Hardware-Free Testing for Antimicrobial Resistance Using Artificial Intelligence

ABSTRACT

Antimicrobial resistance (AMR) is one of the most challenging public health problems, and implementation of effective and accessible testing solutions is an ever-increasing unmet need. Artificial intelligence (AI) offers a promising avenue for enhanced testing performance and accuracy. We introduce an AI system specifically designed for rapid AMR testing, eliminating the requirement for bulky hardware and extensive automation. Our system incorporates a novel approach for nanotechnology-empowered intelligent diagnostics (NEIDx), leveraging nanoparticles to enable novel AI-based advanced systems for detection. We employ catalytic nanoparticle-based NEIDx coupled with magnetic separation to facilitate the direct detection of AMR-associated enzymes from blood samples. This is achieved through the formation of easily visible and detectable large bubbles, a process streamlined by AI running on a cellphone. We evaluated the performance of our AI system using two clinically relevant AMR enzymes: Klebsiella pneumoniae carbapenemase-2 (KPC-2) and Sulfhydryl variable-1 (SHV-1) β-lactamases. The system demonstrated qualitative detection with a sensitivity of 82.61% (CI of 79.7 - 85.5%) and a specificity of 92.31% (CI of 90.3 - 94.3%) in blood samples, respectively. This innovative approach holds significant promise for advancing point-of-care diagnostics and addressing the urgent need for rapid and accessible AMR testing in diverse healthcare settings.

Competing Interest Statement

We Filled Patent Application with the Included Approach and Material

Funding Statement

None to Declare

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Blood samples were obtained from the Hematopoietic Stem Cell Facility of Case Western Reserve University and University Hospitals (UH) under the approved Institutional Review Board (IRB) protocol UH IRB 09-90-195

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present work are contained in the manuscript

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