Electrochemical β-lactamase immunostrip sensor with 3D hydrogel-paper scaffold for rapid detection & post-antibiotic therapy monitoring in drug-resistant bloodstream infections

Background

The increasing prevalence of drug-resistant bacterial bloodstream infections, particularly those caused by Methicillin-resistant Staphylococcus aureus (MRSA), presents a critical global healthcare challenge. Current diagnostic methods often lack the speed and sensitivity necessary for timely antibiotic interventions, leading to poor patient outcomes and increased resistance due to misuse of broad-spectrum antibiotics. Existing platforms rarely combine rapid detection, low detection limits, and real-time therapy monitoring, leaving a crucial gap in effective infection management.

Results

This study introduces an electrochemical immunostrip sensor for the rapid detection of β-lactamase (BL), an enzyme associated with drug resistance. Using a novel 3D hydrogel-paper scaffold, the sensor achieves a detection limit of 0.146 mU/ml and accurately detects BL-producing pathogens, including MRSA, from clinical samples with bacterial loads as low as 10² CFU/ml. The platform provides post culture detection results within 1 h, post antibiotic therapy monitoring within 4 h and demonstrates high specificity (∼100 %) by differentiating BL-producing strains from non-producing isolates.

Significance and novelty

This study introduces a new electrochemical smart immunostrip sensor integrated with a 3D hydrogel-paper scaffold for β-lactamase detection, which offers high sensitivity and specificity. Unlike conventional diagnostics, it enables user-friendly, rapid, cost-effective detection within 1 h post-blood culture and real-time antibiotic therapy monitoring in just 4 h, transforming clinically actionable point-of-care (POC) management of drug-resistant bloodstream infections.