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Oral Presentations
O04 – ANTIMICROBIAL RESISTANCE IN STI PATHOGENS
Monday, July 15, 2019 4:15 PM – 5:45 PM
O04.5 Point-of-care magnetofluidic assay cartridge for neisseria gonorrhoeae detection and antimicrobial resistance determination
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  1. Alexander Trick1,
  2. Johan Melendez2,
  3. Liben Chen3,
  4. Tiffany Hu1,
  5. Charlotte Gaydos2,
  6. Tza-Huei Wang3
  1. 1Johns Hopkins University, Biomedical Engineering, Baltimore, USA
  2. 2Johns Hopkins University, Division of Infectious Diseases, Baltimore, USA
  3. 3Johns Hopkins University, Mechanical Engineering, Baltimore, USA

Abstract

Background The rise of antimicrobial resistant (AMR) Neisseria gonorrhoeae (NG) has prompted worldwide concern over the looming possibility of untreatable gonococcal infections. A reduction of antimicrobial use by transitioning from generalized prescriptions to targeted pathogen-specific treatments would aid in treatment efficacy and reduce the risk of AMR NG development. However, actual implementation of such targeted treatments has been limited by the lack of rapid diagnostic tools that can provide antimicrobial susceptibility results at the point-of-care (POC).

Methods To address the need for a rapid NG screening test, we have developed a portable magnetofluidic instrument and corresponding assay cartridge. The assay cartridges use functionalized magnetic beads to couple nucleic acid extraction directly to a PCR-based duplexed nucleic acid amplification test (NAAT). The NAAT targets the opa gene for NG identification and the gyrA gene for characterization of ciprofloxacin susceptibility. In order to assess assay performance, we analyzed 27 well characterized NG strains and 29 swabs (20 urethral, 9 penile meatal) previously tested by culture.

Results The instrument has a compact footprint (5’x5.3’x3.3’) and runs on a 5V, 2A power supply that can be provided by a small portable battery pack. Detection of NG and genotypic characterization of ciprofloxacin susceptibility was completed in <40 minutes. The cartridge-based assay correctly identified 100% (27/27) of the NG isolates as well as 100% (10/10) of the ciprofloxacin-resistant NG strains. All urethral and penile swabs were correctly identified as well (15/15 positive, 14/14 negative).

Conclusion Magnetofluidic assay cartridges allow automation of NAAT-based testing for NG and assessment of antimicrobial susceptibility. The portability, low power consumption, and ease-of-use of our platform has potential for enabling rapid diagnostics at the POC and in low-resource settings to guide targeted use of antimicrobials. Further studies with clinical samples are warranted.

Disclosure No significant relationships.

  • Neisseria gonorrhoeae
  • antimicrobial resistance

https://doi.org/10.1136/sextrans-2019-sti.126

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