Fluorescence Biosensor for One-Step Simultaneous Detection of Mycobacterium tuberculosis Multidrug-Resistant Genes Using nanoCoTPyP and Double Quantum Dots

Exploring diagnostic methods for drug-resistant tuberculosis: A comprehensive overview

Despite available global efforts and funding, Tuberculosis (TB) continues to affect a considerable number of patients worldwide. Policy makers and stakeholders set clear goals to reduce TB incidence and mortality, but the emergence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) complicate the reach of these goals. Drug-resistance TB needs to be diagnosed rapidly and accurately to effectively treat patients, prevent the transmission of MDR-TB, minimise mortality, reduce treatment costs and avoid unnecessary hospitalisations. In this narrative review, we provide a comprehensive overview of laboratory methods for detecting drug resistance in MTB, focusing on phenotypic, molecular and other drug susceptibility testing (DST) techniques. We found a large variety of methods used, with the BACTEC MGIT 960 being the most common phenotypic DST and the Xpert MTB/RIF being the most common molecular DST. We emphasise the importance of integrating phenotypic and molecular DST to address issues like resistance to new drugs, heteroresistance, mixed infections and low-level resistance mutations. Notably, most of the analysed studies adhered to the outdated definition of XDR-TB and did not consider the pre-XDR definition, thus posing challenges in aligning diagnostic methods with the current landscape of TB resistance.

Multidrug-resistant tuberculosis

One of predominant contributors to global mortality is tuberculosis (TB), an infection caused by Mycobacterium tuberculosis (MTB). Inappropriate and ineffectual treatment can lead to the development of drug-resistant TB. One of the most common forms of drug-resistant TB is multidrug-resistant tuberculosis (MDR-TB), caused by mutations in the rpoB and katG genes that lead to resistance to anti-TB drugs, rifampicin (RIF) and isoniazid (INH), respectively. Although culturing remains the gold standard, it is not rapid thereby delaying potential treatment and potentially increasing the incidence of MDR-TB. In contrast, molecular techniques provide a highly sensitive and specific alternative. This review discusses the classification of biomarkers used to detect MDR-TB, some of the commonly used anti-TB drugs, and DNA mutations in MTB that lead to anti-TB resistance. The objective of this review is to increase awareness of the need for rapid and precise detection of MDR-TB cases to decrease morbidity and mortality of this infectious disease worldwide.

Smart Stimuli-Responsive Spherical Nucleic Acids: Cutting-Edge Platforms for Biosensing, Bioimaging, and Therapeutics

Spherical nucleic acids (SNAs) with exceptional colloidal stability, multiple modularity, and programmability are excellent candidates to address common molecular delivery-related issues. Based on this, the higher targeting accuracy and enhanced controllability of stimuli-responsive SNAs render them precise nanoplatforms with inestimable prospects for diverse biomedical applications. Therefore, tailored diagnosis and treatment with stimuli-responsive SNAs may be a robust strategy to break through the bottlenecks associated with traditional nanocarriers. Various stimuli-responsive SNAs are engineered through the incorporation of multifunctional modifications to meet biomedical demands with the development of nucleic acid functionalization. This review provides a comprehensive overview of prominent research in this area and recent advancements in the utilization of stimuli-responsive SNAs in biosensing, bioimaging, and therapeutics. For each aspect, SNA nanoplatforms that exhibit responsive behavior to both internal stimuli (including sequence, enzyme, redox reactions, and pH) and external stimuli (such as light and temperature) are highlighted. This review is expected to offer inspiration and guidance strategies for the rational design and development of stimuli-responsive SNAs in the field of biomedicine.

Rapid, Ultrasensitive, and Visual Detection of Pathogens Based on Cation Dye-Triggered Gold Nanoparticle Electrokinetic Agglutination Analysis

Rapid prescribing of the right antibiotic is the key to treat infectious diseases and decelerate the challenge of bacterial antibiotic resistance. Herein, by targeting the 16S rRNA of bacteria, we developed a cation dye-triggered electrokinetic gold nanoparticle (AuNP) agglutination (CD-TEAA) method, which is rapid, visual, ultrasensitive, culture-independent, and low in cost. The limit of detection (LOD) is as low as 1 CFU mL-1 Escherichia coli. The infection identifications of aseptic fluid samples (n = 11) and urine samples with a clinically suspected urinary tract infection (UTI, n = 78) were accomplished within 50 and 30 min for each sample, respectively. The antimicrobial susceptibility testing (AST) of UTI urine samples was achieved within 2.5 h. In ROC analysis of urine, the sensitivity and specificity were 100 and 96% for infection identification, and 100 and 98% for AST, respectively. Moreover, the overall cost of materials for each test is about US$0.69. Therefore, the CD-TEAA method is a superior approach to existing, time-consuming, and expensive methods, especially in less developed areas.

Potential-resolved electrochemiluminescence biosensor for simultaneous determination of multiplex miRNA

The multi-target simultaneous detection strategy based on potential-resolved electrochemiluminescence (ECL) has still been a research hotspot in analytical science, but the limited selection of ECL luminophores hinders the development of this field. Herein, polyethyleneimine functionalized perylene derivatives (PTC-PEI) and luminol functionalized gold nanoparticles (Lu-Au NPs) possessed significantly resolved emission potentials as ECL luminophore. The ternary ECL system was constructed with MoS2 nanoflowers and K2S2O8 as the coreaction accelerator and coreactant respectively, which significantly improved the cathode ECL emission of PTC-PEI. Simultaneously, the anode coreaction accelerator ZnO nanoflowers could promote the anode coreactant dissolved O2 reduction, and extremely enhanced the anode ECL emission of Lu-Au NPs. The proposed strategy addressed the major technical challenge of cross interference and competition of the coreactants for dual-biomarker detection, thus enabling accurate detection of miRNA-205 and miRNA-21 from 10 fM to 100 nM, with detection limits of 2.57 and 1.15 fM, respectively. In general, this work achieved a single-step synchronous detection of dual biomarkers, providing a new idea for the ECL detection of multiple biomarkers, and having potential value in the clinical diagnosis.

Nucleic Acids Detection for Mycobacterium tuberculosis Based on Gold Nanoparticles Counting and Rolling-Circle Amplification

Tuberculosis (TB) is a common infectious disease caused by Mycobacterium tuberculosis, which usually disturbs the lungs, and remains the second leading cause of death from an infectious disease worldwide after the human immunodeficiency virus. Herein, we constructed a simple and sensitive method for Mycobacterium tuberculosis-specific DNA detection with the dark-field microscopic imaging of gold nanoparticles (AuNPs) counting strategy and rolling-circle amplification (RCA). Taking advantage of RCA amplification, one target molecule produced hundreds of general oligonucleotides, which could form the sandwich structure with capture-strand-modified magnetic beads and AuNPs. After magnetic separation, AuNPs were released and detected by dark-field imaging; about 10 fM Mycobacterium tuberculosis-specific DNA target can still be differentiated from the blank. No significant change of the absorbance signals was observed when the target DNA to genomic DNA ratio (in mass) was from 1:0 to 1:10⁶. The spike recovery results in genomic DNA from human and Klebsiella pneumoniae suggested that the proposed method has the feasibility for application with biological samples. This proposed method is performed on an entry-level dark-field microscope setup with only a 6 μL detection volume, which creates a new, simple, sensitive, and valuable tool for pathogen detection.