1
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Jiang X, Borkum T, Shprits S, Boen J, Arshavsky-Graham S, Rofman B, Strauss M, Colodner R, Sulam J, Halachmi S, Leonard H, Segal E. Accurate Prediction of Antimicrobial Susceptibility for Point-of-Care Testing of Urine in Less than 90 Minutes via iPRISM Cassettes. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2303285. [PMID: 37587020 PMCID: PMC10625094 DOI: 10.1002/advs.202303285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/04/2023] [Indexed: 08/18/2023]
Abstract
The extensive and improper use of antibiotics has led to a dramatic increase in the frequency of antibiotic resistance among human pathogens, complicating infectious disease treatments. In this work, a method for rapid antimicrobial susceptibility testing (AST) is presented using microstructured silicon diffraction gratings integrated into prototype devices, which enhance bacteria-surface interactions and promote bacterial colonization. The silicon microstructures act also as optical sensors for monitoring bacterial growth upon exposure to antibiotics in a real-time and label-free manner via intensity-based phase-shift reflectometric interference spectroscopic measurements (iPRISM). Rapid AST using clinical isolates of Escherichia coli (E. coli) from urine is established and the assay is applied directly on unprocessed urine samples from urinary tract infection patients. When coupled with a machine learning algorithm trained on clinical samples, the iPRISM AST is able to predict the resistance or susceptibility of a new clinical sample with an Area Under the Receiver Operating Characteristic curve (AUC) of ∼ 0.85 in 1 h, and AUC > 0.9 in 90 min, when compared to state-of-the-art automated AST methods used in the clinic while being an order of magnitude faster.
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Affiliation(s)
- Xin Jiang
- Department of Biotechnology and Food Engineering, Technion - Israel Institute of Technology, Haifa, 3200003, Israel
| | - Talya Borkum
- Department of Biotechnology and Food Engineering, Technion - Israel Institute of Technology, Haifa, 3200003, Israel
| | - Sagi Shprits
- Department of Urology, Bnai Zion Medical Center, Haifa, 3104800, Israel
| | - Joseph Boen
- Department of Biomedical Engineering, Johns Hopkins University, Clark 320B, 3400 N Charles St, Baltimore, MD, 21218, USA
| | - Sofia Arshavsky-Graham
- Department of Biotechnology and Food Engineering, Technion - Israel Institute of Technology, Haifa, 3200003, Israel
| | - Baruch Rofman
- Department of Mechanical Engineering, Technion - Israel Institute of Technology, Haifa, 3200003, Israel
| | - Merav Strauss
- Laboratory of Clinical Microbiology, Emek Medical Center, Afula, 1834111, Israel
| | - Raul Colodner
- Laboratory of Clinical Microbiology, Emek Medical Center, Afula, 1834111, Israel
| | - Jeremias Sulam
- Department of Biomedical Engineering, Johns Hopkins University, Clark 320B, 3400 N Charles St, Baltimore, MD, 21218, USA
| | - Sarel Halachmi
- Department of Urology, Bnai Zion Medical Center, Haifa, 3104800, Israel
- The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, 3200003, Israel
| | - Heidi Leonard
- Department of Biotechnology and Food Engineering, Technion - Israel Institute of Technology, Haifa, 3200003, Israel
| | - Ester Segal
- Department of Biotechnology and Food Engineering, Technion - Israel Institute of Technology, Haifa, 3200003, Israel
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2
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di Toma A, Brunetti G, Chiriacò MS, Ferrara F, Ciminelli C. A Novel Hybrid Platform for Live/Dead Bacteria Accurate Sorting by On-Chip DEP Device. Int J Mol Sci 2023; 24:ijms24087077. [PMID: 37108235 PMCID: PMC10139405 DOI: 10.3390/ijms24087077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/23/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
According to the World Health Organization (WHO) forecasts, Antimicrobial Resistance (AMR) will be the leading cause of death worldwide in the next decades. To prevent this phenomenon, rapid Antimicrobial Susceptibility Testing (AST) techniques are required to drive the selection of the most suitable antibiotic and its dosage. In this context, we propose an on-chip platform, based on a micromixer and a microfluidic channel, combined with a pattern of engineered electrodes to exploit the di-electrophoresis (DEP) effect. The role of the micromixer is to ensure the proper interaction of the antibiotic with the bacteria over a long time (≈1 h), and the DEP-based microfluidic channel enables the efficient sorting of live from dead bacteria. A sorting efficiency of more than 98%, with low power consumption (Vpp = 1 V) and time response of 5 s, within a chip footprint of ≈86 mm2, has been calculated, which makes the proposed system very attractive and innovative for efficient and rapid monitoring of the antimicrobial susceptibility at the single-bacterium level in next-generation medicine.
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Affiliation(s)
- Annarita di Toma
- Optoelectronics Laboratory, Politecnico di Bari, Via E. Orabona 6, 70125 Bari, Italy
| | - Giuseppe Brunetti
- Optoelectronics Laboratory, Politecnico di Bari, Via E. Orabona 6, 70125 Bari, Italy
| | | | - Francesco Ferrara
- CNR NANOTEC-Institute of Nanotechnology, Via per Monteroni, 73100 Lecce, Italy
| | - Caterina Ciminelli
- Optoelectronics Laboratory, Politecnico di Bari, Via E. Orabona 6, 70125 Bari, Italy
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3
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Pitruzzello G, Johnson S, Krauss TF. Exploring the fundamental limit of antimicrobial susceptibility by near-single-cell electrical impedance spectroscopy. Biosens Bioelectron 2023; 224:115056. [PMID: 36630745 DOI: 10.1016/j.bios.2022.115056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/19/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022]
Abstract
Many novel susceptibility tests are being developed to tackle the worldwide problem of antimicrobial resistance (AMR). The key driver behind these developments, that is the need to reduce the response time, requires an understanding of which bacterial characteristic needs to be monitored to provide a rapid and ideally universal signature of susceptibility. Many characteristics have already been studied, most notably bacterial growth, metabolism and motility. Here, we consider electrical impedance to directly access bacterial metabolism, which can be considered a fundamental indicator of bacterial viability. By studying the electrical response of individual bacteria to an antibiotic challenge, we detect antimicrobial action close to its biological limit. Specifically, we find that it takes 30-60 min to register significant changes in impedance for clinical concentrations of antibiotics, in line with other rapid indicators. Our findings suggest that 60 min is the fundamental lower limit of response time for a realistic susceptibility test at clinically relevant antibiotic concentrations.
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Affiliation(s)
- Giampaolo Pitruzzello
- School of Physics, Engineering and Technology, University of York, YO10 5DD, York, UK.
| | - Steven Johnson
- School of Physics, Engineering and Technology, University of York, YO10 5DD, York, UK
| | - Thomas F Krauss
- School of Physics, Engineering and Technology, University of York, YO10 5DD, York, UK.
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4
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Diep TT, Needs SH, Bizley S, Edwards AD. Rapid Bacterial Motility Monitoring Using Inexpensive 3D-Printed OpenFlexure Microscopy Allows Microfluidic Antibiotic Susceptibility Testing. MICROMACHINES 2022; 13:mi13111974. [PMID: 36422401 PMCID: PMC9699482 DOI: 10.3390/mi13111974] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/10/2022] [Accepted: 11/12/2022] [Indexed: 05/30/2023]
Abstract
Antibiotic susceptibility testing is vital to tackle the emergence and spread of antimicrobial resistance. Inexpensive digital CMOS cameras can be converted into portable digital microscopes using 3D printed x-y-z stages. Microscopic examination of bacterial motility can rapidly detect the response of microbes to antibiotics to determine susceptibility. Here, we present a new simple microdevice-miniature microscope cell measurement system for multiplexed antibiotic susceptibility testing. The microdevice is made using melt-extruded plastic film strips containing ten parallel 0.2 mm diameter microcapillaries. Two different antibiotics, ceftazidime and gentamicin, were prepared in Mueller-Hinton agar (0.4%) to produce an antibiotic-loaded microdevice for simple sample addition. This combination was selected to closely match current standard methods for both antibiotic susceptibility testing and motility testing. Use of low agar concentration permits observation of motile bacteria responding to antibiotic exposure as they enter capillaries. This device fits onto the OpenFlexure 3D-printed digital microscope using a Raspberry Pi computer and v2 camera, avoiding need for expensive laboratory microscopes. This inexpensive and portable digital microscope platform had sufficient magnification to detect motile bacteria, yet wide enough field of view to monitor bacteria behavior as they entered antibiotic-loaded microcapillaries. The image quality was sufficient to detect how bacterial motility was inhibited by different concentrations of antibiotic. We conclude that a 3D-printed Raspberry Pi-based microscope combined with disposable microfluidic test strips permit rapid, easy-to-use bacterial motility detection, with potential for aiding detection of antibiotic resistance.
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Affiliation(s)
- Tai The Diep
- Reading School of Pharmacy, University of Reading, Reading RG6 6AD, UK
| | - Sarah Helen Needs
- Reading School of Pharmacy, University of Reading, Reading RG6 6AD, UK
| | - Samuel Bizley
- Reading School of Pharmacy, University of Reading, Reading RG6 6AD, UK
| | - Alexander D. Edwards
- Reading School of Pharmacy, University of Reading, Reading RG6 6AD, UK
- Capillary Film Technology Ltd., Billingshurst RH14 9TF, UK
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5
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Recent advances of integrated microfluidic systems for fungal and bacterial analysis. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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6
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Rackus DG, Jusková P, Yokoyama F, Dittrich PS. Parallel study of transient dosing of antibiotics in a microfluidic device. BIOMICROFLUIDICS 2022; 16:044105. [PMID: 35935120 PMCID: PMC9348895 DOI: 10.1063/5.0091704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
Microfluidic tools are well suited for studying bacteria as they enable the analysis of small colonies or single cells. However, current techniques for studying bacterial response to antibiotics are largely limited to static dosing. Here, we describe a microfluidic device and a method for entrapping and cultivating bacteria in hydrogel plugs. Ring-shaped isolation valves are used to define the shape of the plugs and also to control exposure of the plugs to the surrounding medium. We demonstrate bacterial cultivation, determination of the minimum inhibitory concentration of an antibiotic, and transient dosing of an antibiotic at sub-1-h doses. The transient dosing experiments reveal that at dose durations on the order of minutes, ampicillin's bactericidal effect has both a time and concentration dependency.
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7
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Pitruzzello G, Baumann CG, Johnson S, Krauss TF. Single‐Cell Motility Rapidly Quantifying Heteroresistance in Populations of
Escherichia coli
and
Salmonella typhimurium. SMALL SCIENCE 2022. [DOI: 10.1002/smsc.202100123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
| | | | - Steven Johnson
- Department of Electronic Engineering University of York York YO10 5DD UK
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8
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Fitzpatrick KJ, Rohlf HJ, Sutherland TD, Koo KM, Beckett S, Okelo WO, Keyburn AL, Morgan BS, Drigo B, Trau M, Donner E, Djordjevic SP, De Barro PJ. Progressing Antimicrobial Resistance Sensing Technologies across Human, Animal, and Environmental Health Domains. ACS Sens 2021; 6:4283-4296. [PMID: 34874700 DOI: 10.1021/acssensors.1c01973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The spread of antimicrobial resistance (AMR) is a rapidly growing threat to humankind on both regional and global scales. As countries worldwide prepare to embrace a One Health approach to AMR management, which is one that recognizes the interconnectivity between human, animal, and environmental health, increasing attention is being paid to identifying and monitoring key contributing factors and critical control points. Presently, AMR sensing technologies have significantly progressed phenotypic antimicrobial susceptibility testing (AST) and genotypic antimicrobial resistance gene (ARG) detection in human healthcare. For effective AMR management, an evolution of innovative sensing technologies is needed for tackling the unique challenges of interconnected AMR across various and different health domains. This review comprehensively discusses the modern state-of-play for innovative commercial and emerging AMR sensing technologies, including sequencing, microfluidic, and miniaturized point-of-need platforms. With a unique view toward the future of One Health, we also provide our perspectives and outlook on the constantly changing landscape of AMR sensing technologies beyond the human health domain.
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Affiliation(s)
- Kira J. Fitzpatrick
- XING Applied Research & Assay Development (XARAD) Division, XING Technologies Pty. Ltd., Brisbane, Queensland 4073, Australia
| | - Hayden J. Rohlf
- XING Applied Research & Assay Development (XARAD) Division, XING Technologies Pty. Ltd., Brisbane, Queensland 4073, Australia
| | - Tara D. Sutherland
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Black Mountain, Canberra, Australian Capital Territory 2601, Australia
| | - Kevin M. Koo
- XING Applied Research & Assay Development (XARAD) Division, XING Technologies Pty. Ltd., Brisbane, Queensland 4073, Australia
- The University of Queensland Centre for Clinical Research (UQCCR), Brisbane, Queensland 4029, Australia
| | - Sam Beckett
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Black Mountain, Canberra, Australian Capital Territory 2601, Australia
| | - Walter O. Okelo
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Black Mountain, Canberra, Australian Capital Territory 2601, Australia
| | - Anthony L. Keyburn
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Australian Centre for Disease Preparedness (ACDP), Geelong, Victoria 3220, Australia
| | - Branwen S. Morgan
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Black Mountain, Canberra, Australian Capital Territory 2601, Australia
| | - Barbara Drigo
- Future Industries Institute, University of South Australia, Adelaide, South Australia 5095, Australia
| | - Matt Trau
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Queensland 4072, Australia
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Erica Donner
- Future Industries Institute, University of South Australia, Adelaide, South Australia 5095, Australia
| | - Steven P. Djordjevic
- Ithree Institute, University of Technology Sydney, Sydney, New South Wales 2007, Australia
| | - Paul J. De Barro
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health & Biosecurity, EcoSciences Precinct, Brisbane, Queensland 4001, Australia
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9
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Ma L, He W, Petersen M, Chou KC, Lu X. Next-Generation Antimicrobial Resistance Surveillance System Based on the Internet-of-Things and Microfluidic Technique. ACS Sens 2021; 6:3477-3484. [PMID: 34494420 DOI: 10.1021/acssensors.1c01453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Antimicrobial resistance (AMR) of foodborne pathogens is a global crisis in public health and economic growth. A real-time surveillance system is key to track the emergence of AMR bacteria and provides a comprehensive AMR trend from farm to fork. However, current AMR surveillance systems, which integrate results from multiple laboratories using the conventional broth microdilution method, are labor-intensive and time-consuming. To address these challenges, we present the internet of things (IoT), including colorimetric-based microfluidic sensors, a custom-built portable incubator, and machine learning algorithms, to monitor AMR trends in real time. As a top priority microbe that poses risks to human health, Campylobacter was selected as a bacterial model to demonstrate and validate the IoT-assisted AMR surveillance. Image classification with convolution neural network ResNet50 on the colorimetric sensors achieved an accuracy of 99.5% in classifying bacterial growth/inhibition patterns. The IoT was used to carry out a small-scale survey study, identifying eight Campylobacter isolates out of 35 chicken samples. A 96% agreement on Campylobacter AMR profiles was achieved between the results from the IoT and the conventional broth microdilution method. The data collected from the intelligent sensors were transmitted from local computers to a cloud server, facilitating real-time data collection and integration. A web browser was developed to demonstrate the spatial and temporal AMR trends to end-users. This rapid, cost-effective, and portable approach is able to monitor, assess, and mitigate the burden of bacterial AMR in the agri-food chain.
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Affiliation(s)
- Luyao Ma
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
- Department of Food Science and Agricultural Chemistry, Faculty of Agricultural and Environmental Sciences, McGill University, Sainte-Anne-de-Bellevue, Quebec H9X 3V9, Canada
| | - Weidong He
- College of Computer Science, Chongqing University, Chongqing 400044, China
| | - Marlen Petersen
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - Keng C. Chou
- Department of Chemistry, Faculty of Science, The University of British Columbia, Vancouver V6T 1Z1, Canada
| | - Xiaonan Lu
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
- Department of Food Science and Agricultural Chemistry, Faculty of Agricultural and Environmental Sciences, McGill University, Sainte-Anne-de-Bellevue, Quebec H9X 3V9, Canada
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10
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Kaprou GD, Bergšpica I, Alexa EA, Alvarez-Ordóñez A, Prieto M. Rapid Methods for Antimicrobial Resistance Diagnostics. Antibiotics (Basel) 2021; 10:209. [PMID: 33672677 PMCID: PMC7924329 DOI: 10.3390/antibiotics10020209] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/09/2021] [Accepted: 02/13/2021] [Indexed: 02/06/2023] Open
Abstract
Antimicrobial resistance (AMR) is one of the most challenging threats in public health; thus, there is a growing demand for methods and technologies that enable rapid antimicrobial susceptibility testing (AST). The conventional methods and technologies addressing AMR diagnostics and AST employed in clinical microbiology are tedious, with high turnaround times (TAT), and are usually expensive. As a result, empirical antimicrobial therapies are prescribed leading to AMR spread, which in turn causes higher mortality rates and increased healthcare costs. This review describes the developments in current cutting-edge methods and technologies, organized by key enabling research domains, towards fighting the looming AMR menace by employing recent advances in AMR diagnostic tools. First, we summarize the conventional methods addressing AMR detection, surveillance, and AST. Thereafter, we examine more recent non-conventional methods and the advancements in each field, including whole genome sequencing (WGS), matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) spectrometry, Fourier transform infrared (FTIR) spectroscopy, and microfluidics technology. Following, we provide examples of commercially available diagnostic platforms for AST. Finally, perspectives on the implementation of emerging concepts towards developing paradigm-changing technologies and methodologies for AMR diagnostics are discussed.
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Affiliation(s)
- Georgia D. Kaprou
- Department of Food Hygiene and Technology, University of León, 24071 León, Spain; (I.B.); (E.A.A.); (A.A.-O.); (M.P.)
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, L-4367 Belvaux, Luxembourg
| | - Ieva Bergšpica
- Department of Food Hygiene and Technology, University of León, 24071 León, Spain; (I.B.); (E.A.A.); (A.A.-O.); (M.P.)
- Institute of Food Safety, Animal Health and Environment BIOR, LV-1076 Riga, Latvia
| | - Elena A. Alexa
- Department of Food Hygiene and Technology, University of León, 24071 León, Spain; (I.B.); (E.A.A.); (A.A.-O.); (M.P.)
| | - Avelino Alvarez-Ordóñez
- Department of Food Hygiene and Technology, University of León, 24071 León, Spain; (I.B.); (E.A.A.); (A.A.-O.); (M.P.)
- Institute of Food Science and Technology, University of León, 24071 León, Spain
| | - Miguel Prieto
- Department of Food Hygiene and Technology, University of León, 24071 León, Spain; (I.B.); (E.A.A.); (A.A.-O.); (M.P.)
- Institute of Food Science and Technology, University of León, 24071 León, Spain
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11
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Perebikovsky A, Liu Y, Hwu A, Kido H, Shamloo E, Song D, Monti G, Shoval O, Gussin D, Madou M. Rapid sample preparation for detection of antibiotic resistance on a microfluidic disc platform. LAB ON A CHIP 2021; 21:534-545. [PMID: 33393956 DOI: 10.1039/d0lc00838a] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Rapid, point-of-care (PoC) diagnostics for antibiotic susceptibility testing (AST) are critical in combating the antimicrobial resistance epidemic. While new, alternative technologies are capable of rapidly identifying antibiotic resistance, traditional AST methods, where a patient sample is incubated with different antibiotics, remain the most reliable and practical in determining antibiotic effectiveness. Here, we demonstrate a novel sample incubation technique on a microfluidic centrifugal disc (CD) as a proof of concept automated sample processing platform for AST. By using ribosomal RNA (rRNA) as a marker for cell growth, we demonstrated that incubation on the microfluidic CD was enhanced (>1.6 fold) for 11 out of 14 clinically relevant isolates of Escherichia coli compared to traditional shaker incubators. Finally, we utilize the system to identify antibiotic resistance of 11 E. coli isolates incubated with 5 different antibiotics in under 2 hours.
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Affiliation(s)
- Alexandra Perebikovsky
- Department of Physics and Astronomy, University of California, 4129 Frederick Reines Hall, Irvine, CA 92697, USA.
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12
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Klein AK, Dietzel A. Microfluidic Systems for Antimicrobial Susceptibility Testing. ADVANCES IN BIOCHEMICAL ENGINEERING/BIOTECHNOLOGY 2021; 179:291-309. [PMID: 33851232 DOI: 10.1007/10_2021_164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Human health is threatened by the spread of antimicrobial resistance and resulting infections. One reason for the resistance spread is the treatment with inappropriate and ineffective antibiotics because standard antimicrobial susceptibility testing methods are time-consuming and laborious. To reduce the antimicrobial susceptibility detection time, minimize treatments with empirical broad-spectrum antibiotics, and thereby combat the further spread of antimicrobial resistance, faster and point-of-care methods are needed. This requires many different research approaches. Microfluidic systems for antimicrobial susceptibility testing offer the possibility to reduce the detection time, as small sample and reagent volumes can be used and the detection of single cells is possible. In some cases, the aim is to use human samples without pretreatment or pre-cultivation. This chapter first provides an overview of conventional detection methods. It then presents the potential of and various current approaches in microfluidics. The focus is on microfluidic methods for phenotypic antimicrobial susceptibility testing.
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Affiliation(s)
- Ann-Kathrin Klein
- Institute of Microtechnology Technische Universität Braunschweig, Braunschweig, Germany
| | - Andreas Dietzel
- Institute of Microtechnology Technische Universität Braunschweig, Braunschweig, Germany.
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13
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Zhang F, Sun Y, Luo C. Microfluidic approaches for synthetic gene circuits’ construction and analysis. QUANTITATIVE BIOLOGY 2021. [DOI: 10.15302/j-qb-021-0235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Lim T, Kim EG, Choi J, Kwon S. A high-throughput cell culture system based on capillary and centrifugal actions for rapid antimicrobial susceptibility testing. LAB ON A CHIP 2020; 20:4552-4560. [PMID: 33169754 DOI: 10.1039/d0lc00753f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Antibiotic resistance is a global threat to modern society. Rapid determination of suitable antibiotics that inhibit bacterial growth can effectively reduce antibiotic resistance and improve clinical treatment. The conventional methods of antimicrobial susceptibility testing (AST) depend on optical density measurements, which require long-time incubation. Various kinds of rapid AST systems which utilize various technologies from the field of lab on a chip have promised a great reduction in measurement time, but cannot achieve high-throughput, user-friendly testing due to the complexity of the testing system. Here, we introduce a capillary and centrifuge-based rapid AST system that reduces the time of loading the sample and culture media while achieving a high-throughput testing capacity. The capability of the proposed system is validated in a systematic analysis that includes sample loading characteristics and AST trials with standard strains. The proposed system provides a useful tool for drug testing in cell-culture systems with user-friendly and high-throughput analysis.
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Affiliation(s)
- Taegeun Lim
- QuantaMatrix Inc., Seoul National University Hospital CMI, Seoul, 03082, Republic of Korea and Department of Electrical Engineering and Computer Science, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Eun-Geun Kim
- Lowendtechnologies Co., Anyang, 14056, Republic of Korea
| | - Jungil Choi
- School of Mechanical Engineering, Kookmin University, Seoul, 02707, Republic of Korea.
| | - Sunghoon Kwon
- QuantaMatrix Inc., Seoul National University Hospital CMI, Seoul, 03082, Republic of Korea and Department of Electrical Engineering and Computer Science, Seoul National University, Seoul, 08826, Republic of Korea.
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15
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Abstract
![]()
Growing
antimicrobial resistance (AMR) is a serious global threat to human
health. Current methods to detect resistance include phenotypic antibiotic
sensitivity testing (AST), which measures bacterial growth and is
therefore hampered by a slow time to obtain results (∼12–24
h). Therefore, new rapid phenotypic methods for AST are urgently needed.
Nanomechanical cantilever sensors have recently shown promise for
rapid AST but challenges of bacterial immobilization can lead to variable
results. Herein, a novel cantilever-based method is described for
detecting phenotypic antibiotic resistance within ∼45 min,
capable of detecting single bacteria. This method does not require
complex, variable bacterial immobilization and instead uses a laser
and detector system to detect single bacterial cells in media as they
pass through the laser focus. This provides a simple readout of bacterial
antibiotic resistance by detecting growth (resistant) or death (sensitive),
much faster than the current methods. The potential of this technique
is demonstrated by determining the resistance in both laboratory and
clinical strains of Escherichia coli (E. coli), a key species responsible
for clinically burdensome urinary tract infections. This work provides
the basis for a simple and fast diagnostic tool to detect antibiotic
resistance in bacteria, reducing the health and economic burdens of
AMR.
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Affiliation(s)
- Isabel Bennett
- London Centre for Nanotechnology, University College London, 17-19 Gordon Street, London WC1H 0AH, United Kingdom
- Division of Medicine, University College London, Cruciform Building, Gower Street, London WC1E 6BT, United Kingdom
| | - Alice L. B. Pyne
- London Centre for Nanotechnology, University College London, 17-19 Gordon Street, London WC1H 0AH, United Kingdom
- Department of Materials Science and Engineering, Sir Robert Hadfield Building, University of Sheffield, Sheffield S1 3JD, United Kingdom
| | - Rachel A. McKendry
- London Centre for Nanotechnology, University College London, 17-19 Gordon Street, London WC1H 0AH, United Kingdom
- Division of Medicine, University College London, Cruciform Building, Gower Street, London WC1E 6BT, United Kingdom
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16
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Ghosh R, Malhotra M, Sathe RR, Jayakannan M. Biodegradable Polymer Theranostic Fluorescent Nanoprobe for Direct Visualization and Quantitative Determination of Antimicrobial Activity. Biomacromolecules 2020; 21:2896-2912. [PMID: 32539360 DOI: 10.1021/acs.biomac.0c00653] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We report a biodegradable fluorescent theranostic nanoprobe design strategy for simultaneous visualization and quantitative determination of antibacterial activity for the treatment of bacterial infections. Cationic-charged polycaprolactone (PCL) was tailor-made through ring-opening polymerization methodology, and it was self-assembled into well-defined tiny 5.0 ± 0.1 nm aqueous nanoparticles (NPs) having a zeta potential of +45 mV. Excellent bactericidal activity at 10.0 ng/mL concentration was accomplished in Gram-negative bacterium Escherichia coli (E. coli) while maintaining their nonhemolytic nature in mice red blood cells (RBC) and their nontoxic trend in wild-type mouse embryonic fibroblast cells with a selectivity index of >104. Electron microscopic studies are evident of the E. coli membrane disruption mechanism by the cationic NP with respect to their high selectivity for antibacterial activity. Anionic biomarker 8-hydroxy-pyrene-1,3,6-trisulfonic acid (HPTS) was loaded in the cationic PCL NP via electrostatic interaction to yield a new fluorescent theranostic nanoprobe to accomplish both therapeutics and diagnostics together in a single nanosystem. The theranostic NP was readily degradable by a bacteria-secreted lipase enzyme as well as by lysosomal esterase enzymes at the intracellular compartments in <12 h and support their suitability for biomedical application. In the absence of bactericidal activity, the theranostic nanoprobe functions exclusively as a biomarker to exhibit strong green-fluorescent signals in live E. coli. Once it became active, the theranostic probe induces membrane disruption on E. coli, which enabled the costaining of nuclei by red fluorescent propidium iodide. As a result, live and dead bacteria could be visualized via green and orange signals (merging of red+green), respectively, during the course of the antibacterial activity by the theranostic probe. This has enabled the development of a new image-based fluorescence assay to directly visualize and quantitatively estimate the real-time antibacterial activity. Time-dependent bactericidal activity was coupled with selective photoexcitation in a confocal microscope to demonstrate the proof-of-concept of the working principle of a theranostic probe in E. coli. This new theranostic nanoprobe creates a new platform for the simultaneous probing and treating of bacterial infections in a single nanodesign, which is very useful for a long-term impact in healthcare applications.
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All-electrical monitoring of bacterial antibiotic susceptibility in a microfluidic device. Proc Natl Acad Sci U S A 2020; 117:10639-10644. [PMID: 32350139 DOI: 10.1073/pnas.1922172117] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The lack of rapid antibiotic susceptibility tests adversely affects the treatment of bacterial infections and contributes to increased prevalence of multidrug-resistant bacteria. Here, we describe an all-electrical approach that allows for ultrasensitive measurement of growth signals from only tens of bacteria in a microfluidic device. Our device is essentially a set of microfluidic channels, each with a nanoconstriction at one end and cross-sectional dimensions close to that of a single bacterium. Flowing a liquid bacteria sample (e.g., urine) through the microchannels rapidly traps the bacteria in the device, allowing for subsequent incubation in drugs. We measure the electrical resistance of the microchannels, which increases (or decreases) in proportion to the number of bacteria in the microchannels. The method and device allow for rapid antibiotic susceptibility tests in about 2 h. Further, the short-time fluctuations in the electrical resistance during an antibiotic susceptibility test are correlated with the morphological changes of bacteria caused by the antibiotic. In contrast to other electrical approaches, the underlying geometric blockage effect provides a robust and sensitive signal, which is straightforward to interpret without electrical models. The approach also obviates the need for a high-resolution microscope and other complex equipment, making it potentially usable in resource-limited settings.
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Ma L, Petersen M, Lu X. Identification and Antimicrobial Susceptibility Testing of Campylobacter Using a Microfluidic Lab-on-a-Chip Device. Appl Environ Microbiol 2020; 86:e00096-20. [PMID: 32111591 PMCID: PMC7170473 DOI: 10.1128/aem.00096-20] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 02/22/2020] [Indexed: 01/14/2023] Open
Abstract
Campylobacter spp. have been recognized as major foodborne pathogens worldwide. An increasing frequency of antibiotic-resistant pathogens, including Campylobacter spp., have been identified to transmit from food products to humans and cause severe threats to public health. To better mitigate the antibiotic resistance crisis, rapid detection methods are required to provide timely antimicrobial resistance surveillance data for agri-food systems. Herein, we developed a polymer-based microfluidic device for the identification and antimicrobial susceptibility testing (AST) of Campylobacter spp. An array of bacterial incubation chambers were created in the microfluidic device, where chromogenic medium and antibiotics were loaded. The growth of Campylobacter spp. was visualized by color change due to chromogenic reactions. This platform achieved 100% specificity for Campylobacter identification. Sensitive detection of multiple Campylobacter species (C. jejuni, C. coli, and C. lari) was obtained in artificially contaminated milk and poultry meat, with detection limits down to 1 × 102 CFU/ml and 1 × 104 CFU/25 g, respectively. On-chip AST determined Campylobacter antibiotic susceptibilities by the lowest concentration of antibiotics that can inhibit bacterial growth (i.e., no color change observed). High coincidences (91% to 100%) of on-chip AST and the conventional agar dilution method were achieved against several clinically important antibiotics. For a presumptive colony, on-chip identification and AST were completed in parallel within 24 h, whereas standard methods, including biochemical assays and traditional culture-based AST, take several days for multiple sequential steps. In conclusion, this lab-on-a-chip device can achieve rapid and reliable detection of antibiotic-resistant Campylobacter spp.IMPORTANCE Increasing concerns of antibiotic-resistant Campylobacter spp. with regard to public health emphasize the importance of efficient and fast detection. This study described the timely identification and antimicrobial susceptibility testing of Campylobacter spp. by using a microfluidic device. Our developed method not only reduced the total analysis time, but it also simplified food sample preparation and chip operation for end users. Due to the miniaturized size of the lab-on-a-chip platform, the detection was achieved by using up to 1,000 times less of the reagents than with standard reference methods, making it a competitive approach for rapid screening and surveillance study in food industries. In addition, multiple clinically important Campylobacter species (C. jejuni, C. coli, and C. lari) could be tested by our device. This device has potential for wide application in food safety management and clinical diagnostics, especially in resource-limited regions.
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Affiliation(s)
- Luyao Ma
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Marlen Petersen
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Xiaonan Lu
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada
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Prangemeier T, Lehr FX, Schoeman RM, Koeppl H. Microfluidic platforms for the dynamic characterisation of synthetic circuitry. Curr Opin Biotechnol 2020; 63:167-176. [PMID: 32172160 DOI: 10.1016/j.copbio.2020.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 01/28/2023]
Abstract
Generating novel functionality from well characterised synthetic parts and modules lies at the heart of synthetic biology. Ideally, circuitry is rationally designed in silico with quantitatively predictive models to predetermined design specifications. Synthetic circuits are intrinsically stochastic, often dynamically modulated and set in a dynamic fluctuating environment within a living cell. To build more complex circuits and to gain insight into context effects, intrinsic noise and transient performance, characterisation techniques that resolve both heterogeneity and dynamics are required. Here we review recent advances in both in vitro and in vivo microfluidic technologies that are suitable for the characterisation of synthetic circuitry, modules and parts.
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Affiliation(s)
- Tim Prangemeier
- Centre for Synthetic Biology, Department of Electrical Engineering and Information Technology, Department of Biology, Technische Universität Darmstadt, Germany
| | - François-Xavier Lehr
- Centre for Synthetic Biology, Department of Electrical Engineering and Information Technology, Department of Biology, Technische Universität Darmstadt, Germany
| | - Rogier M Schoeman
- Centre for Synthetic Biology, Department of Electrical Engineering and Information Technology, Department of Biology, Technische Universität Darmstadt, Germany
| | - Heinz Koeppl
- Centre for Synthetic Biology, Department of Electrical Engineering and Information Technology, Department of Biology, Technische Universität Darmstadt, Germany.
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20
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Innovative and rapid antimicrobial susceptibility testing systems. Nat Rev Microbiol 2020; 18:299-311. [PMID: 32055026 DOI: 10.1038/s41579-020-0327-x] [Citation(s) in RCA: 160] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2020] [Indexed: 12/21/2022]
Abstract
Antimicrobial resistance (AMR) is a major threat to human health worldwide, and the rapid detection and quantification of resistance, combined with antimicrobial stewardship, are key interventions to combat the spread and emergence of AMR. Antimicrobial susceptibility testing (AST) systems are the collective set of diagnostic processes that facilitate the phenotypic and genotypic assessment of AMR and antibiotic susceptibility. Over the past 30 years, only a few high-throughput AST methods have been developed and widely implemented. By contrast, several studies have established proof of principle for various innovative AST methods, including both molecular-based and genome-based methods, which await clinical trials and regulatory review. In this Review, we discuss the current state of AST systems in the broadest technical, translational and implementation-related scope.
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Cross-Flow Filtration of Escherichia coli at a Nanofluidic Gap for Fast Immobilization and Antibiotic Susceptibility Testing. MICROMACHINES 2019; 10:mi10100691. [PMID: 31614761 PMCID: PMC6843207 DOI: 10.3390/mi10100691] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 10/08/2019] [Accepted: 10/10/2019] [Indexed: 01/17/2023]
Abstract
Infections with antimicrobial-resistant (AMR) bacteria are globally on the rise. In the future, multi-resistant infections will become one of the major problems in global health care. In order to enable reserve antibiotics to retain their effect as long as possible, broad-spectrum antibiotics must be used sparingly. This can be achieved by a rapid microfluidic phenotypic antibiotic susceptibility test, which provides the information needed for a targeted antibiotic therapy in less time than conventional tests. Such microfluidic tests must cope with a low bacteria concentration. On-chip filtering of the samples to accumulate bacteria can shorten the test time. By means of fluorescence microscopy, we examined a novel nanogap filtration principle to hold back Escherichia coli and to perform cultivation experiments with and without antibiotics present. Microfluidic chips based on the nanogap flow principle showed to be useful for the concentration and cultivation of E. coli. With a concentration of 106 cells/mL, a specific growth rate of 0.013 min-1 and a doubling time of 53 min were achieved. In the presence of an antibiotic, no growth was observed. The results prove that this principle can, in future, be used in fast and marker-free antimicrobial susceptibility testing (AST).
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Conteduca D, Brunetti G, Dell'Olio F, Armenise MN, Krauss TF, Ciminelli C. Monitoring of individual bacteria using electro-photonic traps. BIOMEDICAL OPTICS EXPRESS 2019; 10:3463-3471. [PMID: 31467790 PMCID: PMC6706028 DOI: 10.1364/boe.10.003463] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 05/07/2023]
Abstract
Antimicrobial resistance (AMR) describes the ability of bacteria to become immune to antimicrobial treatments. Current testing for AMR is based on culturing methods that are very slow because they assess the average response of billions of bacteria. In principle, if tests were available that could assess the response of individual bacteria, they could be much faster. Here, we propose an electro-photonic approach for the analysis and the monitoring of susceptibility at the single-bacterium level. Our method employs optical tweezers based on photonic crystal cavities for the trapping of individual bacteria. While the bacteria are trapped, antibiotics can be added to the medium and the corresponding changes in the optical properties and motility of the bacteria be monitored via changes of the resonance wavelength and transmission. Furthermore, the proposed assay is able to monitor the impedance of the medium surrounding the bacterium, which allows us to record changes in metabolic rate in response to the antibiotic challenge. For example, our simulations predict a variation in measurable electrical current of up to 40% between dead and live bacteria. The proposed platform is the first, to our knowledge, that allows the parallel study of both the optical and the electrical response of individual bacteria to antibiotic challenge. Our platform opens up new lines of enquiry for monitoring the response of bacteria and it could lead the way towards the dissemination of a new generation of antibiogram study, which is relevant for the development of a point-of-care AMR diagnostics.
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Affiliation(s)
- Donato Conteduca
- Optoelectronics Laboratory, Politecnico di Bari, Via Orabona, 4, 70125, Bari, Italy
- Photonics Group, Department of Physics, University of York, Heslington, York, YO10 5DD, UK
| | - Giuseppe Brunetti
- Optoelectronics Laboratory, Politecnico di Bari, Via Orabona, 4, 70125, Bari, Italy
| | - Francesco Dell'Olio
- Optoelectronics Laboratory, Politecnico di Bari, Via Orabona, 4, 70125, Bari, Italy
| | - Mario N Armenise
- Optoelectronics Laboratory, Politecnico di Bari, Via Orabona, 4, 70125, Bari, Italy
| | - Thomas F Krauss
- Photonics Group, Department of Physics, University of York, Heslington, York, YO10 5DD, UK
| | - Caterina Ciminelli
- Optoelectronics Laboratory, Politecnico di Bari, Via Orabona, 4, 70125, Bari, Italy
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