluid actuation. Therefore, understanding the know-how and obtaining truthful knowledge of existing integrated POC molecular diagnostic devices comprising sample preparations, nucleic acid amplification, and signal transduction can generate innovative solutions to achieve personalized precision medicine and improve global health.In this Account, we discuss the challenges of automated sample preparation solutions integrated with nucleic acid amplification and signal transduction for rapid and precise home diagnostics. Blood, nasal swab, saliva, urine, and stool are emphasized as the most commonly used clinical samples for integrated POC molecular diagnostics of infectious diseases. Even though these five types of samples possess relatively correlated biomarkers due to the human body's circulatory system, each shows unique properties and exclusive advantages for molecular diagnostics in specific situations, which are included in this Account. We examine different integrated POC devices for sample preparation, which includes pathogen isolation and enrichment from the crude sample and nucleic acid purification from isolated pathogens. We present the promising on-chip integration approaches for nucleic acid amplification. We also investigate the on-chip integration methods for reagent storage, which is crucial to simplify the manual operation for end-users. Finally, we present several integrated POC molecular diagnostic devices for infectious diseases. The integrated sample preparation and nucleic acid amplification approach reviewed here can potentially impact the next generation of POC molecular home diagnostic chips, which will significantly impact public health, emergency medicine, and global biosecurity.

Scaffold-free generation of heterotypic cell spheroids using acoustofluidics

3D cell cultures such as cell spheroids are widely used for tissue engineering, regenerative medicine, and translational medicine, but challenges remain in recapitulating the architectural complexity and spatiotemporal heterogeneity of tissues. Thus, we developed a scaffold-free and versatile acoustofluidic device to fabricate heterotypic cell spheroids with complexity over cell architectures and components. By varying the concentrations of cell suspension, we can precisely control the size of spheroids aggregated by a contact-free acoustic radiation force. By tuning the cell components including tumor cells, fibroblasts, and endothelial cells, heterotypic spheroids were controllably fabricated. These heterotypic spheroids can be used as a proof-of concept to model the spatial organization of tumor tissues. We demonstrated that the assembled components can self-assemble into layered structures as instructed by their cadherin expression. Finally, we demonstrated the acoustic assembly of mouse mammary gland components into spheroids and observed their maturation in culture. To conclude, we developed an acoustofluidic platform to fabricate complex spheroids with multiple components. We envision that this platform will pave the way for the high accuracy of spheroid fabrication and offer broad applications in numerous areas, such as tumor research, tissue engineering, developmental biology, and drug discovery.

Surface acoustic wave (SAW) techniques in tissue engineering

Recently, the introduction of surface acoustic wave (SAW) technique for microfluidics has drawn a lot of attention. The pattern and mutual communication in cell layers, tissues, and organs play a critical role in tissue homeostasis and regeneration and may contribute to disease occurrence and progression. Tissue engineering aims to repair and regenerate damaged organs, depending on biomimetic scaffolds and advanced fabrication technology. However, traditional bioengineering synthesis approaches are time-consuming, heterogeneous, and unmanageable. It is hard to pattern cells in scaffolds effectively with no impact on cell viability and function. Here, we summarize a biocompatible, easily available, label-free, and non-invasive tool, surface acoustic wave (SAW) technique, which is getting a lot of attention in tissue engineering. SAW technique can realize accurate sorting, manipulation, and cells' pattern and rapid formation of spheroids. By integrating several SAW devices onto lab-on-a-chip platforms, tissue engineering lab-on-a-chip system was proposed. To the best of our knowledge, this is the first report to summarize the application of this novel technique in the field of tissue engineering.

The Yin and Yang of exosome isolation methods: conventional practice, microfluidics, and commercial kits

Exosomes are a subset of extracellular vesicles released from various cells, and they can be found in different bodily fluids. Exosomes are used as biomarkers to diagnose many diseases and to monitor therapy efficiency as they represent the status and origin of the cell, which they are released from. Considering that they co-exist in bodily fluids with other types of particles, their isolation still remains challenging since conventional separation methods are time-consuming, user-dependent, and result in low isolation yield. This review summarizes the conventional strategies and microfluidic-based methods for exosome isolation along with their strengths and limitations. Microfluidic devices emerge as a promising approach to overcome the limitations of the conventional methods due to their inherent characteristics, such as the need for minute sample volume and rapid operation, in order to isolate exosomes with a high yield and a high purity in a short amount of time, which make them unprecedented tools for molecular biology and clinical applications. This review elaborates on the existing microfluidic-based exosome isolation methods and denotes their benefits and drawbacks. Herein, we also introduce various commercially available platforms and kits for exosome isolation along with their working principles.

Unconventional acoustic approaches for localized and designed micromanipulation

Acoustic fields are ideal for micromanipulation, being biocompatible and with force gradients approaching the scale of single cells. They have accordingly found use in a variety of microfluidic devices, including for microscale patterning, separation, and mixing. The bulk of work in acoustofluidics has been predicated on the formation of standing waves that form periodic nodal positions along which suspended particles and cells are aligned. An evolving range of applications, however, requires more targeted micromanipulation to create unique patterns and effects. To this end, recent work has made important advances in improving the flexibility with which acoustic fields can be applied, impressively demonstrating generating arbitrary arrangements of pressure fields, spatially localizing acoustic fields and selectively translating individual particles in ways that are not achievable via traditional approaches. In this critical review we categorize and examine these advances, each of which open the door to a wide range of applications in which single-cell fidelity and flexible micromanipulation are advantageous, including for tissue engineering, diagnostic devices, high-throughput sorting and microfabrication.

Label-Free Multitarget Separation of Particles and Cells under Flow Using Acoustic, Electrophoretic, and Hydrodynamic Forces

Multiplex separation of mixed biological samples is essential in a considerable portion of biomedical research and clinical applications. An automated and operator-independent process for the separation of samples is highly sought after. There is a significant unmet need for methods that can perform fractionation of small volumes of multicomponent mixtures. Herein, we design an integrated chip that combines acoustic and electric fields to enable efficient and label-free separation of multiple different cells and particles under flow. To facilitate the connection of multiple sorting mechanisms in tandem, we investigate the electroosmosis (EO)-induced deterministic lateral displacement (DLD) separation in a combined pressure- and DC field-driven flow and exploit the combination of the bipolar electrode (BPE) focusing and surface acoustic wave (SAW) sorting modules. We successfully integrate four sequential microfluidic modules for multitarget separation within a single platform: (i) sorting particles and cells relying on the size and surface charge by adjusting the flow rate and electric field using a DLD array; (ii) alignment of cells or particles within a microfluidic channel by a bipolar electrode; (iii) separation of particles based on compressibility and density by the acoustic force; and (iv) separation of viable and nonviable cells using dielectric properties via the dielectrophoresis (DEP) force. As a proof of principle, we demonstrate the sorting of multiple cell and particle types (polystyrene (PS) particles, oil droplets, and viable and nonviable yeast cells) with high efficiency. This integrated microfluidic platform combines multiple functional components and, with its ability to noninvasively sort multiple targeted cells in a label-free manner relying on different properties, is compatible with high-definition imaging, showing great potential in diverse diagnostic and analysis applications.

Theory of acoustophoresis in counterpropagating surface acoustic wave fields for particle separation

Acousotophoretic particle separations in counterpropagating surface acoustic wave (SAW) fields, e.g., standing SAWs (SSAWs), phase modulated SSAWs, tilted angle SSAWs, and partial standing SAWs, have proven successful. But there still lacks analytical tools for predicting the particle trajectory and optimizing the device designs. Here, we study the acoustophoresis of spherical Rayleigh particles in counterpropagating SAW fields and find that particle motions can be characterized into two distinct modes, the drift mode and the locked mode. Through theoretical studies, we provide analytical expressions of particle trajectories in different fields and different moving patterns. Based on these, we obtain theory-based protocols for designing such SAW acoustofluidic particle separation chips, which are demonstrated through finite-element simulations. The results here provide theoretical guidelines for designing high throughput and high efficiency particle separation devices.

AC Insulator-Based Dielectrophoretic Focusing of Particles and Cells in an "Infinite" Microchannel

It is often necessary to prefocus particles and cells into a tight stream for subsequent separation and/or analysis in microfluidic devices. A DC electric field has been widely used for particle and cell focusing in insulator-based dielectrophoretic (iDEP) microdevices, where a large field magnitude, a high constriction ratio, and/or a long microchannel are usually required to enhance the iDEP effect. We demonstrate, in this work, an AC iDEP focusing technique, which utilizes a low-frequency AC electric field to generate both an oscillatory electrokinetic flow of the particle/cell suspension and a field direction-independent dielectrophoretic force for particle/cell focusing in a virtually "infinite" microchannel. We also develop a theoretical analysis to evaluate this focusing in terms of the AC voltage frequency, amplitude, and particle size, which are each validated through both experimental demonstration and numerical simulation. The effectiveness of AC iDEP focusing increases with the second order of electric field magnitude, superior to DC iDEP focusing with only a first-order dependence. This feature and the "infinite" channel length together remove the necessity of large electric field and/or small constriction in DC iDEP focusing of small particles.

Label-Free Multivariate Biophysical Phenotyping-Activated Acoustic Sorting at the Single-Cell Level

Biophysical markers of cells such as cellular electrical and mechanical properties have been proven as promising label-free biomarkers for studying, characterizing, and classifying different cell types and even their subpopulations. Further analysis or manipulation of specific cell types or subtypes requires accurate isolation of them from the original heterogeneous samples. However, there is currently a lack of cell sorting ability that could actively separate a large number of individual cells at the single-cell level based on their multivariate biophysical makers or phenotypes. In this work, we, for the first time, demonstrate label-free and high-throughput acoustic single-cell sorting activated by the characterization of multivariate biophysical phenotypes. Electrical phenotyping is implemented by single-cell electrical impedance characterization with two pairs of differential sensing electrodes, while mechanical phenotyping is performed by extracting the transit time for the single cell to pass through microconstriction from the recorded impedance signals. A real-time impedance signal processing and triggering algorithm has been developed to identify the target sample population and activate a pulsed highly focused surface acoustic wave for single-cell level sorting. We have demonstrated acoustic single-particle sorting solely based on electrical or mechanical phenotyping. Furthermore, we have applied the developed microfluidic system to sort live MCF-7 cells from a mixture of fixed and live MCF-7 population activated by a combined electrical and mechanical phenotyping at a high throughput >100 cells/s and purity ∼91.8%. This demonstrated ability to analyze and sort cells based on multivariate biophysical phenotyping provides a solution to the current challenges of cell purification that lack specific molecular biomarkers.

Integrated microfluidic platform with electrohydrodynamic focusing and a carbon-nanotube-based field-effect transistor immunosensor for continuous, selective, and label-free quantification of bacteria

Electrokinetic technologies such as AC electro-osmosis (EO) and dielectrophoresis (DEP) have been used for effective manipulation of bacteria to enhance the sensitivity of an assay, and many previously reported electrokinetics-enhanced biosensors are based on stagnant fluids. An effective region for positive DEP for particle capture is usually too close to the electrode for the flowing particles to move toward the detection zone of a biosensor against the flow direction; this poses a technical challenge for electrokinetics-assisted biosensors implemented within pressure-driven flows, especially if the particles flow with high speed and if the detection zone is small. Here, we present a microfluidic single-walled carbon nanotube (SWCNT)-based field-effect transistor immunosensor with electrohydrodynamic (EHD) focusing and DEP concentration for continuous and label-free detection of flowing Staphylococcus aureus in a 0.01× phosphate buffered saline (PBS) solution. The EHD focusing involved AC EO and negative DEP to align the flowing particles along lines close to the bottom surface of a microfluidic channel for facilitating particle capture downstream at the detection zone. For feasibility, 380 nm-diameter fluorescent beads suspended in 0.001× PBS were tested, and 14.6 times more beads were observed to be concentrated in the detection area with EHD focusing. Moreover, label-free, continuous, and selective measurement of S. aureus in 0.01× PBS was demonstrated, showing good linearity between the relative changes in electrical conductance of the SWCNTs and logarithmic S. aureus concentrations, a capture/detection time of 35 min, and a limit of detection of 150 CFU mL-1, as well as high specificity through electrical manipulation and biological interaction.

Thin film Gallium nitride (GaN) based acoustofluidic Tweezer: Modelling and microparticle manipulation

Gallium nitride (GaN) is a compound semiconductor which shows advantages in new functionalities and applications due to its piezoelectric, optoelectronic, and piezo-resistive properties. This study develops a thin film GaN-based acoustic tweezer (GaNAT) using surface acoustic waves (SAWs) and demonstrates its acoustofluidic ability to pattern and manipulate microparticles. Although the piezoelectric performance of the GaNAT is compromised compared with conventional lithium niobate-based SAW devices, the inherited properties of GaN allow higher input powers and superior thermal stability. This study shows for the first time that thin film GaN is suitable for the fabrication of the acoustofluidic devices to manipulate microparticles with excellent performance. Numerical modelling of the acoustic pressure fields and the trajectories of mixtures of microparticles driven by the GaNAT was performed and the results were verified from the experimental studies using samples of polystyrene microspheres. The work has proved the robustness of thin film GaN as a candidate material to develop high-power acoustic tweezers, with the potential of monolithical integration with electronics to offer diverse microsystem applications.

Acoustofluidic Holography for Micro- to Nanoscale Particle Manipulation

Acoustic-based techniques can manipulate particles in a label-free, contact-free, and biocompatible manner. However, most previous work in acoustic manipulation has been constrained by axisymmetric patterns of pressure nodes and antinodes. Acoustic holography is an emerging technique that offers the potential to generate arbitrary pressure distributions which can be applied to particle manipulation with higher degrees of freedom. However, since current acoustic holography techniques rely on acoustic radiation forces, which decrease dramatically when the target particle size decreases, they have difficulty manipulating particles in the micro/nanoscale. Here, we introduce a holography technique that leverages both an arbitrary acoustic field and controllable fluid motion to offer an effective approach for manipulating micro/nano particles. Our approach, termed acoustofluidic holography (AFH), can manipulate a variety of materials, including cells, polymers, and metals, across sizes ranging from hundreds of micrometers to tens of nanometers.

Antibody Conjugate Assembly on Ultrasound-Confined Microcarrier Particles

Bioconjugates are important next-generation drugs and imaging agents. Assembly of these increasingly complex constructs requires precise control over processing conditions, which is a challenge for conventional manual synthesis. This inadequacy has motivated the pursuit of new approaches for efficient, controlled modification of high-molecular-weight biologics such as proteins, carbohydrates, and nucleic acids. We report a novel, hands-free, semiautomated platform for synthetic manipulation of biomolecules using acoustically responsive microparticles as three-dimensional reaction substrates. The microfluidic reactor incorporates a longitudinal acoustic trap that controls the chemical reactions within a localized acoustic field. Forces generated by this field immobilize the microscale substrates against the continuous flow of participating chemical reagents. Thus, the motion of substrates and reactants is decoupled, enabling exquisite control over multistep reaction conditions and providing high-yield, high-purity products with minimal user input. We demonstrate these capabilities by conjugating clinically relevant antibodies with a small molecule. The on-bead synthesis comprises capture of the antibody, coupling of a fluorescent tag, product purification, and product release. Successful capture and modification of a fluorescently labeled antibody are confirmed via fold increases of 49 and 11 in the green (antibody)- and red (small-molecule dye)-channel median intensities determined using flow cytometry. Antibody conjugates assembled on acoustically responsive, ultrasound-confined microparticles exhibit similar quality and quantity to those prepared manually by a skilled technician.

Acoustic Microfluidic Separation Techniques and Bioapplications: A Review

Microfluidic separation technology has garnered significant attention over the past decade where particles are being separated at a micro/nanoscale in a rapid, low-cost, and simple manner. Amongst a myriad of separation technologies that have emerged thus far, acoustic microfluidic separation techniques are extremely apt to applications involving biological samples attributed to various advantages, including high controllability, biocompatibility, and non-invasive, label-free features. With that being said, downsides such as low throughput and dependence on external equipment still impede successful commercialization from laboratory-based prototypes. Here, we present a comprehensive review of recent advances in acoustic microfluidic separation techniques, along with exemplary applications. Specifically, an inclusive overview of fundamental theory and background is presented, then two sets of mechanisms underlying acoustic separation, bulk acoustic wave and surface acoustic wave, are introduced and discussed. Upon these summaries, we present a variety of applications based on acoustic separation. The primary focus is given to those associated with biological samples such as blood cells, cancer cells, proteins, bacteria, viruses, and DNA/RNA. Finally, we highlight the benefits and challenges behind burgeoning developments in the field and discuss the future perspectives and an outlook towards robust, integrated, and commercialized devices based on acoustic microfluidic separation.

Recent advances in microfluidic technologies for separation of biological cells

Cell separation has always been a key topic in academic research, especially in the fields of medicine and biology, due to its significance in diagnosis and treatment. Accurate, high-throughput and non-invasive separation of individual cells is key to driving the development of biomedicine and cellular biology. In recent years, a series of researches on the use of microfluidic technologies for cell separation have been conducted to solve bio-related problems. Hence, we present here a comprehensive review on the recent developments of microfluidic technologies for cell separation. In this review, we discuss several cell separation methods, mainly including: physical and biochemical method, their working principles as well as their practical applications. We also analyze the advantages and disadvantages of each method in detail. In addition, the current challenges and future prospects of microfluidic-based cell separation were discussed.

The complexity of surface acoustic wave fields used for microfluidic applications

Using surface acoustic waves (SAW) for the agitation and manipulation of fluids and immersed particles or cells in lab-on-a-chip systems has been state of the art for several years. Basic tasks comprise fluid mixing, atomization of liquids as well as sorting and separation (or trapping) of particles and cells, e.g. in so-called acoustic tweezers. Even though the fundamental principles governing SAW excitation and propagation on anisotropic, piezoelectric substrates are well-investigated, the complexity of wave field effects including SAW diffraction, refraction and interference cannot be comprehensively simulated at this point of time with sufficient accuracy. However, the design of microfluidic actuators relies on a profound knowledge of SAW propagation, including superposition of multiple SAWs, to achieve the predestined functionality of the devices. Here, we present extensive experimental results of high-resolution analysis of the lateral distribution of the complex displacement amplitude, i.e. the wave field, alongside with the electrical S-parameters of the generating transducers. These measurements were carried out and are compared in setups utilizing travelling SAW (tSAW) excited by single interdigital transducer (IDT), standing SAW generated between two IDTs (1DsSAW, 1D acoustic tweezers) and between two pairs of IDTs (2DsSAW, 2D acoustic tweezers) with different angular alignment in respect to pure Rayleigh mode propagation directions and other practically relevant orientations. For these basic configurations, typically used to drive SAW-based microfluidics, the influence of common SAW phenomena including beam steering, coupling coefficient dispersion and diffraction on the resultant wave field is investigated. The results show how tailoring of the acoustic conditions, based on profound knowledge of the physical effects, can be achieved to finally realize a desired behavior of a SAW-based microacoustic-fluidic system.

Microfluidic-Based Approaches in Targeted Cell/Particle Separation Based on Physical Properties: Fundamentals and Applications

Cell separation is a key step in many biomedical research areas including biotechnology, cancer research, regenerative medicine, and drug discovery. While conventional cell sorting approaches have led to high-efficiency sorting by exploiting the cell's specific properties, microfluidics has shown great promise in cell separation by exploiting different physical principles and using different properties of the cells. In particular, label-free cell separation techniques are highly recommended to minimize cell damage and avoid costly and labor-intensive steps of labeling molecular signatures of cells. In general, microfluidic-based cell sorting approaches can separate cells using "intrinsic" (e.g., fluid dynamic forces) versus "extrinsic" external forces (e.g., magnetic, electric field, etc.) and by using different properties of cells including size, density, deformability, shape, as well as electrical, magnetic, and compressibility/acoustic properties to select target cells from a heterogeneous cell population. In this work, principles and applications of the most commonly used label-free microfluidic-based cell separation methods are described. In particular, applications of microfluidic methods for the separation of circulating tumor cells, blood cells, immune cells, stem cells, and other biological cells are summarized. Computational approaches complementing such microfluidic methods are also explained. Finally, challenges and perspectives to further develop microfluidic-based cell separation methods are discussed.

A disposable acoustofluidic chip for nano/microparticle separation using unidirectional acoustic transducers

Separation of nano/microparticles based on surface acoustic waves (SAWs) has shown great promise for biological, chemical, and medical applications ranging from sample purification to cancer diagnosis. However, the permanent bonding of a microchannel onto relatively expensive piezoelectric substrates and excitation transducers renders the SAW separation devices non-disposable. This limitation not only requires cumbersome cleaning and increased labor and material costs, but also leads to cross-contamination, preventing their implementation in many biological, chemical, and medical applications. Here, we demonstrate a high-performance, disposable acoustofluidic platform for nano/microparticle separation. Leveraging unidirectional interdigital transducers (IDTs), a hybrid channel design with hard/soft materials, and tilted-angle standing SAWs (taSSAWs), our disposable acoustofluidic devices achieve acoustic radiation forces comparable to those generated by existing permanently bonded, non-disposable devices. Our disposable devices can separate not only microparticles but also nanoparticles. Moreover, they can differentiate bacteria from human red blood cells (RBCs) with a purity of up to 96%. Altogether, we developed a unidirectional IDT-based, disposable acoustofluidic platform for micro/nanoparticle separation that can achieve high separation efficiency, versatility, and biocompatibility.

Rapid Escherichia coli Trapping and Retrieval from Bodily Fluids via a Three-Dimensional Bead-Stacked Nanodevice

A novel micro- and nanofluidic device stacked with magnetic beads has been developed to efficiently trap, concentrate, and retrieve Escherichia coli (E. coli) from the bacterial suspension and pig plasma. The small voids between the magnetic beads are used to physically isolate the bacteria in the device. We used computational fluid dynamics, three-dimensional (3D) tomography technology, and machine learning to probe and explain the bead stacking in a small 3D space with various flow rates. A combination of beads with different sizes is utilized to achieve a high capture efficiency (∼86%) with a flow rate of 50 μL/min. Leveraging the high deformability of this device, an E. coli sample can be retrieved from the designated bacterial suspension by applying a higher flow rate followed by rapid magnetic separation. This unique function is also utilized to concentrate E. coli cells from the original bacterial suspension. An on-chip concentration factor of ∼11× is achieved by inputting 1300 μL of the E. coli sample and then concentrating it in 100 μL of buffer. Importantly, this multiplexed, miniaturized, inexpensive, and transparent device is easy to fabricate and operate, making it ideal for pathogen separation in both laboratory and point-of-care settings.

Cell lysis via acoustically oscillating sharp edges

In this article, we demonstrate an acoustofluidic device for cell lysis using the acoustic streaming effects induced by acoustically oscillating sharp-edged structures. The acoustic streaming locally generates high shear forces that can mechanically rupture cell membranes. With the acoustic-streaming-derived shear forces, our acoustofluidic device can perform cell lysis in a continuous, reagent-free manner, with a lysis efficiency of more than 90% over a range of sample flow rates. We demonstrate that our acoustofluidic lysis device works well on both adherent and non-adherent cells. We also validate it using clinically relevant samples such as red blood cells infected with malarial parasites. Additionally, the unique capability of our acoustofluidic device was demonstrated by performing downstream protein analysis and gene profiling without additional washing steps post-lysis. Our device is simple to fabricate and operate while consuming a relatively low volume of samples. These advantages and other features including the reagent-free nature and controllable lysis efficiency make our platform valuable for many biological and biomedical applications, particularly for the development of point-of-care platforms.

Leukocyte function assessed via serial microlitre sampling of peripheral blood from sepsis patients correlates with disease severity

Dysregulated leukocyte responses underlie the pathobiology of sepsis, which is a leading cause of death. However, measures of leukocyte function are not routinely available in clinical care. Here we report the development and testing of an inertial microfluidic system for the label-free isolation and downstream functional assessment of leukocytes from 50 μl of peripheral blood. We used the system to assess leukocyte phenotype and function in serial samples from 18 hospitalized patients with sepsis and 10 healthy subjects. The sepsis samples had significantly higher levels of CD16^dim and CD16⁻ neutrophils and CD16⁺ ‘intermediate’ monocytes, as well as significantly lower levels of neutrophil-elastase release, O₂⁻ production and phagolysosome formation. Repeated sampling of sepsis patients over 7 days showed that leukocyte activation (measured by isodielectric separation) and leukocyte phenotype and function were significantly more predictive of the clinical course than complete-blood-count parameters. We conclude that the serial assessment of leukocyte function in microlitre blood volumes is feasible and that it provides significantly more prognostic information than leukocyte counting.

The serial assessment of the functional parameters of leukocytes isolated via an inertial microfluidic system from 50 μl of peripheral blood from sepsis patients provides significantly more prognostic information than leukocyte counting.

Aptamer Affinity-Bead Mediated Capture and Displacement of Gram-Negative Bacteria Using Acoustophoresis

Here, we report a simple and effective method for capturing and displacement of gram-negative bacteria using aptamer-modified microbeads and acoustophoresis. As acoustophoresis allows for simultaneous washing and size-dependent separation in continuous flow mode, we efficiently obtained gram-negative bacteria that showed high affinity without any additional washing steps. The proposed device has a simple and efficient channel design, utilizing a long, square-shaped microchannel that shows excellent separation performance in terms of the purity, recovery, and concentration factor. Microbeads (10 µm) coated with the GN6 aptamer can specifically bind gram-negative bacteria. After incubation of bacteria culture sample with aptamer affinity bead, gram-negative bacteria-bound microbeads, and other unbound/contaminants can be separated by size with high purity and recovery. The device demonstrated excellent separation performance, with high recovery (up to 98%), high purity (up to 99%), and a high-volume rate (500 µL/min). The acoustophoretic separation performances were conducted using 5 Gram-negative bacteria and 5 Gram-positive bacteria. Thanks to GN6 aptamer’s binding affinity, aptamer affinity bead also showed binding affinity to multiple strains of gram-negative bacteria, but not to gram-positive bacteria. GN6 coated bead can capture Gram-negative bacteria but not Gram-positive bacteria. This study may present a different perspective in the field of early diagnosis in bacterial infectious diseases. In addition to detecting living bacteria or bacteria-derived biomarkers, this protocol can be extended to monitoring the contamination of water resources and may aid quick responses to bioterrorism and pathogenic bacterial infections.

Microfluidic impedance cytometry device with N-shaped electrodes for lateral position measurement of single cells/particles

Tracking the lateral position of single cells and particles plays an important role in evaluating the efficiency of microfluidic cell focusing, separation and sorting. In this work, we present an N-shaped electrode-based microfluidic impedance cytometry device for the measurement of the lateral position of single cells and particles in continuous flows. Specifically, a simple analytical expression for determining the particle lateral position is derived from the measured electrical signal and geometry relationship among the positions of the flowing particles, electrodes and microchannel. This microfluidic system is experimentally validated by measuring the lateral positions of 5, 7 and 10 μm diameter beads and human red blood cells (RBCs) flowing in a 200 μm wide channel at varying flow rates up to 59.3 μl min^-1. Statistical analyses show a good correlation (R² = 0.99) and agreement (Bland-Altman analysis) between our results and those obtained by a microscopy imaging method. The resolution of our system reflected by the root-mean-square deviation (RMSD) is 10.3 μm (5.15% of the channel width) for 5 and 10 μm beads, and 11.4 μm (5.7% of the channel width) for RBCs at a flow rate of 42.4 μl min^-1. Compared to the existing impedance-based methods for measuring the particle lateral position, we achieve the highest resolution, highest flow rate and smallest measured particle size (3.6 μm beads). The experimental results of the mixture with 5 and 10 μm beads demonstrate that our device does not merely measure the lateral position of single particles or cells, but also can characterize their physical properties (e.g., size) simultaneously. Furthermore, we demonstrate the position monitoring of sheath flow-induced particle focusing, which is in quantitative agreement with the results by imaging quantification. With the advantages of rapid and accurate processing of electrical signal and high throughput of the impedance flow cytometry, this novel N-shaped electrode-based system can be easily integrated with other microfluidic platforms as a downstream approach for the real-time measurement of the lateral position and physical properties of single cells and particles.