Rapid identification of pathogens responsible for necrotizing fasciitis on an integrated microfluidic system

Early diagnosis of necrotizing fasciitis: Imaging techniques and their combined application

Necrotizing fasciitis is a clinical, surgical emergency characterized by an insidious onset, rapid progression, and a high mortality rate. The disease's mortality rate has remained high for many years, mainly because of its atypical clinical presentation, which prevents many cases from being diagnosed early and accurately, resulting in patients who may die from uncontrollable septic shock and multi-organ failure. But unfortunately, no diagnostic indicator can provide a certain early diagnosis of NF, and clinical judgement of NF is still based on the results of various ancillary tests combined with the patient's medical history, clinical manifestations, and the physician's experience. This review provides a brief overview of the epidemiological features of NF and then discusses the most important laboratory indicators and scoring systems currently employed to diagnose NF. Finally, the latest progress of several imaging techniques in the early diagnosis of NF and their combined application with other diagnostic indices are highlighted. We point out promising research directions based on an objective evaluation of the advantages and shortcomings of different methods, which provide a basis for further improving the early diagnosis of NF.

Rapid identification of bacteria directly from blood cultures by Co-magnetic bead enrichment and MALDI-TOF MS profiling

Direct identification of bacteria in blood cultures using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is interfered with by a variety of non-bacterial proteins derived from blood cells and culture media. Thus, appropriate pre-treatments are needed for successful identification. Here, the bacteria in blood culture bottles were enriched using co-magnetic beads and processed for MALDI-TOF MS profiling. In this strategy, the Fc-containing mannose-binding lectin-coated Fe₃O₄ (Fc-MBL@Fe₃O₄) is incorporated with human IgG-coated Fe₃O₄ (IgG@Fe₃O₄) to form co-magnetic beads, which can recognize both Gram-positive and Gram-negative bacteria. Compared to single magnetic beads Fc-MBL@Fe₃O₄ or IgG@Fe₃O₄, co-magnetic beads resulted in better bacterial capture efficiency and, therefore, could decrease the false-negative results. Our proposed strategy is much more suitable for enrichment of clinically unknown bacteria from blood culture bottles for MALDI-TOF MS database identification.