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      Electrochemical sensors for rapid diagnosis of pathogens in real time

      1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9
      The Analyst
      Royal Society of Chemistry (RSC)

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          Abstract

          Electrochemical sensors designed for rapid diagnosis, detection and real-time monitoring of bacterial pathogens in hospital settings.

          Abstract

          Microbial infections remain the principal cause for high morbidity and mortality rates. While approximately 1400 human pathogens have been recognized, the majority of healthcare-associated infectious diseases are caused by only a few opportunistic pathogens ( e.g., Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli), which are associated with increased antibiotic and antimicrobial resistance. Rapid detection, reliable identification and real-time monitoring of these pathogens remain not only a scientific problem but also a practical challenge of vast importance, especially in tailoring effective treatment strategies. Although the development of vaccinations and antibacterial drug treatments are the leading research, progress, and implementation of early warning, quantitative systems indicative of confirming pathogen presence are necessary. Over the years, various approaches, such as conventional culturing, straining, molecular methods ( e.g., polymerase chain reaction and immunological assays), microscopy-based and mass spectrometry techniques, have been employed to identify and quantify pathogenic agents. While being sensitive in some cases, these procedures are costly, time-consuming, mostly qualitative, and are indirect detection methods. A great challenge is therefore to develop rapid, highly sensitive, specific devices with adequate figures of merit to corroborate the presence of microbes and enable dynamic real-time measurements of metabolism. As an alternative, electrochemical sensor platforms have been developed as powerful quantitative tools for label-free detection of infection-related biomarkers with high sensitivity. This minireview is focused on the latest electrochemical-based approaches for pathogen sensing, putting them into the context of standard sensing methods, such as cell culturing, mass spectrometry, and fluorescent-based approaches. Description of the latest, impactful electrochemical sensors for pathogen detection will be presented. Recent breakthroughs will be highlighted, including the use of micro- and nano-electrode arrays for real-time detection of bacteria in polymicrobial infections and microfluidic devices for pathogen separation analysis. We will conclude with perspectives and outlooks to understand shortcomings in designing future sensing schemes. The need for high sensitivity and selectivity, low-cost implementation, fast detection, and screening increases provides an impetus for further development in electrochemical detectors for microorganisms and biologically relevant targets.

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          Most cited references114

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          Bacterial quorum sensing: its role in virulence and possibilities for its control.

          Quorum sensing is a process of cell-cell communication that allows bacteria to share information about cell density and adjust gene expression accordingly. This process enables bacteria to express energetically expensive processes as a collective only when the impact of those processes on the environment or on a host will be maximized. Among the many traits controlled by quorum sensing is the expression of virulence factors by pathogenic bacteria. Here we review the quorum-sensing circuits of Staphylococcus aureus, Bacillus cereus, Pseudomonas aeruginosa, and Vibrio cholerae. We outline these canonical quorum-sensing mechanisms and how each uniquely controls virulence factor production. Additionally, we examine recent efforts to inhibit quorum sensing in these pathogens with the goal of designing novel antimicrobial therapeutics.
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            Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America.

            The Infectious Diseases Society of America (IDSA) continues to view with concern the lean pipeline for novel therapeutics to treat drug-resistant infections, especially those caused by gram-negative pathogens. Infections now occur that are resistant to all current antibacterial options. Although the IDSA is encouraged by the prospect of success for some agents currently in preclinical development, there is an urgent, immediate need for new agents with activity against these panresistant organisms. There is no evidence that this need will be met in the foreseeable future. Furthermore, we remain concerned that the infrastructure for discovering and developing new antibacterials continues to stagnate, thereby risking the future pipeline of antibacterial drugs. The IDSA proposed solutions in its 2004 policy report, "Bad Bugs, No Drugs: As Antibiotic R&D Stagnates, a Public Health Crisis Brews," and recently issued a "Call to Action" to provide an update on the scope of the problem and the proposed solutions. A primary objective of these periodic reports is to encourage a community and legislative response to establish greater financial parity between the antimicrobial development and the development of other drugs. Although recent actions of the Food and Drug Administration and the 110th US Congress present a glimmer of hope, significant uncertainly remains. Now, more than ever, it is essential to create a robust and sustainable antibacterial research and development infrastructure--one that can respond to current antibacterial resistance now and anticipate evolving resistance. This challenge requires that industry, academia, the National Institutes of Health, the Food and Drug Administration, the Centers for Disease Control and Prevention, the US Department of Defense, and the new Biomedical Advanced Research and Development Authority at the Department of Health and Human Services work productively together. This report provides an update on potentially effective antibacterial drugs in the late-stage development pipeline, in the hope of encouraging such collaborative action.
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              Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem.

              Antimicrobial resistance is a global public health challenge, which has accelerated by the overuse of antibiotics worldwide. Increased antimicrobial resistance is the cause of severe infections, complications, longer hospital stays and increased mortality. Overprescribing of antibiotics is associated with an increased risk of adverse effects, more frequent re-attendance and increased medicalization of self-limiting conditions. Antibiotic overprescribing is a particular problem in primary care, where viruses cause most infections. About 90% of all antibiotic prescriptions are issued by general practitioners, and respiratory tract infections are the leading reason for prescribing. Multifaceted interventions to reduce overuse of antibiotics have been found to be effective and better than single initiatives. Interventions should encompass the enforcement of the policy of prohibiting the over-the-counter sale of antibiotics, the use of antimicrobial stewardship programmes, the active participation of clinicians in audits, the utilization of valid rapid point-of-care tests, the promotion of delayed antibiotic prescribing strategies, the enhancement of communication skills with patients with the aid of information brochures and the performance of more pragmatic studies in primary care with outcomes that are of clinicians' interest, such as complications and clinical outcomes.
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                Author and article information

                Contributors
                (View ORCID Profile)
                (View ORCID Profile)
                Journal
                ANALAO
                The Analyst
                Analyst
                Royal Society of Chemistry (RSC)
                0003-2654
                1364-5528
                November 4 2019
                2019
                : 144
                : 22
                : 6461-6478
                Affiliations
                [1 ]Department of Chemistry
                [2 ]University of Texas at Austin
                [3 ]1 University Station
                [4 ]Austin
                [5 ]USA
                [6 ]Center for Energy Science and Technology
                [7 ]Skolkovo Institute of Science and Technology
                [8 ]Moscow 121205
                [9 ]Russia
                Article
                10.1039/C9AN01747J
                31603150
                2a2eafbe-c66c-4e18-b3c9-e7af07e32aab
                © 2019

                http://rsc.li/journals-terms-of-use

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