Rapid Antimicrobial Susceptibility Testing Based on a Bio-Inspired Chemiluminescence Sensor

Indiscriminate usage of antibiotics has caused accelerating growth and global expansion of antimicrobial resistance. Therefore, rapid antimicrobial susceptibility testing (AST) for guiding antibiotic prescription and preventing the spread of antimicrobial resistance is in urgent need. Phenotypic AST is the clinical gold standard method; however, no phenotypic AST has realized a colony-to-answer at about 1 h by utilizing the chemiluminescence sensor to detect the enzyme expressed by bacteria. Inspired by the bubble formation in the mixture of Escherichia coli and H2O2, we demonstrate a strategy based on the chemiluminescence sensor for rapid AST. Compared with the gold standard methods, the values of AUC are 0.960 for E. coli and 0.950 for Staphylococcus aureus, close to 1, indicating superb diagnostic performance as an AST method. The whole process from colonies to answer is 55 min for E. coli and 70 min for S. aureus. The chemiluminescence readout is based on the common equipment in the laboratory of the hospital, which is conducive to follow-up clinical promotion. Our sensor promises great potential in rapid AST, facilitating antimicrobial stewardship.