Towards enhanced selection of antibiotics in a hospital laboratory – development of a rapid electrochemical-based antimicrobial sensitivity test for Urinary Tract Infections.

Antimicrobial resistance (AMR) poses a major global health threat, often driven by empirical antibiotic use due to the relatively slow (24-72 hour) diagnostic pathway for urinary tract infections (UTIs). Due to their low cost and ease of multiplexing, electro-chemical biosensors offer a promising alternative. Herein, we report on the Microplate Dx RapidPlate™ platform, a rapid electrochemical impedance spectroscopy (EIS) based approach for accelerated antibiotic susceptibility testing (AST) directly from urine samples, without pre-treatment. This report charts the evolution of the core EIS based AST measurement from laboratory proto-type into fully realised Alpha prototype platform with an accompanying 32-channel electrochemical cartridge designed specifically for interrogation of urine samples. A total of 89 clinically derived urine samples were evaluated at three clinical sites (UK and India), with results compared against standard methods (VITEK 2 and disk diffusion). The impedance based RapidPlate™ system detected bacterial growth within 50 minutes and provided susceptibility profiles by 85 minutes, with 94% concordance to reference tests. Consistent performance is demonstrated across diverse clinical settings and organisms, including Escherichia coli and Klebsiella pneumoniae. The RapidPlate™ AST system has demonstrated great potential as a cost-effective, point-of-care tool for rapid AST, supporting and improving UTI management and antimicrobial stewardship.