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Ogunlade B, Tadesse LF, Li H, Vu N, Banaei N, Barczak AK, Saleh AAE, Prakash M, Dionne JA. Rapid, antibiotic incubation-free determination of tuberculosis drug resistance using machine learning and Raman spectroscopy. ArXiv 2024:arXiv:2306.05653v2. [PMID: 37332564 PMCID: PMC10274949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Tuberculosis (TB) is the world's deadliest infectious disease, with over 1.5 million deaths annually and 10 million new cases reported each year1. The causative organism, Mycobacterium tuberculosis (Mtb) can take nearly 40 days to culture2,3, a required step to determine the pathogen's antibiotic susceptibility. Both rapid identification of Mtb and rapid antibiotic susceptibility testing (AST) are essential for effective patient treatment and combating antimicrobial resistance. Here, we demonstrate a rapid, culture-free, and antibiotic incubation-free drug susceptibility test for TB using Raman spectroscopy and machine learning. We collect few-to-single-cell Raman spectra from over 25,000 cells of the MtB complex strain Bacillus Calmette-Guérin (BCG) resistant to one of the four mainstay anti-TB drugs, isoniazid, rifampicin, moxifloxacin and amikacin, as well as a pan-susceptible wildtype strain. By training a neural network on this data, we classify the antibiotic resistance profile of each strain, both on dried samples and in patient sputum samples. On dried samples, we achieve >98% resistant versus susceptible classification accuracy across all 5 BCG strains. In patient sputum samples, we achieve ~79% average classification accuracy. We develop a feature recognition algorithm in order to verify that our machine learning model is using biologically relevant spectral features to assess the resistance profiles of our mycobacterial strains. Finally, we demonstrate how this approach can be deployed in resource-limited settings by developing a low-cost, portable Raman microscope that costs <$5000. We show how this instrument and our machine learning model enables combined microscopy and spectroscopy for accurate few-to-single-cell drug susceptibility testing of BCG.
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Affiliation(s)
- Babatunde Ogunlade
- Department of Materials Science and Engineering, Stanford University; Stanford, 94305, CA, USA
| | - Loza F. Tadesse
- Department of Bioengineering, Stanford University School of Medicine and School of Engineering; Stanford, 94305, CA, USA
- Department of Mechanical Engineering, Massachusetts Institute of Technology; Cambridge, 02142, MA, USA
- The Ragon Institute, Massachusetts General Hospital; Cambridge, 02139, MA, USA
| | - Hongquan Li
- Department of Applied Physics, Stanford University; Stanford, 94305, CA, USA
| | - Nhat Vu
- Pumpkinseed Technologies, Inc; Palo Alto, 94306, CA, USA
| | - Niaz Banaei
- Department of Pathology, Stanford University School of Medicine; Stanford, 94305, CA, USA
| | - Amy K. Barczak
- The Ragon Institute, Massachusetts General Hospital; Cambridge, 02139, MA, USA
- Division of Infectious Diseases, Massachusetts General Hospital; Boston, 02114, MA, USA
- Department of Medicine, Harvard Medical School; Boston, 02115, MA, USA
| | - Amr. A. E. Saleh
- Department of Materials Science and Engineering, Stanford University; Stanford, 94305, CA, USA
- Department of Engineering Mathematics and Physics, Cairo University; Giza, 12613, Egypt
| | - Manu Prakash
- Department of Bioengineering, Stanford University School of Medicine and School of Engineering; Stanford, 94305, CA, USA
| | - Jennifer A. Dionne
- Department of Materials Science and Engineering, Stanford University; Stanford, 94305, CA, USA
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine; Stanford, 94035, CA, USA
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2
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Safir F, Vu N, Tadesse LF, Firouzi K, Banaei N, Jeffrey SS, Saleh AAE, Khuri-Yakub B(P, Dionne JA. Combining Acoustic Bioprinting with AI-Assisted Raman Spectroscopy for High-Throughput Identification of Bacteria in Blood. Nano Lett 2023; 23:2065-2073. [PMID: 36856600 PMCID: PMC10037319 DOI: 10.1021/acs.nanolett.2c03015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Identifying pathogens in complex samples such as blood, urine, and wastewater is critical to detect infection and inform optimal treatment. Surface-enhanced Raman spectroscopy (SERS) and machine learning (ML) can distinguish among multiple pathogen species, but processing complex fluid samples to sensitively and specifically detect pathogens remains an outstanding challenge. Here, we develop an acoustic bioprinter to digitize samples into millions of droplets, each containing just a few cells, which are identified with SERS and ML. We demonstrate rapid printing of 2 pL droplets from solutions containing S. epidermidis, E. coli, and blood; when they are mixed with gold nanorods (GNRs), SERS enhancements of up to 1500× are achieved.We then train a ML model and achieve ≥99% classification accuracy from cellularly pure samples and ≥87% accuracy from cellularly mixed samples. We also obtain ≥90% accuracy from droplets with pathogen:blood cell ratios <1. Our combined bioprinting and SERS platform could accelerate rapid, sensitive pathogen detection in clinical, environmental, and industrial settings.
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Affiliation(s)
- Fareeha Safir
- *Department
of Mechanical Engineering, Stanford University, Stanford, California 94305, United States
| | - Nhat Vu
- Pumpkinseed
Technologies, Inc., Palo Alto, California 94306, United States
| | - Loza F. Tadesse
- Department
of Bioengineering, Stanford University School
of Medicine and School of Engineering, Stanford, California 94305, United States
| | - Kamyar Firouzi
- E.
L. Ginzton Laboratory, Stanford University, Stanford, California 94305, United States
| | - Niaz Banaei
- Department
of Pathology, Stanford University School
of Medicine, Stanford, 94305 California, United
States
- Clinical
Microbiology Laboratory, Stanford Health Care, Palo Alto, California 94304, United States
- Department
of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California 94305, United States
| | - Stefanie S. Jeffrey
- Department
of Surgery, Stanford University School of
Medicine, Stanford, California 94305, United States
| | - Amr. A. E. Saleh
- Department
of Engineering Mathematics and Physics, Cairo University, Cairo 12613, Egypt
- Department
of Materials Science and Engineering, Stanford
University, Stanford, California 94305, United States
| | - Butrus (Pierre)
T. Khuri-Yakub
- E.
L. Ginzton Laboratory, Stanford University, Stanford, California 94305, United States
- Department
of Electrical Engineering, Stanford University, Stanford, California 94305, United States
| | - Jennifer A. Dionne
- Department
of Materials Science and Engineering, Stanford
University, Stanford, California 94305, United States
- Department
of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, California 94035, United States
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Datyner E, Adeseye V, Porter K, Dryden I, Sarma A, Vu N, Patrick AE, Paueksakon P. Small vessel childhood primary angiitis of the central nervous system with positive anti-glial fibrillary acidic protein antibodies: a case report and review of literature. BMC Neurol 2023; 23:57. [PMID: 36737749 PMCID: PMC9895965 DOI: 10.1186/s12883-023-03093-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/25/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Small vessel childhood primary angiitis of the central nervous system (SV-cPACNS) is a rare disease characterized by inflammation within small vessels such as arterioles or capillaries. CASE PRESENTATION We report a case of SV-cPACNS in an 8-year-old boy confirmed by brain biopsy. This patient was also incidentally found to have anti-glial fibrillary acidic protein (GFAP) antibodies in the cerebrospinal fluid (CSF) but had no evidence of antibody-mediated disease on brain biopsy. A literature review highlighted the rarity of SV-cPACNS and found no prior reports of CSF GFAP-associated SV-cPACNS in the pediatric age group. CONCLUSION We present the first case of biopsy proven SV-cPACNS vasculitis associated with an incidental finding of CSF GFAP antibodies. The GFAP antibodies are likely a clinically insignificant bystander in this case and possibly in other diseases with CNS inflammation. Further research is needed to determine the clinical significance of newer CSF autoantibodies such as anti-GFAP before they are used for medical decision-making in pediatrics.
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Affiliation(s)
- E Datyner
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN USA
| | - V Adeseye
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN USA
| | - K Porter
- grid.152326.10000 0001 2264 7217Vanderbilt University, Nashville, TN USA
| | - I Dryden
- grid.412807.80000 0004 1936 9916Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 1161 21St Avenue South, Nashville, TN MCN C2318B37232-2561 USA
| | - A Sarma
- grid.412807.80000 0004 1936 9916Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - N Vu
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN USA
| | - AE Patrick
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN USA
| | - P Paueksakon
- grid.412807.80000 0004 1936 9916Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 1161 21St Avenue South, Nashville, TN MCN C2318B37232-2561 USA
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Stewart K, Vu N, Redmon C, Nguyen C, Jackson E, Lee A, Kilic S. Knowledge of pelvic floor disorders among reproductive aged women a cross sectional study. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vu N. The Changes in Tumor Volume and Location During Stereotactic Body Radiotherapy (SBRT) Period in Patients with Stage I Non-Small Cell Lung Cancer (NSCLC): The Need for Implementation of the Adaptive Radiotherapy (ART) Planning. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vu N, Stelter B, Huang D, Kao M, Cagaanan A, Weisman P, Al-Niaimi A, McGregor S. Hormone Receptor Expression and Prognosis of Uterine Papillary Serous Carcinoma: Redefining the Threshold for Positivity. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sethi A, Obi G, Manhas A, Scholoff A, Vu N, Carrum G, Kamble R. Primary Refractory Double Hit Diffuse Large B Cell Lymphoma: Complete Response with Ibrutinib and Rituximab. Clinical Lymphoma Myeloma and Leukemia 2018. [DOI: 10.1016/j.clml.2018.07.239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lam N, Vu N. P3.02-021 Secondary EGFR Exon 20 T790m Mutation for Therapy of Non-Small Cell Lung Cancer at Phat Ngoc Thach - Ho Chi Minh City - Vietnam. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lam N, Thanh T, Vu N. P3.02-020 Comparison of Diagnostic Ability for EGFR Mutation of the Specimen Groups: Histology – Cytology – Plasma. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wong J, Dang L, Le T, Phan N, James S, Katona P, Vu N, Vu T, Katona L, Rosen J, Nguyen C. Strengthening Health System - Evidence from the use of Bi-directional
SMS-based Screening and Feedback System to Improve Efficiency and Quality of
Disease Surveillance in Vietnam. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Nguyen L, Vu N, Duong H, O'Neil J, Wiljer D, Nguyen C. mMOM - Improving maternal and child health for ethnic minority people in
mountainous region of Thai Nguyen province of Vietnam through integration of
mHealth in HMIS and user-provider interaction. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.948] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Le Maux A, Noël G, Birebent B, Grosset JM, Vu N, De Guibert S, Bernard M, Semana G, Amiot L. Soluble human leucocyte antigen-G molecules in peripheral blood haematopoietic stem cell transplantation: a specific role to prevent acute graft-versus-host disease and a link with regulatory T cells. Clin Exp Immunol 2008; 152:50-6. [PMID: 18241225 DOI: 10.1111/j.1365-2249.2008.03598.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Haematopoietic stem cell transplantation is often complicated by the life-threatening graft-versus-host disease (GVHD) which consists of an allogeneic reaction of the graft cells against the host organs. The aim of this study was to investigate the putative involvement of soluble human leucocyte antigen (sHLA) class I molecules, and particularly sHLA-G molecules, in the occurrence and/or prevention of acute GVHD (aGVHD) in allogeneic peripheral blood stem cell (PSC) transplantation. Whole sHLA class I molecules seem to be involved in aGVHD pathogenesis because detection of a high concentration of these molecules in the first month post allograft is correlated with aGVHD occurrence. Conversely, a high level of sHLA-G molecules before and after allograft could indicate good prognosis in PSC allograft transplantation. sHLA-G molecules seem to be involved in aGVHD prevention, not only because they are enriched in plasma of patients without aGVHD, but also because: (i) a positive correlation has been found between sHLA-G level and CD4+ CD25+ CD152+ natural regulatory T cell (T(reg)) frequency in the blood of transplanted patients; and (ii) the presence of CD4+ CD25+ CD152+ natural T(reg) is correlated with increased sHLA-G expression in in vitro mixed leucocyte reaction cultures. Altogether, these results support the immunomodulatory function of sHLA-G molecules that might create a regulatory network together with the natural T(reg) to foster the induction of a tolerogenic environment and improve PSC transplantation favourable outcome.
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Affiliation(s)
- A Le Maux
- UPRES EA 3889 Immunologie/Hématologie, Faculté de Médecine, Université de Rennes 1, France
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Michelet C, Avril JL, Arvieux C, Jacquelinet C, Vu N, Cartier F. Comparative activities of new fluoroquinolones, alone or in combination with amoxicillin, trimethoprim-sulfamethoxazole, or rifampin, against intracellular Listeria monocytogenes. Antimicrob Agents Chemother 1997; 41:60-5. [PMID: 8980755 PMCID: PMC163660 DOI: 10.1128/aac.41.1.60] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
We studied the activities of the new fluoroquinolones clinafloxacin, levofloxacin, ofloxacin, and sparfloxacin alone or in combination on the intracellular growth of Listeria monocytogenes. Against intracellular growth of the four strains tested, a similar reduction of the bacterial count was obtained with clinafloxacin at the dose of 10 x MIC (delta log10 CFU/ml = -2.19 +/- 0.24), with levofloxacin at 8 x MIC (delta log10 CFU/ml = -2.28 +/- 0.25), and with sparfloxacin at 4 x MIC (delta log10 CFU/ml = -2.16 +/- 0.21) after 24 h of incubation. The combination of the quinolones with trimethoprim-sulfamethoxazole or amoxicillin did not show a substantial increase in activity compared to the fluoroquinolone alone. Antagonism with rifampin was strongly suggested. No modification of the MIC was observed after 20 successive infections of HeLa cells and contact with subinhibitory concentrations of clinafloxacin, levofloxacin, and sparfloxacin for 24 h. We conclude that clinafloxacin, levofloxacin, or sparfloxacin could represent a therapeutic alternative to amoxicillin for the treatment of Listeria infections in adults, especially clinafloxacin, whose MIC is low (0.06 to 0.12 micrograms/ml), and whose best activity against intracellular L. monocytogenes was obtained at a concentration of 1.2 micrograms/ml, which is similar to clinically achievable levels. The results must be confirmed in an experimental model.
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Affiliation(s)
- C Michelet
- Clinique des Maladies Infectieuses, Centre Hospitalier, Regional et Universitaire, Rennes, France
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Abstract
In view of Canada's commitment to immigration, understanding the sources of successful adaptation by immigrant and refugee children is vital. This paper reviews the literature on the mental health of migrant children and suggests an agenda for future research.
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Affiliation(s)
- M Beiser
- Clarke Institute of Psychiatry, Toronto, Ontario
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