Fighting nosocomial antibiotic-resistant infections through rapid and sensitive isothermal amplification-powered point-of-care (POC) diagnostics

Point-of-care nucleic acid screening is a crucial clinical practice for addressing nosocomial infections in developed and developing countries, as well as in settings where a centralized laboratory approach encounters limitations. This rapid and accurate detection is important not only for the timely initiation of appropriate antibiotic therapy but also for resolving outbreaks and minimizing subsequent antimicrobial resistance. Current systems to diagnose nosocomial infectious diseases are mainly culture-based or PCR-based methods, with limitations of complex and time/cost-consuming procedures. Designing an integrated device that can simultaneously deliver sample preparation, nucleic acid amplification, and detection in a sensitive, specific, and timely manner remains a challenge. This review reports recent advances that may address this challenge, with particular emphasis on emerging developments that may lead to significant improvements in the point-of-care diagnosis of multidrug-resistant pathogens and new directions that can be used to guide antibiotic therapy.