Direct detection of the bacterial stress response in intact samples of platelets by differential impedance

Single-cell level methods for studying the effect of antibiotics on bacteria during infection

Considerable evidence about phenotypic heterogeneity among bacteria during infection has accumulated during recent years. This heterogeneity has to be considered if the mechanisms of infection and antibiotic action are to be understood, so we need to implement existing and find novel methods to monitor the effects of antibiotics on bacteria at the single-cell level. This review provides an overview of methods by which this aim can be achieved. Fluorescence label-based methods and Raman scattering as a label-free approach are discussed in particular detail. Other label-free methods that can provide single-cell level information, such as impedance spectroscopy and surface plasmon resonance, are briefly summarized. The advantages and disadvantages of these different methods are discussed in light of a challenging in vivo environment.

Better tests, better care: improved diagnostics for infectious diseases

In this IDSA policy paper, we review the current diagnostic landscape, including unmet needs and emerging technologies, and assess the challenges to the development and clinical integration of improved tests. To fulfill the promise of emerging diagnostics, IDSA presents recommendations that address a host of identified barriers. Achieving these goals will require the engagement and coordination of a number of stakeholders, including Congress, funding and regulatory bodies, public health agencies, the diagnostics industry, healthcare systems, professional societies, and individual clinicians.

Rapid detection of contaminant bacteria in platelet concentrate using differential impedance

BACKGROUND AND OBJECTIVES

Current FDA-approved culture-based methods for the bacterial testing of platelet concentrate (PC) can yield false-negative results attributed to Poisson-limited sampling errors incurred near the time of collection that result in undetectable bacterial concentrations. Testing PC at the point of issue (POI) extends the incubation period for any contaminant bacteria increasing the probability of detection. Data are presented from time-course experiments designed to simulate POI testing of bacterially contaminated PCs at different stages of growth using differential impedance sensing.

STUDY DESIGN AND METHODS

Whole-blood-derived PCs were typically spiked with low numbers of bacteria (approximately 100 CFU/ml) and incubated under standard PC storage conditions. Each infected unit was evaluated every two hours over a 12-h period. All samples were treated with a chemical compound that induces stress in the bacterial cells only. The development of any bacterial stress was monitored by detecting changes in the dielectric properties of the PC using differential impedance.

RESULTS

Differential impedance measurements and corresponding cell counts at the different time-points are presented for six organisms implicated in post-transfusion-septic reactions. All infected PCs were detected once contaminant bacteria reached concentrations ranging between 0·6 × 10(3) and 6 × 10(3)  CFU/ml irrespective of the phase of growth. Results were obtained within 30 min after the start of the assay and without the need for cell lysis or centrifugation.

CONCLUSION

Differential impedance sensing can detect bacterial contamination in PC rapidly at concentrations below clinical thresholds known to cause adverse effects.

Rapid clinical bacteriology and its future impact

Clinical microbiology has always been a slowly evolving and conservative science. The sub-field of bacteriology has been and still is dominated for over a century by culture-based technologies. The integration of serological and molecular methodologies during the seventies and eighties of the previous century took place relatively slowly and in a cumbersome fashion. When nucleic acid amplification technologies became available in the early nineties, the predicted "revolution" was again slow but in the end a real paradigm shift did take place. Several of the culture-based technologies were successfully replaced by tests aimed at nucleic acid detection. More recently a second revolution occurred. Mass spectrometry was introduced and broadly accepted as a new diagnostic gold standard for microbial species identification. Apparently, the diagnostic landscape is changing, albeit slowly, and the combination of newly identified infectious etiologies and the availability of innovative technologies has now opened new avenues for modernizing clinical microbiology. However, the improvement of microbial antibiotic susceptibility testing is still lagging behind. In this review we aim to sketch the most recent developments in laboratory-based clinical bacteriology and to provide an overview of emerging novel diagnostic approaches.

Advances in transfusion medicine in the first decade of the 21st century: Advances in miniaturized technologies

Several miniaturized high throughput technologies have been developed in the last decade, primarily to study genomic structures and gene expression patterns under various conditions. At the same time, the microarrays, biosensors, integrated microfluidic lab-on-a-chip devices, next generation sequencing or digital PCR are gradually finding their diagnostic applications, although their suitability for specialised diagnostic fields has still to be assessed. In this review we discuss the potential applications of the new technologies to blood testing.